MIGRAINE is common in FIBROMYALGIA: THE ETIOLOGY is readily explained. Let me explain:
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Hypermobility is a tissue variation found in about 15% of women. The connective tissue laxity impacts flexibility to body parts and especially to the pelvis, thereby providing for easier childbirth.
A common concomitant of greater ligament flexibility is a functional scoliosis. The vertebral disks are ligaments that connect the vertebral bones. The spines of hyper-mobile women are often scoliotic when these women are upright, but straight when reclined. The reason is ….
The upper body tower above the waist is supported by the vertebral spine. This body tower has weight & this weight is supported by the spine, which commonly assumes an S-shaped or reverse S-shaped scoliosis when the host is upright.
The upper scoliosis curve meets shoulder girdles at other than a true vertical orientation; commonly imparting tilt to the shoulder girdles, with one lower. Clinicians interested in this phenomenon merely need to observe hyper-mobile women upright & relaxed to observe this.
The scoliosis curve and one lower shoulder is commonly a constant pattern of the same curve & the same lower shoulder from one examination session to another. Often times the same unilateral lower shoulder can be seen in the patient’s drivers license photo.
As result of a chronically slightly lower shoulder on one side, there is often an associated slight tilt of the head toward the lower shoulder side. This tilted head posture can also often be seen in the driver’s license photo.
A chronically slightly tilted head can have consequences. Head weighs about 10-11 pounds & is supported by the Superior trapezium muscles. The Superior trapezius muscle on side of the higher shoulder is usually hypertrophic from supporting the head tilted toward lower shoulder.
The clinician can easily detect asymmetry, tone, & muscle mass of the 2 Superior trapezius muscles by grasping the anterior leading edge of each muscle and comparing them. The girth of the anterior leading edge is usually greater on the side where the shoulder is higher.
When a muscle is chronically spastic it tends to impinge nerve tracks that travel through it after exiting the spine. Nerves that service the scalp often pass through the Superior trapezium after exiting the spinal cord.
People with Fibromyalgia often have scoliosis, slightly tilted heads, & attendant hyperdynamic function, hypertrophy, & chronic muscle spasm of the Superior trapezius muscle associated with the higher shoulder.
The chronically spastic Superior trapezius muscle associated with a slightly tilted head causes chronic cervicalgia in some patients &/or chronic muscle tension headaches. The muscle spasm also pinches nerve tracks that traverse the muscle.
Persons with chronic muscle tension headaches oft have intermittent & frequent migraines; an association suggesting a common etiology. It might be theorized that chronic muscle tension headaches evoke migraine by a neural feedback loop involving the cerebral arterial nerves.
Perhaps chronically constricted arterioles that inhabit spastic cervical muscles alert the brain that blood flow is being impinged; causing brain arterioles to reflexly dilate and lead to the vascular phenomena of migraines.
Amongst woman with Hypermobility and migraines there is common occurrence of migraines during or around the time of menses. This is the same time during which pelvic glands secrete Relaxin, a hormone that cause connective tissues to be more flexible.
Perhaps the scoliosis, asymmetric shoulder girdles, tilted head, & Superior trapezius muscle spasms that accompany Hypermobility becomes greater during this time of Relaxin secretion; culminating in the migraine phenomena.
The clinical observations and theories in this essay are novel findings & speculations of the author & should not be regarded to be recounts of reports found in the medical literature. In my next essay, I will discuss the relationship of Hypermobility & Fibromyalgia. THE END
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