Category Archives: Migraines and Headaches

A Single Nerve Block May Result in Reduced Migraine Days and Increased Serotonin

Dear Pain Matters blog readers,

Feature Image sourced from:

http://upcouture.com/en/blog//do-you-have-regular-headaches-or-migraine-watch-out-to-relax-your-neck-and-upper-back-muscles-and-adopt-a-good-posture

INTRODUCTION

Here is some good news for migraine sufferers:

single nerve block called a Greater Occipital Nerve Block (GON block) may lead to reduced migraine days and increased serotonin!

DETAILS OF MIGRAINE STUDY

Specifically, an Italian study involving 17 migraine patients and 19 healthy controls found that a single Greater Occipital Nerve Block (GON block) significantly reduced the total number of migraine days per month by 35%.

The GON block offered the biggest migraine relief in 11 of 12 patients who also endured Medical Overuse Headache (MOH).  Medical Overuse Headache results from medication overuse.

Once the GON block’s effects wore off, episodic migraine returned in 8 of 17 patients.

It is thought that serotonin deficiency may contribute to migraines.

Thus, it is likely that enhanced serotonin release and increased central serotonergic tone resulted in migraineurs who enjoyed fewer migraine days following a single GON block.

The slope of the intensity dependence of auditory evoked potentials (IDAP) was significantly flatter in those patients who benefited from the GON block.  Decreased IDAP values are linked with stronger central serotonergic tone.

A flatter IDAP slope as well as migraine relief offered by a single GON block are suggestive of changes in the brain (i.e. plastic brain changes, neuroplasticity) (Viganò et al, 2018).

SUMMARY

Migraineurs may benefit from a GON block.

Given that a single GON block led to 35% fewer migraine days per month and given that increased serotonin occurred (as indicated by a flatter IDAP slope), migraines may be (partly or fully) centrally mediated in the brain by serotonergic mechanisms.  Finally, these mechanisms may be modulated by a GON block.

A flatter IDAP slope as well as migraine relief offered by a single GON block are suggestive of changes in the brain (i.e. plastic brain changes, neuroplasticity) (Viganò et al, 2018).

All this is good news for migraine sufferers!

Sabina Walker

Blogger, Pain Matters (in WordPress)

REFERENCE

Viganò et al. Neurophysiological correlates of clinical improvement after greater occipital nerve (GON) block in chronic migraine: relevance for chronic migraine pathophysiology. The Journal of Headache and Pain (Dec 2018). 19: 73: pages 1-9.

https://link.springer.com/content/pdf/10.1186%2Fs10194-018-0901-z.pdf

Now There Is An App For Migraines!

Source Of Featured Image:

http://www.schmerzklinik.de/2017/01/16/migrane-und-kopfschmerzen-digitales-selbstmanagement-jetzt-mit-apple-watch-und-migrane-app/

Dear Pain Matters blog readers,

How exciting!! Now there are App’s to help sufferers manage their migraines and headaches more effectively!

images-1.jpeg

Source of image:  http://www.schmerzklinik.de/2011/08/17/migraineapp-app-fuer-iphone-ipad-und-ipod-touch/

For example, respected migraine researcher, Professor Hartmut Göbel, Kiel Migraine and Headache Centre, Kiel, Germany, and his team and collaborators recently developed and released Migraine App to help sufferers better manage their migraines on a day-to-day basis.

dsc_4245.jpg

Source of image:  http://www.schmerzklinik.de/ueber-uns/team-der-schmerzklinik/

Professor Hartmut Göbel states that 900,000 migraine attacks arise daily in Germany including 100,000 migraines so severe that they render sufferers bedridden in dark, quiet rooms. There are more than 360 different types of headaches and migraines and this is the third most common disease affecting the nervous system after dementia and stroke. Migraines and headaches affect every second adult worldwide, with costs in Europe exceeding 43.5 Billion Euros annually.

Migraine App encourages patients to record triggers, symptoms and treatments of migraines and headaches via a Migraine Calendar and other screens. This App also helps users find migraine and headache experts in their area as well as fellow sufferers. Time and space prevents me from listing all the great features of this App and I will conclude by encouraging all migraine and headache sufferers to download Migraine App.

Being free of charge, there is nothing to lose … except maybe a migraine!  Furthermore, the privacy of patient information on Migraine App is guaranteed as the data is only stored on the patient’s own device. Being available in English and German, it is compatible with iPhone, iPad, iPod Touch and Apple Watch while an Android version is also available.

Whilst a great App, wouldn’t it be great if one day there is an App available that could zap pain away altogether??

Sabina Walker, Blogger of Pain Matters

PS Also, please refer to my blog post called ‘German Composer, Richard Wagner, His Painful Migraines And The Opera Siegfried’ for more interesting details on Dr Göbel’s amazing insight into migraines:

https://painmatters.wordpress.com/category/migraines-and-wagnerian-opera/

References (in German;  please use Google translator into English if necessary):

References From Kiel Migraine and Headache Centre, Kiel, Germany, Website:

(1) Migraine App (Schmerzklinik Kiel)

https://itunes.apple.com/de/app/migrane-app/id1133949944?mt=8

General Information

https://www.schmerzklinik.de/information-en/

Allgemeine Informationen

https://www.schmerzklinik.de/information-de/

Datenschutz

Datenschutz

Migraine App – Der neue online Migränekalender (18 April 2011)

Migraine App – Der neue online Migränekalender

Migraine-App für iPhone & iPad (17 August 2011)

https://www.schmerzklinik.de/2011/08/17/migraineapp-app-fuer-iphone-ipad-und-ipod-touch/

