Summary: Migraines can be problematic. We don’t really know where they come from, and we’re still figuring out how to treat those root causes. A new study published in Plastic and Reconstructive Surgery—Global Open promises some information that might shed some light on that. Until then, many migraine sufferers have to make due with Botox for migraine procedures, which help them cope with significant migraine pain. The plus side is that this Botox treatment for migraines seems to work very well, even if we’re not entirely sure why.
Pain and the Human Body
Sometimes it can feel as though your body is falling apart. Your head hurts, your hands hurt, your joints won’t stop aching, maybe you’ll just stay in bed today. Pain of this kind can be debilitating, and sometimes it can lead to loss of quality of life, and, therefore, loss of productivity. And while there can be all kinds of causes for this kind of pain (and I want to be careful to generalize all types of body pain, as there are certainly different types of chronic pain and acute pain), a recent publication from Plastic and Reconstructive Surgery—Global Open suggests that some pain, at least, might be related where previously it was not thought to be.
The article researches a link between two separate types of pain: migraines and carpal tunnel. The researchers chose these types of pain because, anecdotally, there have been stories for years about patients who go in to have carpal tunnel pressure treated and find relief from migraines as well. The researchers, lead by Dr. Huay-Zong Law at the University of Texas Southwestern Medical Center at Dallas, found that patients who had carpal tunnel syndrome were twice as likely to have migraine headaches. The relationship seemed to run in the opposite direction as well, with patients who had migraine headaches reporting higher odds of suffering from carpal tunnel syndrome.
Migraines and Carpal Tunnel Syndrome
Migraines are, overall, relatively poorly understood. The mechanisms that cause migraines and make them so severe are not known—and, perhaps more frustratingly, are variable from patient to patient. In other words, migraines aren’t well understood, and it could be any number of triggers that brings about the worst headaches in the world. This makes migraines exceptionally difficult to treat, usually leaving doctors to treat the symptoms as well as possible, in hopes that the root cause eventually subsides.
That’s not the case with Carpal Tunnel Syndrome. In fact, this syndrome is pretty well understood. CTS develops through repetitive motion, and the carpal tendons become inflamed due to that repetitive motion. The “tunnel” in your wrist is only so big, so that inflammation causes significant pain. The only way to reduce the pain permanently is to wide the “tunnel” by removing some tissue. Of course, if you want to avoid surgery, you’ll simply need to stop doing those repetitive motions (easier said than done if, for example, you make your living by typing).
CTS and Migraines: Causation or Correlation?
The researchers found that, in general, if you had a high rate of migraines, you also were more likely to have Carpal Tunnel Syndrome. And if you suffered from CTS, you were also more likely to combat migraines. The researchers think that this might be due to some kind of nerve compression happening (there’s been some evidence of late that nerve compression, especially in the neck and shoulders, can cause migraines). This seems somewhat sensible, as nerve compression isn’t all that different from what causes Carpal Tunnel Syndrome.
However, I do think we should be careful not to draw any lines of causation between this correlation. In other words, it could be that migraines and Carpal Tunnel Syndrome have a common cause rather than one causing the other. Or they could have a shared set of circumstances under which they manifest most profoundly. It wouldn’t surprise me, for example, if migraines could be caused by long hours of staring at a computer monitor while CTS is caused by long hours of typing. The behavior—long hours working at a computer—could easily cause both ailments without the need for some deeper, more profound cause (other than the way our society structures and values work, that is). But there would not necessarily be a need for such a medical cause. Obviously, the researchers of this study aren’t saying they’ve discovered that medical cause—they’re simply noting the correlation.
Botox for Migraine Procedures to the Rescue… for Now
Of course, if you suffer from migraines, that correlation might be cold comfort. However, that doesn’t mean there isn’t hope. As practiced by at least one Los Angeles cosmetic surgeon, migraines can be treated using Botox injections. This, of course, lends even more credence to the idea that nerve compression causes migraines, because the thinking behind Botox is that it relaxes the muscles—making migraines less intense and less frequent. Whether this happens because the nerves are compressed less often isn’t necessarily known. What is known is that the Botox injections seem to diminish the pain and discomfort brought on by migraines—and that’s a huge relief to those who suffer from those migraines.
If there’s one thing we don’t understand particularly well, it’s pain. We’re getting better at it, but there are certain fundamental mysteries about where pain comes from and how it manifests differently in some people. Thankfully, research such as the scholarship cited here keeps pushing our knowledge forward.