Category: Wellbeing

When you’ve got a headache that just won’t go away, what’s your go-to fix? If you’ve been diagnosed with migraines and throw out a Facebook query to your family and friends, pressure points for migraines are sure to come up.
But let’s face it … the majority of migraine remedy suggestions tend to fall into two camps: old wives’ tales and science-backed options that you really need to follow up on. So can figuring out pressure points for migraines really help?
Here’s the good news: There’s actual science behind the idea that manipulating pressure points or trigger points can help manage your migraines. In America, 28 million people over the age of 12 suffer from migraines, and studies have been launched to find everything from nausea relief to pain relief.
Although you may be able to find some relief at home using pressure points on your body, trying to use them without proper knowledge could just irritate your muscles. So what do you need to know about pressure points before you start poking around?

What causes migraines?

Before you start digging in, you need to know what you’re working with.
The word migraine gets thrown around a lot, but from a medical perspective, the National Library of Medicine defines a migraine as a type of headache that typically occurs with other symptoms such as nausea, vomiting, or sensitivity to light and sound. A throbbing pain is felt on only one side of the head in typical cases.
“It is not uncommon for some people to concentrate stress in one part of the body,” explains Nada Milosavljevic, MD, a physician and faculty member at Harvard Medical School and founder of Sage Tonic. “One typical area is the head, and the symptom is the all-too-familiar headache. For some people, headaches are easily triggered and recurring, causing distraction, irritability, and the tendency to rely on medications to feel normal. For others, intermittent migraines can drive them to distraction, blocking out other activities for several hours or even whole days.”
Treatments for migraines vary from daily medications to pharmaceuticals that can be taken orally when someone senses the headache coming on.
But pills aren’t the only options out there. More natural remedies can be helpful for some patients, Milosavljevic says.
“Behavioral, stress reduction, and integrative therapies like acupressure, biofeedback, CBT (cognitive behavioral therapy), and physical therapy can be beneficial,” she notes.
One of the most popular of those natural remedies is pressure point massage, sometimes known as pressure point manipulation or acupressure.

Pressure Points for Migraines

This form of massage treatment focuses on myofascial trigger points in the muscles, says Michele Macomber, a certified myofascial trigger point therapist at Pain Free Maryland.
“Myofascial trigger points form in muscles that have become too tight, are injured, or are in spasm,” Macomber explains. “There can be any number of them in any individual person, depending on the events of their life. Trigger points can form at birth, every time a child gets a bump, any time an adult gets a repetitive strain injury or has an accident, any time someone spends countless work hours in a posture of poor ergonomics.”
“A migraine sufferer may need medication, changes in habits or foods, and to avoid perfumes, smoke, and chemicals as well, but the tension aspect of the headache, whether true migraine or not, is easily and effectively treated with myofascial trigger point therapy and stretch,” she adds.
That usually means calling someone like Macomber to help relieve those tight muscles causing a headache. Medical practitioners have developed cold lasers, for example, a relatively painless procedure that can be used only in a medical setting to tackle pressure points and relieve migraine symptoms. There are also compression techniques that can be done in an office setting to quiet the muscle pain that can lead to a migraine.
Sometimes a practitioner will use a needle in the spot (think acupuncture) or compression via massage, putting pressure on the pressure point, which triggers the body to send blood to that area and signals the body to release the pain. The goal is to eventually signal the body to relax the pressure point, creating relief for both the muscles and the headaches.

Pressure Point Treatment at Home

But that doesn’t mean you can’t get some migraine relief at home using pressure points.
With some 400 acupressure or trigger points in the body, there are spots that may supply relief if you can find them.
“With a bit of practice and some initial guidance, a migraine sufferer can readily stimulate acupressure points on their own,” Milosavljevic says, “especially those on the face and arms, which allow for easy access.”
In addition to providing migraine relief, pressure point massage can help relieve the stress associated with a migraine attack. Milosavljevic recommends these two to get you started:

LI 4

This trigger point is located on the top side of the hand in the web between thumb and index finger. “To find the point, squeeze the thumb against the base of the index finger,” Milosavljevic says. “The point is located on the highest point of the bulge (fleshy prominence) of the muscle, level with the end of the crease.”