Migraine-App Update 2014 für iPad und iPhone (2 January 2014)

Migraine-App Update 2014 für iPad und iPhone

Die neue Migräne-App – Die Service-Seite (1 October 2016)

Die neue Migräne-App – Die Service-Seite

Migräne und Kopfschmerzen: Digitales Selbstmanagement jetzt mit Apple Watch und Migräne-App (16 January 2017)

Digitales Selbstmanagement jetzt mit Apple Watch und Migräne-App

Die Migräne-App für Android ist da (23 February 2017)

https://www.schmerzklinik.de/2017/02/23/die-migrane-app-fur-android-ist-da/

Media References

(2) Liebram, Claudia; Eine App gegen Kopfschmerzen; Die Welt – Wissen (23 February 2017), page 20

(3) Klostermann, Ralf; Jede Dritte Frau ist betroffen – So bekommen Sie Migräne endlich in den Griff! (5 March 2017).

http://m.bild.de/ratgeber/gesundheit/migraene/serie-kopfschmerz-migraene-50714872.bildMobile.html

 

Headache/Migraine and Constipation – Is there a Link?

Dear Pain Matters blog readers,

A Korean study found that 25% of young patients with ongoing headaches and migraines also had constipation that, when resolved, also resulted in improved symptoms concerning their headaches/migraines.

While young patients with constipation-predominant irritable bowel syndrome (constipation-predominant IBS; IBS-C) were excluded from this study, it is reported that 25%-50% of all IBS patients also suffered from persistent migraines or headaches.

Details of Study:

A total of 96 children (46 males, 50 females; aged from 3 to 17), who were treated for ongoing headaches/migraines and followed up for >100 days, were allocated into 2 groups:

  • Group A – Children (17 males, 7 females) with ongoing headaches/migraines who also had constipation, and whose headaches/migraines improved following treatment for constipation only (n=24; 25%).  Specifically, Group A included children with:
    • Tension-type headache (including probable tension-type headache) (n=16); and
    • Migraine (including probable migraine) (n=8),

and

  • Group B – Children (29 males, 43 females) whose headaches/migraines were not linked with constipation (n=72; 75%).

Summary:

The Korean study found that the headaches/migraines automatically improved in all young headache/migraine patients following resolution of constipation, where their constipation was linked with their headaches/migraines in the first place (n=24/96, or 25% of all young patients).

This suggests a possible link between headache/migraine and constipation in ~25% of young patients (Park et al, 2015).

This is a sobering revelation, and one that should not be ‘glossed-over’ nor overlooked.  Instead, research should explore whether constipation (including constipation in IBS patients) may be linked with chronic headaches/migraines in some patients.

As a starting point, clinicians are urged to always ask their headache/migraine patients whether they also have constipation.  

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCE:

Park M-N, Choi M-G, You SJ.

The relationship between primary headache and constipation in children and adolescents.

Korean Journal of Pediatrics. 2015;58(2):60-63.

doi:10.3345/kjp.2015.58.2.60.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357773/

An Ethiopian-American Woman’s Migraines Eliminated By Traditional Chinese Medicine (Acupuncture, Improved Diet and Enemas)

Source of Featured Image (above):   http://wallpapersafari.com/yin-yang-wallpaper-1920×1200/

Dear Pain Matters blog readers,

An Ethiopian-American woman (32) suffered severe migraines every 7-10 days for 10 years.  She rated her painful migraine attacks as being ’10 out of 10′ (based on a pain scale).  During her regular migraine attacks, she had sharp pain, extreme sensitivity to light and sound, altered vision including auras, a ‘heavy’ feeling, dizziness, weekly nausea and vomiting, irritability and a longing to lie very still in a dark and quiet room.  The migraines were frequently on her right side of her head.

Imaging was done 2 years earlier to rule out any abnormalities, and the patient had no previous major illness (nor any family history thereof) or surgeries.  She did not take any medications or nutritional supplements.

Traditional Chinese Medicine (TCM) Treatment:

A Traditional Chinese Medicine (TCM) diagnosis (including analysis of tongue, sublingual vein and Chinese pulse) in October 2011 revealed cold hands and cold feet with a warmer middle body.  She sweated easily, and suffered allergies, sinus congestion as well as weekly nausea, vomiting and painful migraines.

The patient’s diet was high in fat and sodium/salt, and included food cravings such as chocolate, ice cream and fatty fried foods.

She was constipated 1-2 times a week that included occasional blood in the toilet caused by excess strain in her attempt to clear bowels.

She had stress, anxiety and an irregular menstrual cycle (perhaps linked to her migraines and constipation).

The patient was offered TCM treatment for 6-8 weeks involving:

  • Acupuncture (20 minutes per session, done weekly for 6 weeks).  The needles were inserted and manipulated until the patient felt a ‘dull pulling’ sensation (‘de qi’) at the needle insertion site;
  • Diet changes.  Diet changes included sodium/salt intake not exceeding 3 grams a day and replacing all fatty fried food with organic fruits and vegetables plus fresh fish and chicken; and
  • Chinese herbal- and coffee-based enemas (heated to 98.9 ℃, for her chronic constipation).  One enema treatment was done during the first week, 2 enemas during the 2nd week and 3 enemas during the 3rd week.  The enemas help to (1) clear the colon of toxic feces and bacteria and (2) dilate the gall bladder and liver ducts (via caffeine) to promote a generous release of bile.  Removal of toxins via enemas (i.e. to reverse constipation) may promote self-healing mechanisms, hence reduce the incidence of, or eliminate, severe migraines.

