Proactivity vs. Reactivity: What Migraines Teach Us All About Chronic Pain

Pictured above, it is October of 2015 and I walk into Human Garage for the first time, one day after my most recent episode of a migraine attack. At center, following my first session at Human Garage. And to the far right, a picture taken on Thursday, September 29th when I arrived to work at Human Garage. Smiling. Pain free. Healthy. My facial expressions are telling.

Many of our clients, just like me above, arrive at Human Garage because of some form of chronic pain. There’s some part of our body (or maybe multiple parts of our bodies) with a more persistent ache or pain. Maybe it’s been hurting for months. Maybe years. Perhaps decades.

At Human Garage, we are all about identifying the root causes of symptoms. Migraine headaches pose an interesting dilemma because the root cause is not singular. I’ve learned tremendously through my own process of healing and through the various people I’ve encountered suffering from them.

I’m often asked: what can I do to stop them? What do I do when I feel them coming on? What’s the cure? Migraine headaches and chronic headaches in particular have been perplexing doctors, traditionally trained and otherwise, for decades.

An important note: while I am using the example of migraine headaches to illustrate my point, the words within are intended to serve a wide variety of chronic health conditions. 

To illustrate the answer, let me use an analogy of a glass with water. When a cup fills with water, there is a limit to how much water it can hold. Logically, the glass fills up as we pour more water in. If the cup continues to fill without pouring out any of the water, eventually the water will spill over. It needs somewhere to go.

I like to think of human bodies and migraine headaches in the same way. There may not be just one cause, but when filled up with enough causes (triggers), the water is bound to overflow. 

For me, stress, wine, days leading up to menstruation, dehydration, and sleep deprivation are all triggers for my migraine pain, meaning they increase my susceptibility to migraines. I also have body posture tendencies that make me more susceptible to migraine headaches. (It’s worth noting here that postural realignment, the essence of what we do at Human Garage, is the critical starting place for anyone in chronic pain. What follows here can support that work and keep us out of pain for the long term). 

In isolation, any one of these factors alone does not trigger a headache. In conjunction with one another, too many of these variables on a given day can lead to pain. Why?

We have to give the water a place to go, metaphorically speaking, or it will naturally find its way out. Imagine a flooding river or a dam if that is more fitting. Unfortunately for those of us with migraine pain, it finds its way out with throbbing and burning pain out the side of our temples. And for those of us with chronic pain or migraines, we tend to be especially sensitive to our environments.

Here’s my secret: managing chronic conditions means we need to learn to live our lives proactively, not reactively. The trouble is, we live in a reactive society. We take medication once pain starts. We seek help once we are already broken and in pain.

Once the water is flowing out of the cup it becomes challenging to put it back in. How can we prevent the water from overflowing to begin with? We can drink the water gradually, manage our stress as it comes, and listen to our bodies at the first indication the cup is getting too full. 

When I am asked: “what can I do once my headache has started?,” we are already in a reactive state. Reacting to pain. That is a challenging place to be in (and yes, postural realignment is an important foundation to start with). Inevitably, people come to us at Human Garage in pain and suddenly feel better, yet we need to develop ways of maintaining this over time.

This is the secret to managing pain: do not wait for your cup to overflow. Do not wait for the dam to break.

Pain comes from living in a chronic state of tension, a consistent state where the nervous system is forced into fight or flight mode. Thousands of years ago, it was easier to notice when the body was going into fight or flight. But in modern day urban dwelling it can be much more challenging, as we are accustomed to living in high stress states where our nervous system is always on edge. We don’t often realize we are operating in “fight” mode. Ask any Los Angeles resident about the 405 freeway and road rage at rush hour or a New Yorker about Penn Station on a Friday evening as people flood by the thousands from one platform to another.

Let’s look at some simple neurobiology to understand this. Once in acute pain, fight or flight response kicks in as our bodies detect pain and our bodies shift into the sympathetic nervous system. In short, your brain is saying: “Danger!” you’re in pain. We shift into “attack” mode, perceiving just about everything in our environment as a possible threat to our survival. Our brain starts to send out pain signals (as well as cortisol, a stress hormone, amongst other chemicals), flooding our nervous system in response to pain, increasing heart rate, blood pressure, and the like.

Over-activation of the fight or flight response over time leads to a variety of chronic health conditions (digestive problems, headaches, high blood pressure, and fibromyalgia just to name a few) due to a buildup of stress hormones. A biological system intended to help us and keep us alive can be counterproductive at times. 

Staying out of pain involves staying out of the sympathetic nervous system and staying in the parasympathetic nervous system. Now, for clarification: the sympathetic nervous system is necessary and helpful. It’s what keeps us from getting into car accidents when suddenly cut off on the freeway. It’s what keeps us safe when we have no idea how we ever reacted so quickly to that cyclist barreling down the wrong side of the road at night in a black t-shirt.

The parasympathetic nervous system, however, slows the heart rate, induces feelings of relaxation and aides in rest, recovery, and digestion. The more we learn to access this part of our bodies and our brains, the less pain we will be in. Activating the parasympathetic response aides in recovering from muscle soreness and swelling.