Yintang

Sometimes called the “third eye point,” this trigger point is located on the face. You can find it midway between the medial ends of your eyebrows, right in the center of your forehead.
To get relief from at-home manipulation of the pressure points for your migraines, William Charschan, a chiropractor and owner of Charschan Chiropractic and Sports Injury Associates in North Brunswick, New Jersey, suggests pushing firmly on the pressure point for about a minute, using the index finger or index and middle fingers together.
The pain should slowly ebb, but the pressure can be repeated as needed. The amount of pressure you exert on the trigger point is up to you, although the feeling should be a “good hurt” rather than an excruciating pain. If it’s the latter, stop!
If pressure point massage alone doesn’t work, Macomber suggests incorporating heat and stretching.
“These are not a sufficient substitute for treatment, but until and after they get treatment, stretches may help reduce tension and pain,” she explains, but she quickly adds one note of warning. “Stretching far enough to feel pain makes muscles reflexively tighten up and can exacerbate the problem.”
To avoid this, don’t stretch if it is painful, and never stretch as far as the joint will allow.
“You should feel a comfortable, pleasant stretchy feeling, but never an extreme stretch sensation or pain,” Macomber says. Heat can also be added via a heating pad placed directly on the neck, shoulders, or other pressure points to soothe the irritated muscles.

Post-Pressure Procedure

It’s important to follow up with your physician, even if at-home treatment alleviates the migraine pain. “The problem with treatment is that without understanding or relieving the common triggers, migraines will continue to occur and may be frequent,” Charschan says. “Also, there is often a genetic link to those who get migraines, which may be linked to body style.”
“We not only look like our parents but walk like them and hold ourselves like them,” Charschan continues. “In other words, our mechanical signatures are often quite similar.”
For example, you may have your dad’s feet, which predispose you to back issues or asymmetrical body mechanics that create stress, which pulls on one side of the neck. That can be a migraine trigger and is often a main reason that patients who receive chiropractic treatment for migraines see improvement,” Charschan sys.
“Medically, they look at the mechanism of the migraine and treat it with medicine but ignore the mechanical causes which can often be eliminated or improved with chiropractic manipulation and soft tissue treatment,” he says.
The good news? Regardless of the cause of migraines, science points to the possibility of long-term relief with the help of appropriate treatment.
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Sudden weight gain. Three words few people want to hear. And yet, there you are. You’ve stepped on the scale, and seemingly out of nowhere, your weight has skyrocketed.
If you haven’t eaten a Thanksgiving-sized meal or recently found out you’re pregnant, a sudden weight gain can send you into a tailspin, wondering exactly what the heck is going on with your body. Are you getting sick? Is your thyroid acting up? Is it cancer? Or are you absolutely fine and just need to refocus on your fitness?
That depends on how much weight you’ve gained and how fast, says Susan Besser, MD, a primary care physician with Overlea Personal Physicians and a physician certified in treatment of obesity through the American Board of Obesity Medicine. Most of us gain a few pounds every now and then, whether it’s because we’ve been spending a lot more time sitting or we’ve been under the weather.
Weight gain isn’t typically a problem unless it’s sudden, Besser says, but even then, a pound or two is considered well within the range of normal.
It’s when you’ve gained at least 10 pounds in as little as a week that Besser says she starts to get concerned. She’s quick to point out that it’s not just the weight gain itself but other symptoms that tend to coincide with sudden weight gain, such as obvious swelling of the legs, sudden shortness of breath, or chest pain.
“These things all suggest a systemic illness,” Besser explains. “Alternatively, many chronic health problems don’t cause sudden weight gain but slow, steady unexplained gain.”
If you’ve had sudden weight gain like the type Besser has described, here’s what the experts say could be going on (and what to do about it).