Results:

After the 1st week of TCM treatment, the patient’s severe migraine was reduced from a migraine to a headache (pain rating = ‘5 out of 10’).  She felt ‘better and less bloated’ after the 1st enema.

After her 2nd week, the patient’s sinus congestion improved, and her headache was milder and shorter in duration.

After her 3rd enema during her 3rd week, the patient had a full bowel movement and felt much better.  Just prior to this bowel movement, the patient had a right temple-area headache.

By her 4th week, she felt improvement in general.  She mistakenly ‘celebrated’ this milestone by indulging in fatty fried food (that she had avoided for 3 weeks).  She immediately suffered a migraine on her right side of her head, followed by vomit of green bile and acid reflux.

During her 5th week, she (once again) avoided fatty fried food and returned to 3 enemas per week.  Her headache was rated as ‘3 out of 10’, and her sinus congestion improved.

Following 6 weeks of acupuncture, the patient continued with her improved diet and enemas in her own home.

She returned for a follow-up visit 8 months later, and stated that her new and improved diet plus her ongoing enemas had changed her life for the better.  She can now go on holidays without worrying about migraines.  A food and migraine journal helped her monitor any food products that triggered any new migraines, hence enabling her to avoid these food items in the future.

For the first time in 10 years, and following strict compliance with TCM treatment, the patient finally experienced lasting relief from her severe and painful migraines. 

Summary:

Fatty fried food and chronic constipation had (likely) triggered the woman’s severe and chronic migraines in the first place.

Acupuncture for 6 weeks offered many benefits including restoring energy flow in her body.

Making a life-long commitment to:

  • Avoid fatty fried food, improve overall diet and lifestyle; 
  • Manage constipation (via regular enemas); and 
  • Seek acupuncture for any acute headaches

enabled this woman to finally obtain relief from her severe and painful migraines that had plagued her for 10 years.

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCES

(1) Payant, Misha-Josef Payant

A single case study: Treating migraine headache with acupuncture, chinese herbs, and diet

Glob Adv Health Med. 2014 Jan; 3(1): 71–74

doi: 10.7453/gahmj.2013.060

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921614/#R19

(2) Zheng H, Chen M, Wu X, Li Y, Liang FR.

Manage migraine with acupuncture: a review of acupuncture protocols in randomized controlled trials

Am J Chin Med. 2010; 38(4): 639–650

doi: 10.1142/S0192415X10008111

http://www.ncbi.nlm.nih.gov/pubmed/20626050

(3) Iseri SO, Cabıoğlu T.

Migraine treatment and the role of acupuncture: a literature review

J Australian Traditional-Med Soc. 2012; 18(2): 89–93

http://search.informit.com.au/documentSummary;dn=966314131189601;res=IELHEA

(4) Zijlstra FJ, van den Berg-de Lange I, Huygen FJPM, Klein J.

Anti-inflammatory actions of acupuncture

Mediators of Inflammation. 2003;12(2):59-69

doi:10.1080/0962935031000114943

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781596/pdf/12775355.pdf

(5) Peilin S.

The treatment of pain with Chinese herbs and acupuncture (2nd edition)

London, England: Churchill Livingstone; 15 September 2010: 1-704

ISBN-10: 0702031798

ISBN-13: 978-0702031793

https://www.amazon.com/Treatment-Pain-Chinese-Herbs-Acupuncture/dp/0702031798

 

 

Migraines and Low Level Laser Therapy (LLLT) – More Case Studies

Dear Pain Matters blog readers,

Despite being common, migraines are often difficult to manage as their underlying reasons are frequently unknown.

Low level laser therapy (LLLT; also known as cold laser therapy) may alleviate some migraines in certain cases.

Case Studies by Lee et al:

(1) A study involving 32 chronic migraine patients (10 males, 22 females; mean age 44.1, aged 21 to 67) was performed.  Most patients had unpleasant pressure and/or pulsating pain as well as tender areas and/or swelling around the head and in the frontal and temporal areas.

Clinical histories that (likely) caused migraines included motor vehicle accidents, sports and other injuries (e.g. falls) and trauma (e.g. birth trauma).  Injuries included muscle-tendon tears and ligament insertion injuries (i.e. possible tearing of Sharpey’s fibres at the periosteal-osseous junctions) in the head and neck areas.

Painless low level laser therapy (LLLT; near infrared 830 nm wavelength) was directly applied to injury/trauma-affected anatomical sites in the head/neck regions (30 to 100 mW, 1 – 2 minutes per damaged region).

All patients benefited from LLLT treatment including significantly reduced pain in some patients and complete elimination of pain and tenderness in other patients.  Decreased edema and relaxed muscles resulted at the tender sites within 1-5 minutes following LLLT treatment.

Low level laser therapy (LLLT) treatment resulted in nil adverse effects including no toxicity (Lee et al).

(2) An earlier study with 9 female migraineurs (mean age 49.4, aged 41 to 60) reported similarly impressive results.  Specifically, overall mean pain scores reduced from 7.2 to 4.3 following LLLT treatment for 10 minutes maximum to the frontal, temporal and/or occipital areas.  Three (3) of 9 patients enjoyed nil migraine pain, post-LLLT.

No side effects were reported (Lee et al).

NB It is not known how long the pain relief lasted, post-LLLT treatment, as this was not reported in these 2 studies.

