Bloomington / Normal, IL

Working with the community... for a healthier community.

Troubleshooting Migraines—Eliminating Triggers—Part 2


By Alexander Germanis

Whether firing a gun or using a squirt bottle of kitchen cleanser, neither object will perform its action without a squeeze of the trigger. It is the trigger that sets off the next action. Indeed, any initial act or object that sets off a series of actions is called a trigger.

But perhaps the most common association of the word ‘trigger’ is with some type of explosion—literal or figurative.

Migraine sufferers understand that explosive association extremely well. The pain brought on by a migraine can be blinding, nauseating, and debilitating. It is no wonder why those who deal with migraines often look for any means to ameliorate the agony. But what pain specialists like Dr. Ramsin Benyamin, founder of Millennium Pain Center in Bloomington, suggest should not come as a surprise.

Seeing a pain specialist or neurologist as soon as migraines occur may seem like a logical first step to some people, but Dr. Benyamin explains the best first step is finding the root cause of the problem. “When I first examine a patient with migraines,” he says, “I look to see if there are any triggers that may be causing the pain.”

Unfortunately, there is a veritable laundry list of migraine triggers. While stress, bright lights, loud noises, hormonal imbalances and strong smells such as perfume are fairly well known culprits, there are some lesser known triggers as well.

Certain foods or food additives can catapult one from feeling fine to feeling like one’s head is in a vice within minutes. Cheese is a surprisingly powerful trigger, as is wine, beer, hot dogs, and cured meats such as sausages. Most can contain a substance similar to epinephrine called ty-ramine. While it is still not completely understood, it is believed tyramine can raise the blood pressure and possibly even alter the brain chemistry, bringing on migraines.

And there are many more triggers to follow. Something many people may not want to hear is that chocolate can be a strong migraine-starter. Artificial sweeteners such as aspartame and flavor enhancers like monosodium glutamate are also guilty producers of pain. Lack of sleep, too much sleep, too much caffeine, hunger, dehydration, and intense physical activity are also triggers for some people.

Even mother nature can be an enemy when it comes to fighting these horrific headaches. These triggers are, of course, impossible to avoid, but they can be predicted. While none of these things have been conclusively proven or even understood, there is mounting evidence that certain aspects of the weather can carry ill portents for migraine sufferers. A change in barometric pressure, the arrival of a full moon, and even lightning have all been linked to the onset of pain.

Documenting and keeping a record of migraines can be an aid in determining which triggers are the ones to avoid. Knowing what days they occur, what time of the day, how quickly their onset, what the weather was like, what was eaten, etc., can help to rapidly narrow down those migraine causing triggers and give a person better control over the pain.

Of course some people still get headaches even when there is no apparent trigger. Dr. Benyamin applies the concept of troubleshooting to these cases. “You want to make sure there are no structural problems,” he points out. “Make sure the sinuses, ears, or eyes are not contributing. These are all things you need to rule out before you can call it a migraine. You want to make sure these are not contributing—either directly or acting as a trigger.”

“Then you look at imaging,” he continues. “You want to make sure there are, for example, no degenerative changes in the cervical spine, especially in the upper cervical spine. If you have de-generation there, it potentially can contribute to headaches. It can either do it by itself or act like a trigger for migraines.”

In the end, once the diagnosis of migraine is reached, Dr. Benyamin subscribes to Benjamin Franklin’s advice: prevention. “The best thing you can do,” he states simply, “is find the triggers and eliminate them.”

To learn more about how pain doctors combat and prevent migraines, read “Troubleshooting Migraines, Part 3” in next month’s issue of Healthy Cells Magazine.

For more information or to schedule an appointment, contact Millennium Pain Center at 309-662-4321 or The office is located at 1015 S. Mercer Ave. in Bloomington. The practice provides the most advanced and compre-hensive pain management for a wide variety of conditions, including a new treatment for knee osteoarthritis. Drs. Benyamin and Vallejo have been selected among 70 of the Best Pain Physicians in America.