Causes of Sudden Weight Gain

Medicine

If you’ve had a change in medicine recently, and your weight has increased suddenly, a call to your pharmacist might be in order.
There are a range of drugs that can cause varying degrees of weight gain, says Julie Cantrell, MD, lead physician at OhioHealth Medical Weight Management. Some may cause sudden weight gain, while some may cause the body to pack on weight more slowly, albeit still significantly.
One of the worst offenders is prednisone, a steroid used to fight inflammation in patients with everything from asthma to lupus to psoriasis. Known for giving patients a “moon face” because of swelling, prednisone and similar steroids cause both fluid retention and an increased appetite, Cantrell says. Together, these symptoms can cause the numbers on the scale to climb, and for folks who have a chronic disease that requires extended steroid usage, weight management can be a significant challenge.
Antidepressants make the list too, in large part because they affect many of the different hunger hormones, Cantrell says. In particular, Paxil is known for its effect on hunger and resulting weight gain.
Other drugs that can cause a fluctuation in weight include anticonvulsants, beta blockers, diabetes medications, antipsychotics, and heart medications, although Cantrell notes that typically gains are slow rather than sudden.

Heart and/or Kidney Disease

The medications used to treat heart disease aren’t the only trigger of weight gain. Heart disease itself, along with kidney disease, can also cause a spike when you step on the scale.
That’s because congestive heart failure and renal failure both result in “significant water retention,” Besser says.
If you don’t have a medication to blame, and you’ve noted sudden weight gain, the risk of heart or kidney disease is a reason to call your doctor ASAP.
“Increased weight due to heart or kidney disease could be life threatening,” Besser warns, not because of the weight itself but because of the underlying disease.

Thyroid

When patients show up in Cantrell’s office complaining of weight gain, they often hope it’s a malfunctioning thyroid, she says, “because then we can fix it!”
Some 12 percent of Americans will develop a thyroid disorder during their lifetime, according to the American Thyroid Association, but up to 60 percent of Americans with a malfunctioning thyroid never know it.
For those who have hypothyroidism, meaning the thyroid gland is not producing enough hormones, weight gain can be a problem, along with fatigue, depression, and forgetfulness.
“The thyroid is like the body’s gas pedal, determining how many calories we burn at rest,” explains Jacob Teitelbaum, MD, author of the Beat Sugar Addiction NOW! series. “For most of us, that plays a much larger effect than exercise on weight.”
Treatment of hypothyroidism with synthetic hormones will typically help reverse weight gain.

Cushing’s Disease

Although it’s considered a rare condition, Cushing’s disease, or Cushing’s syndrome, can sometimes be the culprit of sudden weight gain. Most common in adults aged anywhere from 20 to 50, Cushing’s is an illness that results in excessive levels of cortisol, an adrenal stress hormone.
“This triggers insulin resistance and marked fat deposition,” Teitelbaum explains. That means fat won’t be spread evenly across the body; instead it’s often deposited in spots on the upper body such as around the neck, while legs and arms may remain thin.
Treatment for Cushing’s disease is dependent on the cause, as some cases of the condition are familial (meaning it was passed down through your genes), while others can actually be caused by medications such as the steroids described earlier.

Cancer

It may be a major fear for most of us when we note body changes, but this is one that can typically be written off when it comes to a sudden weight gain, says Avram Abramowitz, MD, a board-certified oncologist and hematologist with Queens Medical Associates.
Typically, cancer will cause weight loss rather than weight gain.
“The way cancer works is that tumors produce their own chemistry, which interferes with the body’s ability to use the nutrition intake. Whether people eat a lot or a little, well or poorly, is almost irrelevant when cancer takes over the body,” Abramowitz notes. “Their ability to use nutrients is subsumed by the behavior of the cancer.”
The only time cancer may cause weight gain, he adds, is at the end stage. Called ascites, this weight gain is actually a filling of the body with fluid, but other symptoms are apparent long before this point.