Summary:

Targeted low level laser therapy (LLLT; 830 nm wavelength) may offer effective and safe pain relief from migraines.

Sabina Walker

“Sedare dolorem divinum opus est”

“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCES

(1A) Lee, Garrett; Wong, Edmund; Choy, Norman; Mason, Dean T

Safety and Efficacy of Treatment of Common Migrainous Headaches Applying the Low Power Laser by the Principles and Methods of Wong

San Francisco, CA

http://www.830laser.com/Migraines.pdf

(1B) Seymore, Brian L; Cappelletti, Ryan J

A Brief Synopsis of the Research on Cold Laser Therapy (Low Level Laser Therapy) (Pages 6-7)

http://www.integralnatmed.com/pdf/CLT-Research.pdf

(2) Lee, Garrett; Zucherman, James; Mason, Dean T

Application of the Low Power Laser in a Single-Blind Randomised Trial in Migrainous Headache Patients

St. Mary’s Spine Center, San Francisco, CA

http://www.sfspine.com/wp-content/uploads/2015/10/Application-of-the-low-power-laser-in-a-single-blind.pdf

 

Low Level Laser Therapy (LLLT) for Migraines Caused By Traumatic Brain Injury?

Dear Pain Matters blog readers,

Low level laser therapy (LLLT) may alleviate migraines in some cases.

Case Study:

A 25-year old man suffered a traumatic brain injury (TBI) when he was savagely attacked and repeatedly hit over the head with a lead pipe in May 2010.  He required many surgical stitches and sutures to close the head injury, and was left with a permanent scar on his brain.

Since that fateful day, the TBI victim experienced ongoing excruciating and incapacitating migraines for 2 long years.  His daily migraine pain ranged from 7 to 10 (on a scale from 0 to 10, using the visual analog scale ‘VAS’).  He stated that his migraines were ‘throbbing’ and ‘squeezing’, and were mainly in his occipital part of his brain.  He was unable to sleep properly nor play with his 4 children (aged up to 9) due to his constant migraines.

After ‘literally trying everything’ for 2 long years, and almost giving up hope, he agreed to try LLLT.  He was given 5 LLLT treatments over 2 weeks.

Specifically, LLLT treatment was delivered at 905 nm (near infrared) superpulsed wavelength set to 50 mW average power.  His LLLT targeted 4 areas on his scalp, 2.5 minutes each area (i.e. the occipital region, the area above the Circle of Willis as well as above the mastoid processes, both right and left side), totalling 10 minutes per treatment.

Results:

Following the first 10-minute-treatment, the patient immediately reported a 43% reduction in migraine pain (i.e. from VAS = 7 to VAS = 4).  He added that the ‘throbbing’ and ‘squeezing’ part of his migraine had disappeared immediately following his first LLLT treatment, and he was left with a residual ‘dull achy pain’.

He continued with 4 additional LLLT treatments, and his migraine pain further diminished after each treatment.

After completing 5 LLLT treatments (10 minutes per LLLT treatment), the patient’s overall migraine pain had decreased by more than 90%, while a ‘minor ache’ remained (that was hardly noticeable to him).

The patient had no side effects other than a slight ‘warm’ feeling above the region where the laser was placed.

The patient no longer has constant excruciating migraine pain, and his family says he looks much happier.  After 2 years of severely excruciating ‘throbbing’ and ‘squeezing’ migraines, he was finally able to sleep properly.

Possible Mechanisms:

Low level laser therapy (LLLT) may reduce inflammation and promote temporary vasodilation in capillaries by activating the nitric oxide pathway, leading to increased blood flow.  This may enhance oxygen delivery to TBI-affected brain regions that may ultimately lead to decreased migraine pain.

The 905 nm ‘pulsed’ (as opposed to ‘continuous’) wavelength may increase the expression of the inducible nitric oxide synthase (iNOS) gene by 700% (Stephan et al, 2012; Moriyama et al, 2009).

Summary:

Mr Banas has achieved significant success with most of his LLLT-treated migraine patients (more than 65 migraine patients including TBI and non TBI) (Stephan et al, 2012).

Targeted low level laser therapy (LLLT)  may offer significant, life-changing relief from pain due to migraines.

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCES

(1) Stephan W, Banas L , Bennett M and Tunceroglu H.

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury (TBI): A case study.

World Journal of Neuroscience (2012), 2, 231-233.

doi: 10.4236/wjns.2012.24035

http://www.scirp.org/journal/PaperInformation.aspx?paperID=24793

(2) Moriyama Y, Nguyen J, Akens M, Moriyama E H, Lilge L,

In vivo effects of low level laser therapy on inducible nitric oxide synthase.

Lasers Surg. Med. (2009), 41: 227–231.

doi:10.1002/lsm.20745

http://www.ncbi.nlm.nih.gov/pubmed/19291752

An Australian Woman With Chronic Back Pain, A Beautiful Neurosurgeon and A 3D-Printed Spine Implant (Plus Other Patients With Custom 3D-Printed Body Parts)

Source of Featured Image:

RMIT University

https://www.rmit.edu.au/news/all-news/2015/august/australias-first-3d-printed-spine-implant/

Dear Pain Matters blog readers,

Is this the title of a new science fiction novel??

“An Australian Woman With Chronic Back Pain, A Beautiful (Neurosurgeon’s) Mind and A 3D-Printed Spine Implant”

No, this is not science fiction….This really did happen!

Welcome to the futuristic world of 3D-printed body parts, and its potential role in reducing chronic pain!