This is a challenge, especially for those of us in urban centers like Los Angeles and New York where stress runs high, days are long, horns are blaring, and work days are long. Accessing our parasympathetic nervous system does not have to be so elusive, however.

So, back to my point. How do migraine sufferers (or any of us) stay out of chronic pain? When we learn to tap into the parasympathetic system more frequently, our more naturally relaxed state, we are living proactively. We do not have to react to our pain. Rather, we can proactively preventing its onset. This is simple, yet imperative.

I will not pretend to be a doctor. But, I am a former competitive athlete, hold an (almost) master’s degree in human behavior, and I’ve injured (and healed) almost about every part of my body in just under 30 years of life (impressive feat, I know). I’ve also suffered tremendously from migraines and had my life just about shut down as a result of them. Notice the contrast in my facial expressions in the picture below at left, taken one day after one of my most virulent migraine attacks.

I’ve found relief (not 100% of the time), but I’m much more of aware of what causes migraines and my quality of life has drastically improved. I should also say this: realigning my body’s postural issues was critical to my process of healing. It is a necessary starting point. If the above pictures are any indication, I am working with drastic changes to my body’s biomechanics, alignment, and posture. Now, through my time on staff at Human Garage, I’ve gained insight as to how to continuously stay out of pain, through accessing my parasympathetic nervous system. This is the critical piece of the puzzle if we do not want to lose the progress made in our realignment work at Human Garage. Here, I will shift directions to share some suggestions for staying out of chronic pain and fight or flight mode in the long run.

1). Listen to your own body. 

I could tell you a lot of things. Ultimately, however, I am not you. Pay attention to your triggers and notice when your body is alerting you to shifting to a state of tension. Notice if there are situations, foods, people, times of the month, emotions, etc. that precede your migraines. It is not (necessarily) about avoiding them. Generally speaking, we can’t fully avoid our triggers. We can, however, learn a new way of responding to them. This is the critical difference.

From my own experience, migraine sufferers themselves seem to know more than practitioners about what causes pain and what alleviates their pain. You know the whispers of your own body best. Empowerment comes from listening to your own body and your own source of internal wisdom. 

2). Stop and slow down at the first sign of pain. Better yet, slow down long before. 

I learned something interesting about myself as a result of migraine pain: the only time I ever took time off of work or a day of rest was when I was in excruciating pain. I only allowed myself to stop when I had no other choice. Give your body rest before you are in pain. If we allow our bodies to rest, they will not need to scream in order to get our attention.

Breathe and meditate when you feel too much stress or even very subtle, small signs of pain.

Panicking because you think you may get a migraine is one of the easiest and fastest ways to bring on a migraine headache. I know because I’ve done it. Panicking or obsessing over what may happen if you get a migraine only pushes the body into the sympathetic nervous system (fight or flight response), rattling your nervous system.

Going on a run or sweating through a heavy yoga class to fight through the pain is generally not helpful. Powering through pain often exacerbates it.

Sometimes the best gift we can give our bodies, especially when in pain, is rest. 

3). Identify what is within your control. 

When it comes to any health condition such as migraines, there are certain things within and out of one’s control. Understanding this distinction is critical.

There are certain foods, for example, that can trigger my migraine pain especially if I am under stress. Wine, for example, is often a trigger for many migraine sufferers, as are processed meats and food additives like MSG. Understanding my body, listening to its cues, and avoiding obvious triggers such as these is very helpful.

I cannot, however, often control external stressors, what goes on around me, stress at work, or my menstrual cycle. I can, however, manage my reactions and engage in practices that keep my nervous system calm and balanced.

4). Try alternative remedies to keep your body out of fight or flight mode and in its more relaxed parasympathetic state. 

Try taking a supplement like CBD oil (this does not contain THC and is non-psychoactive but is derived from the cannabis plant.) For high stress individuals prone to pain such as migraines, try taking once in the morning to wake up and again at night. This aides the body in staying in the parasympathetic nervous system, allows your body to recover and renew.

There are also a variety of essential oils for migraines in addition to a wide assortment of oils mean to aid in relaxation, feelings of calm, and pain relief. Using any combination of these daily can also assist in staying out of fight or flight response or help to calm your nervous system once it is activated.

5). Develop a self-care practice that involves keeping your nervous system calm and relaxed.

Develop a self care practice beyond just going to the gym and burning steam (this actually often activates the sympathetic nervous system more so than the parasympathetic and we need the parasympathetic for recovery and healing). Whether it’s getting a massage, meditating, yoga, hiking, spending time in nature, or the like, engage in activities weekly (or even daily) that keep you in a state of calm and relaxation.

6). When all else fails, refer back to numbers one, two, and three. 

Slow down. Breathe. Reflect on what is in your control. Meditate. Listen to what your body needs. Repeat and do so often. 

I don’t make promises often, but I can promise this: trying any or all of the above certainly won’t hurt you. I’ve learned something critical through working in alternative medicine and body realignment: the greatest tools for healing and staying out of pain are usually not all that complicated. We search for complex answers, but there’s something to be said in simplicity. And worst case scenario, you may actually start to feel better. We can all be active participants in our own healing, but we must make conscious choices to maintain our well-being. Happy healing, everybody.

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