Pregnancy Complications

Most women gain steady weight while pregnant, and according to Nancy P. Rahnama, MD, a bariatric physician, as long as the weight gain isn’t sudden, it’s normal.
“General progression of weight gain will vary, but an average of four pounds a month is considered normal as long as the mother stays within the appropriate range,” Rahnama says.
It’s when you see sudden weight gain that you should have a talk with your doctor or midwife.  
“Any more weight gain may be suggestive of gestational diabetes, which can be detrimental to the baby and the mother,” Rahnama says.
Preeclampsia, HELLP syndrome, and other hypertensive disorders that are singular to pregnancy can also cause sudden weight gain in much the same way that kidney and heart disease can cause a weight spike in a non-pregnant woman. According to the Preeclampsia Foundation, “Damaged blood vessels allow more water to leak into and stay in your body’s tissue and not to pass through the kidneys to be excreted.”

Mental Health Issues

Although typically people suffering from depression or a binge eating disorder see slow weight gain rather than sudden weight gain, as lack of energy and increased appetite cause the body to build fat, stepping on the scale and seeing a big jump can be a sign of a mental health issue.
Sometimes, Cantrell says, the weight gain was gradual but seems sudden because “we put our heads in the sand.”

When to Call the Doctor

Whatever may be to blame for sudden weight gain, doctors advise against self-diagnosing in favor of a call to your physician.
“Inappropriate weight gain without an obvious cause that is consecutive should be evaluated,” Rahnama stresses. “When this weight gain is associated with other symptoms, such as fatigue, depression, hair loss, change in skin texture, or a lack of menstruation, the evaluation should be done sooner than later.”

When Amanda LaFleur quotes the PMDD statistics for America, she quickly adds an asterisk.
The medical community estimates 3 to 8 percent of cisgender women of reproductive age have premenstrual dysphoric disorder (PMDD). But that figure may be a wild underestimation of the number of cisgender women, transgender men, and non-binary folks who do battle with the condition every month, says LaFleur, who is the co-founder and executive director of the Gia Allemand Foundation, a non-profit focused on reducing the stigma and raising awareness of reproductive mood disorders, suicidality, and depression.
The foundation is named for Gia Allemand, an actress whose death by suicide rocked the country, her family, and her friends in 2013. Allemand had been diagnosed with PMDD before her death, putting her in that 3 to 8 percent. But PMDD is a condition that many folks don’t realize exists at all, and misdiagnosis is rampant, LaFleur says.
So what is PMDD? And why is it so hard for those who have it to find help? We asked the experts to shed a little light on the mental health condition and how to get treatment if you need it.

What is PMDD?

Most people have heard of PMS or premenstrual syndrome, the symptoms that crop up anywhere from a week to a few days before your period starts. You may feel bloated, have cramps, and even have some mood swings.
PMDD is not PMS. At least not exactly.
Someone with premenstrual dysphoric disorder may have some of those symptoms, and they will show up in the week prior to menses, but PMDD is both more severe and more debilitating, says Cindy Basinski, MD, an OB-GYN from Newburgh, Indiana.
“The symptoms experienced are more severe in PMDD as they affect the ability of a woman to perform normal daily activities,” Basinski explains. And while as many as 80 percent of women experience PMS on a regular basis, PMDD is considerably more rare.  
What sets the two apart?
PMDD is characterized by five or more of the following symptoms, says Nicole B. Washington, DO, a board-certified psychiatrist from Broken Arrow, Oklahoma, and chief medical officer at Elocin Psychiatric Services:

• Mood swings
• Sudden sadness
• Increased sensitivity to rejection
• Anger or irritability
• Depressed mood
• Sense of hopelessness
• Self-critical thoughts
• Tension
• Anxiety or feeling on edge
• Impaired concentration
• Change in appetite or food cravings
• Decreased interest in usual activities
• Low energy
• Feeling out of control
• Breast tenderness
• Bloating
• Aching joints or muscles
• Impaired sleep