Happily, for Amanda Gorvin, the future is now!

Amanda (38) had suffered persistent and crippling lower back pain for more than 30 years.  Amanda suffered shooting pains and countless sleepless nights due to a deformed lower back vertebra.  She had spent an entire adult life on antiinflammatories, ibuprofen, Nurofen, cortisone injections and physiotherapy.  Amanda’s lower back pain had affected her quality of sleep, resulting in only 3-4 hours sleep a night, as well as lethargy and exhaustion during her waking hours.  By now, her lower back pain adversely affected her social, sporting and sex life.  She was unable to dress herself without exerting a huge and painful effort.  As a result of her lower back pain that limited her physical activity, Amanda gained 30 kg in 5 years.

She finally had enough of her ‘bones rubbing’ in her lower back, causing excruciating pain every time she moved.  One night at 2AM, she dragged herself out of bed and crawled into the kitchen, crying out in pain.  At a loss what to do next, Amanda told her neurosurgeon, Dr Marc Coughlan, several days later, “Marc, I can’t do this anymore.”

Her neurosurgeon replied, “I’ve got this new thing.”

Dr Marc Coughlan and another surgeon collaborated with 3D implant company, Anatomics, and a team of scientists and engineers at RMIT University (Melbourne) to custom design a 3D-printed spinal implant for Amanda Gorvin.  Few international surgeons have done this procedure, and Dr Marc Coughan was the first Australian surgeon to attempt this.  His patient, Amanda, was Australia’s first patient to agree to this.

After explaining the risks to Amanda, Dr Marc Coughlan operated on 3 April 2015 to insert a custom 3D-printed spinal implant into her lower back.

In Dr Coughlan’s words (quoting):

“The beautiful thing when we put the implant in was that it felt like a key going into a lock.  I could actually feel it click into place.  It was so intrinsically stable, it was like a dream for a spinal surgeon.”   

marc 201x214

Dr Marc Coughlan, MBChB, FRACS, FCS

Source:

http://www.coastalneurosurgery.com.au/AboutUs.asp

After her 3D-printed spine implant operation, Amanda stated (quoting):

“I was back at work four weeks after the operation, back in the gym after six weeks,” she says. “I was breathing better, my mind was clearer, I felt lighter. It’s incredible how much influence the spine has on the rest of the body. I remember that pre-surgical pain and now I ­haven’t got one per cent of it. It’s nothing short of miraculous.” As she speaks, Gorvin becomes emotional and reaches for a tissue. “This has absolutely changed my life,” she says.”

376025-e6606ef0-418b-11e5-91d1-7a17ec48b9e9

Amanda Gorvin

Source:

http://www.theaustralian.com.au/news/special-features/d-printing-human-organs-it-suddenly-doesnt-seem-so-far-off/story-fnolgd60-1227482157233

Results like this simply speak for themselves….

Amanda has Dr Marc Coughlan, Neurosurgeon, to thank (for his beautiful mind).  Of course, the idea would not have materialized without the help of the 3D-printing team led by RMIT University Professor Milan Brandt and key staff at Anatomics.  The custom 3D-printed spinal implant literally erased Amanda’s lower back pain (that she had suffered for more than 3 decades).

OTHER PATIENTS WITH CUSTOM 3D-PRINTED BODY PARTS INCLUDING A TITANIUM HEEL, A PLASTIC SKULL AND A TITANIUM JAW JOINT

Len Chandler (71), recipient of a 3D-printed titanium heel:

A 71-year old former builder from Rutherglen, Victoria, Australia, Len Chandler, was facing amputation of his right leg below the knee due to rare cartilage cancer in his right heel.

Luckily, a surgically-implanted 3D-printed titanium heel (the first of its kind in the world) changed his fate for the better.

1421375683017_771

Len Chandler (above), together with replicas of his 3D-printed heel

Source:

China Daily Asia

http://www.chinadailyasia.com/asiaweekly/2015-01/16/content_15214917.html

After surgery for his 3D-printed heel implant, he stated (quoting):

“I’ve got no irritation or pain or anything from that.  It just fits perfect, I couldn’t asked for anything better.”

A 22-year old Dutch woman, recipient of a 3D-printed near-entire plastic skull:

A Dutch woman (22) suffered from severe headaches, loss of vision and compromised motor coordination as a result of abnormal skull thickening.  Without drastic intervention, she was facing further brain function loss, ongoing severe headaches and an early death.

Her doctors surgically implanted a near-entire plastic skull, custom 3D-printed by Anatomics.  The operation was a huge success.  Three (3) months after her surgery, the woman’s severe headaches have disappeared and she fully regained her vision.

140327-science-3d-printed-skull_e8f32032da2f37a65e83ba184442e287.nbcnews-ux-600-480

Above, 3D-printed plastic skull

Source:

http://www.nbcnews.com/science/science-news/medical-first-3-d-printed-skull-successfully-implanted-woman-n65576

Richard Stratton (32), recipient of a 3D-printed titanium jaw joint:

Richard Stratton, a 32-year old Melbourne-based psychologist, received a 3D-printed prosthetic jaw implant on 23 May, 2015.

Part of his jaw had never grown properly ever since he was knocked in the jaw during childhood.  In fact, he was missing part of his jawbone including the left condyle (part of the temporomandibular joint, or TMJ).  This caused significant strain on the right side of his jaw and also left him with a crooked smile.

In recent years, he suffered sharp pain while moving his jaw, biting, chewing and eating and he also had painful headaches at night.  He was unable to fully open his mouth.

