The neurogenic chemicals come from a variety of head and neck structures such as muscle and joint over use, sinus infections, ear infections, eye contact with environment, mouth bacterial invasion, and allergies. The migraine headache is now thought to be a neurogenic chemical overload that reaches toxic levels in the blood stream going to the brain. The estrogen-enhanced mast cell inflammation chemical release explains some of the female predominance in the migraine population. This monthly bombardment of neurogenic chemicals takes its toll on the female body. As a result, a female will get more chemicals, more inflammation, more pain, and more swelling from the same stimulus than will a male. One of the substances released by the mast cell is NGF (nerve growth factor)²¹ which stimulates production of substance P and VIP (vasoactive intestinal polypeptide)³ - the main messenger molecules (neurotransmitters) of the pain system. When the estrogen levels flux and blood levels of estrogen increase, estrogen couples with the mast cell receptor making it more sensitive to an inflammation stimulus and the dumping of its load of neurogenic chemicals.²⁰ As it does so, neurogenic chemicals are released more quickly, and with greater numbers of mast cells responding. The mast cell is a storage tanker for many neurogenic chemicals and is the predominant cell in the inflammation process. This receptor - genetically coded to provide the female with an inflammation enhancement - is absent in men. One of the most fascinating research findings in recent years is the estrogen receptor on the female’s mast cell. Only recently have these pieces of the puzzle about the pathophysiology of women’s hormones and headache relationship begun to make sense. There are currently three theories for women’s predisposition to pain:įor many years, it has been found that hormone replacement therapy exacerbates migraines.¹⁵ Oral contraceptives change the character and frequency of migraines.¹⁴ In the presence of estrogen, there is a heightened response to neural injury.¹⁶ Mechanical sensitivity of masticatory muscles increases with ovarian hormone fluctuations.² In 60% of migraine sufferers, the headache worsens around the premenstrual phase of the menstrual cycle.¹⁸ Fourteen percent of women with migraine experience headache only with the menses.¹⁸ Most women see changes in their headache frequency at puberty and menopause.¹⁹ These numbers provide an obvious relationship between estrogen and chronic pain. Some 86% of female chronic pain sufferers in a Swedish study were found to clench or grind their teeth.⁹ Tension headache also has a female predominance with 46% of females having frequent tension headache compare to males at 38%.¹⁰Nearly all the chronic pain syndromes, such as chronic fatigue syndrome, fibromyalgia,¹¹ and certain malignancies, have a female predominance.¹² Migraines affect 18% of females while only 6% of males.¹³ Menstrual migraine is reportedly associated with estrogen fluxes with many of these migraines but typically resolves at menopause.¹⁴
The study of chronic muscle syndromes, such as myofascial pain, jaw joint pathologies,² dysfunction,³ atypical odontalgia,⁴ Meniere’s disease,⁵ Lupus,⁶ burning mouth,⁷ and cervical dysfunction,⁸ all reveal a strong female pre-disposition.
TRAVELL AND SIMONS PAIN PATTERNS FOR HEAL MANUAL
Travell, Simons, & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual has been hailed as the definitive reference on myofascial pain and locating trigger points. All the upper and lower extremity pain patterns and their corresponding trigger points are clearly illustrated on two convenient wall charts, ideal for patient education.
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