Digital Massage
By Stuart Lipton MD. Ph.D.
From the Annals of Neurology Vol. 19, No. 5 May 1986 Prevention of Classic Migraine Headache by Digital Massage of the Superficial Temporal Arteries During Visual Aura.
The Auracol is mostly suited for migraine headaches with aura because the exact moment to begin wearing the device is clearly defined i.e. as soon as the aura phase begins. The aura phase typically lasts for 30 - 45 minutes.
By Stuart A Lipton, Ph.D.
Data were collected on 15 patients suffering from migraine headaches preceded by visual auras. I present here the preliminary report of a method that prevents these incapacitating headaches. The technique consists of vigorous bilateral compression and massage of the frontal branches of the frontal superficial arteries using the second and the third fingers. To be effective, this maneuver must be started at the first sign of the visual aura and continued until the aura has completely subsided. The technique has been successful in blocking 34 out of 42 attacks (81% in 15 patients).
With the massage technique a lasting feeling of malaise occurred rarely after the aura. At times the frontal branches of the superficial temporal artery were compressed so vigorously that the arteries remained tender to further touch for the ensuing hour or two. No other untoward effects were noted. It is most important that the digital massage be performed consistently and not be interrupted during the aura. Once the headache has begun massage does not appear to be as effective in preventing the ensuing increase in the head pain.
Similarly, in attacks of common migraine massage for several minutes at the onset of headache stopped the subsequent increase in pain for only a few patients (3 of 37). As previously reported for some migraine patients compression of the superficial temporal artery during the headache temporarily decreased it, however, improvement of pain with this procedure only occurs during the compression itself.
The mechanism by which digital massage prevents headaches is not clear. In fact the pathogenesis of migraine itself remains controversial. Recent studies have modified our views.
Whatever the mechanism of action of digital massage, it is a technique that can prevent headache of patients with classical migraine. Furthermore this novel method avoids drug therapy and its accompanying side effects. It remains to be determined whether massage only on the side opposite the visual aura is sufficient, or if the technique is effective in migraine patients with non-visual aura's consisting of other sensory or motor symptoms. Also because of the variability in the branches of the external carotid artery, in some patients it is conceivable that it might be necessary to massage the superficial temporal artery in front of the ear rather than the frontal branch near the orbit.
The systematic investigation of these possibilities may lead to new insights into the pathogenesis of classic migraine.
The Longwood Area Neurology Program
Harvard Medical School
Beth Israel and Children's Hospital
Boston, MA.