Dr George Dimitroulis (Oral and Maxillofacial Surgeon, St Vincent’s Hospital, Melbourne) designed a prosthetic jaw that included a 3D-printed titanium jaw joint implant and a 3D-printed plastic jaw joint (in collaboration with Dr Ackland and team, Department of Mechanical Engineering, The University of Melbourne).  The entire process from the initial design stage to the 5-hour operation took 3 years.

The plastic jaw TMJ is (likely) the first 3D-printed jaw joint in the world.

Quoting Dr Dimitroulis:

“The excitement was unbearable I think, just at the last minute we thought it just wasn’t going to fit in but it just slid in nicely.”

“It just clipped in.”

He has reason to be “very proud” that 3 years of hard work had resulted in such positive results.

7b57e551f0f7fcf6b2bcb1e2c5b5faa857feaf7cf02a1813a3445495ac4c.jpg

Above, Dr George Dimitroulis (Oral and Maxillofacial Surgeon, St Vincent Health)

Source:

https://pursuit.unimelb.edu.au/articles/the-jaws-of-life

One month after the post-surgery pain and swelling (that lasted a few days) subsided, Richard Stratton said he was able to open his mouth wider than before the surgery.  Several months later, he was chewing on both sides and eating normally.  His painful headaches at night also disappeared.

For more details, please view video by The University of Melbourne called:

‘When BioMechanics Colllides with Medicine’

Quoting Richard Stratton (several months after his operation):

“The joint has been working really, really well. It really has improved my quality of life.”

6536892-3x2-940x627.jpg

Above, Richard Stratton’s 3D-printed titanium jaw part (attached to a 3D printed version of his skull)

images.jpeg

Above, ‘Before Surgery’ (left) and ‘After Surgery’ – with surgical scar visible on jawline (right)

Source:

http://www.abc.net.au/news/2015-06-20/melbourne-man-receives-titanium-3d-printed-prosthetic-jaw/6536788

Patients with severe TMJ pain caused by jaw joint osteoarthritis, cancer, trauma or congenital abnormalities may benefit from 3D-printed titanium jaw joint implants.  Such implants may lead to complete restoration of jaw function plus significantly reduced/nil jaw pain.

SUMMARY

Here’s to the future that may include 3D-printed body implants to help reduce chronic pain!  Happily, for some, the future is already here!

Sabina Walker

REFERENCES

(1A) The Shape of Things to Come

Richard Guilliatt; The Australian (The Weekend Magazine) (pages 10-14); August 15-16, 2015

http://www.theaustralian.com.au/news/special-features/d-printing-human-organs-it-suddenly-doesnt-seem-so-far-off/story-fnolgd60-1227482157233

(1B) Surgeons Print Out 3-D Body Implant

Richard Guilliatt; The Australian (page 3); August 15-16, 2015

http://www.theaustralian.com.au/news/health-science/surgeons-print-out-3d-body-implant-for-spinal-operation/story-e6frg8y6-1227484209363

(2) Joint Effort Produces Australia’s First 3D Printed Spine Implant

RMIT University; August 17, 2015

https://www.rmit.edu.au/news/all-news/2015/august/australias-first-3d-printed-spine-implant/

(3) Anatomics

http://www.anatomics.com/company/news/

(4A) 3D Printing: Rare Cancer Sufferer, Len Chandler, Back On His Feet After Receiving Titanium Printed Heel
Lisa Tucker; ABC News; 22 Oct 2014

http://www.abc.net.au/news/2014-10-21/rare-cancer-sufferer-receives-3d-printed-heel/5830432

(4B) Close to the Bone
Karl Wilson (in Sydney, Australia); China Daily Asia; 16 January, 2015

http://www.chinadailyasia.com/asiaweekly/2015-01/16/content_15214917.html

(4C) World First Heel Implant at St Vincent’s Private Hospital Melbourne 7 News

(5) Medical First: 3-D Printed Skull Successfully Implanted in Woman
James Eng; NBC News; 27 March 2014

http://www.nbcnews.com/science/science-news/medical-first-3-d-printed-skull-successfully-implanted-woman-n65576

 

(6A) The Jaws of Life

Val McFarlane; The University of Melbourne; 24 September 2015

https://pursuit.unimelb.edu.au/articles/the-jaws-of-life

(6B) Titanium, 3D-Printed Prosthetic Jaw Implanted in Melbourne Man in Australian First Surgery

Stephanie Ferrier; ABC News; 22 Jun 2015

http://www.abc.net.au/news/2015-06-20/melbourne-man-receives-titanium-3d-printed-prosthetic-jaw/6536788

Good News! Chronic Migraines/Headaches Exceeding 25 Years Have Finally Ended For Eva – After Only 2 Consultations with a ‘Gonstead’ Chiropractor!

Feature Image sourced from:

https://strongergreen.com/2017/04/why-seeing-a-chiropractor-is-a-good-idea/

Dear Pain Matters blog readers,

Two days ago, my American friend and I went to a cafe where we were served by a nice woman named Eva.

Our conversation with Eva started because I was admiring her 21 earrings, 10 in one ear and 11 in the other ear!  As we discussed her 21 beautiful earrings, the topic of ‘earrings and X-Rays’ (somehow) came up.

Eva told us that she used to endure frequent, painful, and disabling migraines/headaches (that lasted many days at a time) for more than 25 years (until August 2013).  Eva does not know how these painful migraines/headaches started, although she does remember that they first started when she was only 15 or 16 years old.