The symptoms typically disappear as soon as the period starts or within a day or two of the first sign of blood—only to return again a month later.
Exactly why PMDD happens to some people and not others isn’t fully understood in the medical community, although Washington says it’s thought to be triggered by changes in sex hormones during what is known as the luteal phase of the menstrual cycle.
“This only occurs in susceptible women, but what we don’t really know is what makes one woman susceptible over another,” Washington says.
That’s not for lack of trying by scientists. The more awareness there is of PMDD, the more researchers are trying to suss out what happens to patients in the days and weeks before their period. A National Institutes of Health (NIH) study released in 2017 seems to have keyed in on one of the major components: a hormone susceptibility that only PMDD sufferers have. The scientists said their findings indicate molecular differences detectable in the cells of those with PMDD.
“We found dysregulated expression in a suspect gene complex, which adds to evidence that PMDD is a disorder of cellular response to estrogen and progesterone,” Peter Schmidt, MD, of the NIH’s Behavioral Endocrinology Branch, said in an NIH press release. “Learning more about the role of this gene complex holds hope for improved treatment of such prevalent reproductive endocrine-related mood disorders.”

Getting a PMDD Diagnosis

The path to diagnosis should be simple enough. PMDD is in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), the official guide of the American Psychiatric Association.
But Washington says the frequency of misdiagnosis comes down to issues on both the patient’s and the provider’s part.
“[The patient] may not be thinking that happens around that time of the month,” Washington says, “And the provider may not think to ask.”
In part, LaFleur blames this on a profound lack of understanding of how PMDD differs from PMS. People who struggle in the run-up to their menstrual cycle often doubt themselves, she says, even blaming themselves for not being able to pull themselves up by their bootstraps and muddle through a time of the month that’s hard on just about every person in their shoes.
“So many go through life thinking, ‘Oh, everyone goes through PMS, I’m just being dramatic’,” LaFleur says. In reality, a PMDD sufferer isn’t “just” going through PMS. While timing is the same, the symptoms are far more troublesome. That’s one of the cornerstones of PMDD itself: Symptoms have to interfere with life in order for the diagnosis to be made.
But the condition isn’t talked about very often—not nearly as much as PMS, which most Americans have heard of.
“It has the double stigma of the female problem of menstruation, which isn’t talked about because people think ‘ew, icky, blood, we don’t want to talk about that,’ and then you have the stigma of mental health on top of it,” LaFleur says of PMDD.
Even within the medical community, PMDD patients face stigma. As recently as 2002, the American Psychological Association ran an article in which some psychiatrists and psychologists said PMDD should not be classified as a mental illness at all.
Add to that the fact that some PMDD symptoms can crop up with other mental illnesses, and it’s no wonder there are misdiagnoses, Washington says.
In particular, LaFleur sees a number of patients who say they were first diagnosed with either borderline personality disorder or bipolar disorder before it was finally ascertained that they were experiencing PMDD.
Why?
According to Washington, borderline personality disorder is characterized by mood swings and extreme reactivity. Both are traits that crop up in PMDD sufferers. The difference? Personality disorders are what the medical community calls pervasive, meaning they are there all the time, rather than showing up only cyclically, as PMDD does.
Similarly, bipolar disorder is characterized by extreme mood changes that limit daily functioning—a symptom that can crop up with PMDD—but bipolar disorder is not related to the menstrual cycle.
Narrowing down the correct diagnosis can take time. Patients often don’t even recognize the tie to their menstrual cycle or have repressed it because of the fear that they’re blowing “normal” PMS out of proportion.
Washington says she encourages her patients to begin keeping a diary with their symptoms over a course of several months. She asks them to include important dates, especially the start and end of their periods, so she can see if there’s a link between the mental health component and a patient’s menstrual cycle.
Getting a patient the right diagnosis is crucial for myriad reasons.
First, treating someone for the wrong condition means putting them through unnecessary treatments, Washington says. The medicines used to treat bipolar disorder and borderline personality disorder are different from those used for PMDD, and getting the appropriate treatment right away spares someone having to deal with taking the wrong medication.
What’s more, getting the right treatment can help someone get their life back on track.
The Gia Allemand Foundation estimates that 15 percent of PMDD sufferers will attempt suicide, a shockingly high number that can be lowered by treatment.
Even for those who don’t face suicidal thoughts, the effects of PMDD can be life altering.
Carol (who has asked for her name to be changed) remembers the day she slapped her son in the face. It was the day before she called her counselor and asked for help.
“He was 3, and I thought he was trying to manipulate me,” Carol recalls. Now she realizes she was wrong to hit her child and to put that sort of burden on his shoulders, but at the time, she had no name for her feelings or means to control them.
Having one out-of-control moment that serves as a tipping point and sends them seeking help is common for PMDD sufferers.
“I can think of people who have been hospitalized, who have had marital problems, who have lost their jobs because they snapped at work,” Washington says—all this because they were experiencing untreated PMDD.
In Carol’s case, she’d always been susceptible to mood swings related to her hormones, but she says it wasn’t something her mother had ever talked to her about.
“We never really discussed that kind of stuff in my house,” she recalls.
When she went to find help, the counselor at first thought Carol was in a bad place in her marriage. But by the end of their second session, the counselor had pinpointed a problem related to her menstrual cycle.
“She said, ‘OK, now I see what is going on. I would like you to go see this gynecologist. She should be able to help you out,’” Carol recalls. She went to the OB-GYN, who directed her to keep a diary much like Washington’s patients, and then began treatment.

