Down Dog it, Migraine Warrior!

We need all the angles we can come up with to fight against migraines, especially when they are frequent and hard to treat.

In a study from researchers in India called Effect of yoga as add-on therapy in migraine (CONTAIN): A randomized clinical trial, subjects with migraine and 4-13 headache days per month were randomized into a program of standard medical treatment with or without yoga. The yoga program was 1 month of supervised sessions and then 2 months of at-home yoga.

The subjects who did yoga had an average reduction of 4.4 headache days per month, compared with 0.9 fewer headaches per month for the non-yoga group. The reduction in migraine intensity was double in the yoga group and a measure of overall impact of headaches was reduced significantly more in the yoga group.

That’s a real benefit for something non-pharmacologic! I’ll be glad to share this with my migraine patients. I do always discuss lifestyle issues with people having trouble with migraine control. Of course, smart use of medications is key to a migraine treatment plan, but doesn’t always do the job entirely. We know that variations in daily lifestyle can be a trigger, such as changes in diet, hydration, exercise, sleep, or others. Why should yoga help? To those that achieve a relaxed and centered state, it’s probably a reduction in stress hormone levels that results in less pain and fewer migraine episodes. To those not as inclined to yoga, perhaps a walk, meditation, music or some other relaxing active would help.

But there’s got to be something about a discipline that’s lasted some several thousand years!

Disclaimer: I’m not your doctor and this is not formal medical advice. If you have any health concerns, check with your own health professional before starting a new exercise program.

-DS (8-30-20)

Stay one step ahead of Parkinson’s disease.

Parkinson’s disease, a degenerative condition of the brain, affects about 1% of people over the age of 60. The symptoms range from a mild non-disabling tremor to more troublesome symptoms like slowness, troubles with motor movements and troubles with balance leading to falls.

It’s known that there are some prodromal – or early – symptoms of Parkinson’s that show up some time before the main symptoms of tremor which are: rigidity, slowness and balance problems. It’s also known that physical exercise is an important part of the treatment for Parkinson’s disease along with medication, and that being physically active improves long term outcomes in people with Parkinson’s disease. Moreover, the risk of Parkinson’s is reduced in people who are typically physically active during their lives.

A study from researchers at Harvard joins these concepts together and actually shows that physical activity during young and middle adulthood is associated with reduced tendencies for even the prodromal symptoms of Parkinson’s, namely constipation, body pains, REM behavior disorder (restless sleeping and acting out dreams), daytime sleepiness, and depression. Of course these common symptoms don’t always necessarily lead to the development of Parkinson’s, but it still lends support to the benefit of exercise not only for Parkinson’s, but other problems as well. And the degree of protection from these symptoms associated with physical activity was similar to the protection from developing Parkinson’s. So it seems there must be some link supporting the robust benefit of exercise across the spectrum of Parkinson’s disease.

It’s hard to find any evidence against exercise as beneficial for the aging human. Of course, I must mention: please don’t embark on a major exercise regimen without advice from your doctor, especially if you have any health concerns. And based on my personal experience, don’t expect you can keep up with your 13 year-old budding cross-country running star. This leads to body pains and an unnecessary sense of failure.

-DS (8-10-20)

We’re all a little sick.

One of my mentors in neurology at Yale was making a point to me as we were struggling to figure out how to help an intractable headache patient in clinic one day. Literally nothing helped this person. No standard treatment made any difference. All her tests were normal and she appeared totally normal, yet had headaches all day every day that she described as the worst pain imaginable. As you can imagine she was also very anxious and had a lot of stress. In this situation we always say,