Eva literally tried everything (without success) in her bid to get rid of her painful and disabling migraines/headaches including:

– Prescription drugs (costing more than $1,000 per year);

– CT scans;

– MRI scans;

– Stress clinics;

– Homeopathy;

– Acupuncture (that did help with nausea and vomiting due to her migraines, but that did not reduce migraine pain); and

– Psychologist (for stress caused by painful migraines/headaches).

Sadly, nothing helped with the painful and disabling migraines/headaches for more than 25 years.

Six (6) years ago, she gave birth to a beautiful and healthy baby girl.  However, even as she lovingly nurtured and fed her baby girl, her painful migraines/headaches persisted.

Eva’s chronic and painful migraines/headaches robbed her of 25 years of her life including her youth, health, sleep, career, and social life, including 5 years’ quality time with her daughter (now 6).

Eva spent up to 5 consecutive days and nights in a dark and quiet bedroom, lying very still (but unable to sleep due to migraines), right next to ‘her vomit bowl’ – that was often used for vomiting.  As a result, she missed many days at work, and her social life was severely affected.  She added that often, she recorded 23 to 25 days of debilitating migraines per month, following the birth of her daughter.

‘What kind of life is this?’, she asked.  Finally, on a Thursday in August 2013, Eva couldn’t take it anymore.  She decided that she had to try something new and different for her painful migraines/headaches (for her and her family’s sake).

As she walked past the local Chiropractor/Exercise Physiologist’s practice (near her home in the eastern suburbs of Sydney, Australia), she stopped and walked in for the very 1st time (after having passed by here many times before).  She asked the staff whether she needed a Referral to see the Chiropractor/Exercise Physiologist (also a Gonstead Chiropractor), and the staff replied ‘no’.  Eva added that she desperately and urgently needed help for her migraines/headaches, as she couldn’t take her migraines anymore.  Fortunately for her, the Gonstead Chiropractor was available to see her that very same day.  She was requested to bring in copies of all her imaging reports.

Here is the best part of Eva’s 25-year long, painful and unpleasant journey with migraines/headaches:  It finally ended that same week in August 2013!!  After only 2 consultations with this Gonstead Chiropractor (and a 3rd Follow-Up Visit, 2 days later), Eva’s painful migraines/headaches disappeared FOR THE VERY FIRST TIME, AFTER MORE THAN 25 YEARS OF PAIN AND SUFFERING!  Imagine that!

At Eva’s 1st Consultation in August 2013, her Gonstead Chiropractor took a detailed clinical history including a review of her imaging reports.  As part of his thorough physical examination, he also used a Nervoscope instrument.

Quoting from the Gonstead Chiropractic Society Australia website:

“The Nervoscope detects uneven distributions of heat along the spine which can be indicative of inflammation and nerve pressure. This instrument is guided down the length of your back and feels like two fingers gliding down each side of your spine.”

https://www.gonstead.com.au/what-gonstead

Thereafter, her Gonstead Chiropractor gently treated her neck region with his hands (consistent with the ‘Gonstead System of Chiropractic’ approach).  Eva added that her Gonstead Chiropractor never exerted any strong force nor any painful manipulation during his treatment.

Even after Eva’s 1st (45-minute) consultation/treatment, Eva already knew ‘something was working’.  Her dizziness was gone!  And her vision (that was affected during her severe migraine attacks) was now clear!

The Gonstead Chiropractor suggested that Eva see him again in 2 days (on Saturday).  After this 2nd treatment (15-minutes) on Saturday, Eva confirmed that ALL the nasty and unpleasant symptoms of her painful migraines/headaches had finally disappeared altogether.

With only 1 exception, Eva has not had a single migraine/headache since these 2 consultations in August 2013 with her Gonstead Chiropractor.  Eva’s migraine briefly returned while on a recent holiday in Europe (where she had slept on very large, firm European pillows).  As soon as Eva returned to Sydney, she promptly went back to her Gonstead Chiropractor for treatment.  After only 1 short session (that included very gentle treatment of her neck), she was ‘as good as new’ again.  Importantly, her migraines/headaches have not returned since, and she is now living a pain-free life, without migraines nor headaches.

Eva has routine Follow-Up Appointments with her local Gonstead Chiropractor every 6 months, ‘just to make sure everything is OK’.  So far, so good…..no further treatments are necessary…..and no more painful migraines for Eva.

It is important to note that pain mechanisms vary from one migraine sufferer to the next.  In Eva’s case, the migraines were structural/anatomical in origin, and related to her neck region (that was virtually impossible to detect without the aid of a Nervoscope).

While Eva’s solution for her 25-year painful migraines/headaches may not work for everyone, her decision to see an experienced, qualified and gentle Gonstead Chiropractor is certainly worthwhile.

Different pain treatments may work for different people with chronic pain/migraines/headaches.  It may take a while to find the correct and effective pain treatment(s).

The moral of this story is:

Never, ever give up hope!  After all, Eva never gave up, even after 25 years!

If you have chronic migraines/headaches, please try different treatments … including Eva’s approach.

Thanks to 2 treatments by her Gonstead Chiropractor, Eva was finally able to stop her 25-year long chronic migraines/headaches.

Now in her very early 40’s, Eva is finally able to enjoy her life as a mother and wife, without also enduring constant debilitating and painful migraines/headaches.

One thing is certain to Eva:  The joys of motherhood without painful migraines is a true gift that words can never fully describe.  Her migraine nightmare is finally over.