How to Deal With PMDD

In Carol’s case, treatment was a combination of birth control pills (meant to control her cycle to reduce hormonal ebbs and flows) and a prescription for a selective serotonin reuptake inhibitors (SSRIs), a medication typically used to treat depression.
It hasn’t cured her of PMDD, but it has curbed her symptoms immensely.
“My guys are fully aware of my meds, my freakouts, everything,” she says of her sons and husband. “I make sure they understand that it is my issue and overreaction and not them. I always explain how I was out of line. Sometimes I don’t say I am sorry because I don’t want them to feel as if they have to accept my apology. But I explain that my behavior was out of line.”
The medicine has enabled her to live with her PMDD without it massively impacting her life.
For some patients, more conservative PMDD treatments do work and work well, Basinski says; those can include increasing exercise, meditation, reduction of salt and sugar intake, and getting more rest. Some over-the-counter options, such as black cohosh and St. John’s wort, are also available, but data varies on their success in treatment.
For many patients, however, medication is required up until the beginning of menopause. Typically that means birth control in the form of oral contraceptive pills or hormone injections (such as the Depo-Provera shot) to regulate hormone levels, Basinski says, while some may opt for Mirena, an IUD that includes a hormonal component.  
Some doctors may add an SSRI to the mix as well as or instead of the birth control pill. But unlike those taken by depression sufferers, sometimes the SSRI will be given only during the luteal phase of the cycle, says Lisa Valle, DO, an OB-GYN at Providence Saint John’s Health Center in Santa Monica, California.
For some people, like LaFleur, the next step is surgery. She opted for a full oophorectomy and hysterectomy several years ago, allowing doctors to remove much of her reproductive system, including her uterus and ovaries. This stopped her periods and the hormonal shifts that come with a menstrual cycle, ending her fight with PMDD.
It’s a drastic move, and one that LaFleur acknowledges is not appropriate for many people. It puts an end to any chances of carrying a baby and sends the body into menopause early in life.
But ending her own personal battle with PMDD has empowered LaFleur to fight for more cisgender women, transgender men, and non-binary folks in her position.
“I want them to know it’s not about mental strength. It’s not about willpower. You didn’t do anything wrong to have this happen to you,” she says.
And there is help out there. Beyond the treatment options, the Gia Allemand Foundation offers online support through its website, along with symptom trackers and other tools for PMDD sufferers.