On behalf of all Pain Matters blog readers, thank you, Eva, for sharing your story about your 25-year long journey with painful migraines – that finally ended in August 2013, after 2 visits within 2 days with a Gonstead Chiropractor (Eva’s own guardian angel).

I hope you all enjoyed today’s feature story about Eva, that may offer hope and inspiration to many migraine sufferers.!

Sabina Walker (Blogger of Pain Matters;  Master Appl. Sc. (Neurosc.))

REFERENCES

(1) What is Gonstead?

Gonstead Chiropractic Society Australia

https://www.gonstead.com.au/what-gonstead

Oxytocin for Migraine and Headache?

Dear Pain Matters blog readers,

Oxytocin is a natural hormone made by the hypothalamus and released by the posterior pituitary gland.  Nicknamed the ‘love hormone’, or the ‘cuddle hormone’, oxytocin helps induce labor (during childbirth), as well as promote lactation, maternal care, and couple bonding.

The word oxytocin is derived from Greek for quick birth (‘oksys’ = quick and ‘tokos’ = birth).

Oxytocin for Migraine and Headache?

Did you know that oxycontin may also relieve pain in some chronic migraine and headache sufferers?

Nasal-administration of oxytocin bypasses the Blood-Brain Barrier and directly activates the oxytocin receptors in the trigeminal nerve.  These oxytocin receptors are increased during inflammation.

In a study involving 40 chronic migraine sufferers, half were given a nasal oxytocin agent called ‘TI-001’, while the other half were given placebo.  This study reported that 4 hours after nasal oxytocin (‘TI-001’) treatment, 27% of the migraine sufferers had nil pain. 

Interestingly, nasal oxytocin (‘TI-001’) is most effective in the presence of pain-evoking inflammation.

‘TI-001’ is now being developed for chronic and long-lasting headaches, migraines, trigeminal neuralgia, and other chronic facial and head pains.

http://trigemina.com/category/press-releases/

http://trigemina.com/product-pipeline/

Oxytocin’s Effects on the Autonomic Nervous System

A study found that intranasal oxytocin spray was able to increase heart rate variability in healthy men during rest (compared to placebo) (Kemp et al, 2012).  

A study showed that oxytocin enhances parasympathetic activity without affecting the sympathetic nervous system (Gamer and Büchel, 2012).

Summary

In summary, nasal oxytocin leads to:

(1) Activation of the trigeminal nerve and reduced pain in some migraine sufferers; and

 (2) Increased heart rate variability due to increased parasympathetic (vagal) activity. 

For more information, please listen to Psychologist Kelly McGonigal’s 14-minute speech on stress and oxytocin’s role in modulating the stress response.  Note: While pain is not discussed, oxytocin is specifically discussed by Kelly McGonigal from 7:50 on:

How to make stress your friend

Here’s to oxytocin…..that may help reduce pain and suffering caused by chronic migraines, headaches, etc!

Sabina Walker

REFERENCES

OXYTOCIN’S POSSIBLE PAIN-RELIEVING EFFECTS ON CHRONIC MIGRAINES AND HEADACHES

(1) Megan Talkington; New Possibilities for Pain Treatment
7th Annual Pain Therapeutics Summit showcases therapies in development (20 Feb 2014).

http://www.painresearchforum.org/news/37432-new-possibilities-pain-treatment

(2) Yeomans et al; Abstract P59 Therapeutic Effect of Nasal Oxytocin in Chronic Migraine: Dependence on Cytokines (in ‘Abstracts of the 2013 International Headache Congress’); Cephalalgia (June 2013); 33(8 Supplement); pages 58-59.

(3) Yeomans; In the Pipeline: Nasal Oxytocin Explored for Migraines- Can migraine patients trust the “trust drug” to heal their pain? Practical Neurology (May/June 2013); 29-31.

Click to access PN0513_Pipeline.pdf

(4) Phillips et al; Relief of acute migraine headache with intravenous oxytocin: report of two cases. J Pain Palliat Care Pharmacother (2006); 20(3):25-8.

http://www.ncbi.nlm.nih.gov/pubmed/16931475

(5) Wang et al; The interaction between the oxytocin and pain modulation in headache patients. Neuropeptides (April 2013);47(2):93-7.

doi: 10.1016/j.npep.2012.12.003.

http://www.ncbi.nlm.nih.gov/pubmed/23375440

OXYTOCIN’S EFFECTS ON THE AUTONOMIC NERVOUS SYSTEM AND INFLAMMATION

(6) Kemp, Quintana, Kuhnert, Griffiths, Hickie, Guastalla; Oxytocin Increases Heart Rate Variability in Humans at Rest: Implications for Social Approach-Related Motivation and Capacity for Social Engagement; PLOS One (28 August, 2012); 7(8); e44014 (pages 1-6).

DOI: 10.1371/journal.pone.0044014

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0044014

(7) Gamer, Büchel; Oxytocin specifically enhances valence-dependent parasympathetic responses. Psychoneuroendocrinology (Jan 2012);37(1):87-93.

doi: 10.1016/j.psyneuen.2011.05.007. Epub 2011 Jun 8.

http://www.ncbi.nlm.nih.gov/pubmed/21641726

(8) Szeto et al; Oxytocin administration attenuates atherosclerosis and inflammation in Watanabe Heritable Hyperlipidemic rabbits; Psychoneuroendocrinology (May 2013); 38(5):685-93.

doi: 10.1016/j.psyneuen.2012.08.009.

http://www.ncbi.nlm.nih.gov/pubmed/22998949