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Have you ever wondered why a simple ponytail, a soft brush, or even your pillow touching
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your scalp can suddenly feel unbearable during a migraine?
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Welcome to Migraine Heroes, a podcast for people living with chronic migraines with years of pain,
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misunderstanding and lack of answers. I'm Diane Ducarme. I've helped more than a thousand
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people reduce the burden of migraines and feel more in control. My mission in life? To help a
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million people. Each episode brings you grounded insight into what your body might be asking for
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and what can truly help. Just to keep you fully supported, this podcast is educational. For
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diagnosis or medication, always work with your doctor. Now, take a breath and let's dive in.
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In this episode, you will learn why your scalp can become so sensitive that brushing your hair
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feels like too much, how migraine can turn normal touch into pain through a process called central
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sensitization. One simple, gentle thing you can do today at home to calm your nervous system
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and reduce scalp overwhelm. Stay with me till the end because at the end of this episode, you
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will have a simple scalp soothing ritual you can try today, especially those days when your hair
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itself feels heavy. So first, let us name the experience. When a ponytail hurts, when brushing
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your hair feels sharp or exhausting, when the skin on your scalp feels bruised even though nothing
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happened, this is not being dramatic. This is not just stress and it's definitely not
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your imagination. Many people with migraine describe exactly this. The scalp becomes tender,
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the root of the hair feel painful, and ordinary touch can feel just too intense. Your friends
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or loved ones may feel you're crazy. But today, I'm here to tell you, you are not. Clinically,
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it has a name. It fits under a phenomenon called cutaneous allodynia. Cutaneous comes from the
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Latin word cutis, which means skin. So when we say cutaneous, we're talking about something that
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happens on or through the skin. Allodynia comes from two Greek words, allo, which means other, and
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odynia, which means pain. So allodynia literally means a different kind of pain or pain that comes from
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something that should not normally hurt. So cutaneous allodynia means pain felt on the skin
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for something that should normally feel harmless. In migraine, scalp pain is often a sign that the
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pain system has become amplified. So think of the nervous system like a smoke alarm. A healthy smoke
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alarm alerts you when there's fire. But in migraine, the alarm can become sensitive and it goes off
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when someone makes a toast. The brush itself is not dangerous. The ponytail is not dangerous.
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The pillow is not dangerous. But your nervous system may be interpreting those sensations
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as threat signals or just put you over your threshold. One of the most important scientific
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explanations for this is central sensitization. So this means that the brain and the spinal cord
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pathways that process pain become more reactive than usual. In migraine, it's often involving the
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trigeminal system, which is the major nerve network that carries sensation from the face, head, scalp,
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blood vessels and meninges, the protective layers around the brain. And when a migraine attack builds,
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repeated pain signaling can make neurons in the system more excitable. And over time, a normal
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touch signal from the scalp can be processed as pain. And I think it's quite reassuring to hear
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that it has an explanation that, of course, you know it's in your head, you feel it, right? But people
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around you can't relate to that type of pain and can't relate to the experience. And so it's nice
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to actually know where it comes from. So it's a connection that was described in a landmark study
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in Annals of Neurology in 2000, so a while ago already. And the authors found that many people
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with migraine developed cutaneous helodynia during attacks, sometimes only the painful
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side of the head and sometimes spreading beyond it. And they concluded that this pointed to hyperexcitability
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in a central pain pathway connected to intrafranial sensation. This is why
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scalp pain can feel so strange. The hair itself does not have nerves, but the skin around the hair
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follicles does. The scalp is richly innervated, meaning it has many nerve endings. And when a
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ponytail hurts on the hair, it tugs on those follicles and the surrounding skin. So on a
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normal day, this may feel like pressure. But during migraine sensitization, that same pressure may feel
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like burning, bruising, stabbing or deep soreness. The research also suggests that this is not rare.
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A large population study in the journal Neurology in 2008, so a bit more recent this one,
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studied headache sufferers using the validated helodynia symptom checklist. And the study found
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that cutaneous helodynia varied by headache type and was strongly connected with headache
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diagnosis, frequency, severity and disability. In other words, that scalp sensitivity is not
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a random side note. It can be part of the migraine pattern itself. And when I say that for you, of
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course, you know this is part of it, right? Part of your migraine attack. But it's nice that it's
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sort of confirmed with the science on a large scale and that you feel less isolated, less alone,
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in that quite unusual symptom. Another key point is that cutaneous helodynia often becomes more
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noticeable as an attack progresses. There's a paper published in the journal Brain and the
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author studied how helodynia develops during a migraine attack and measured pain threshold over
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time. And so the finding was important because it supported the idea that helodynia can emerge
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as the migraine attack becomes more fully developed. This helps explain why you may be
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fine in the morning but by afternoon your ponytail suddenly feels impossible. Now let's go deeper.
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Why would migraine create pain in the scalp when the problem is neurological? Well because migraine
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is not a headache. Migraine is a whole brain and a whole body sensory processing condition. And so
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during an attack the brain can become hypersensitive to light, to sounds, to smell, to
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movements, to temperature, to pressure, to barometric pressure and to touch. And that is why sunglasses
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or silence or a dark room and loose clothing can feel sometimes necessary. The scalp is simply
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one of the places where the sensory overload becomes visible, palpable. This is why many people
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say I cannot wash my hair today or I cannot tolerate my hair touching my neck or I had to
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take my hair down because the ponytail was making my migraine so much worse. They're not superficial
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complaints and by the way sometimes those are not made out loud, right? But they are clues and this
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is your body telling you the system is overloaded, the threshold is low and protection is needed.
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And there are also some important patterns to notice. Scalp pain may happen on one side
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especially the side where the migraine pain is the strongest. It may spread across the whole scalp.
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It may be worst with tight hairstyle like hats or helmets, hair clips, glasses or headphones or
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lying on one side. It may appear before the migraine during the attack or when the body
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still feels tender and sort of sore and depleted. Some people experience it as part of the migraine
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postdrome, that migraine hangover period where the head pain may feel much better but the nervous
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system is still recovering. And here's something empowering. Scalp pain can become a signal. It can
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tell you that your migraine threshold is dropping. It's maybe your early warning sign that your
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nervous system needs less stimulation, more hydration, food, rest, warmth, darkness. By the way,
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on the hydration, more hydration, some people would tell me yeah and I cannot hydrate more than I do.
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In the app, this corresponds to a lack of vital fluids or vital fluid depletion. Hydration is not
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it. I agree. Drinking water is important in sort of normal amounts but doesn't solve that issue.
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Anyway, topic for another podcast. So instead of seeing scalp pain as a weird symptom,
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you can begin seeing it as a message. My sensory system needs support right now. So that's how
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you'd see it in the West. In the East, you'd see it slightly, slightly differently. So then let's go East.
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From a traditional Chinese medicine perspective, scalp pain during migraine can be viewed through
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the movement of Qi, so of energy and blood, and the pathways of the meridians. And the head
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is considered the meeting place of many of the yang channels. This means that what happens in
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the head is often connected to movement, heat, tension, rising energy, and circulation. And in
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this view, pain is often described through a simple principle. Where there is free flow, there is no
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pain. And when there is blockage, there is pain. And so when the scalp feels tight, tender, or
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painful to touch, traditional Chinese medicine may interpret this as impaired flow in the channels
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that travel across the head. And so the ponytail is of course not the root problem. The brush is of
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course not the root problem. But these are things that revealed the deeper root. Migraine with scalp
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tenderness may be associated, depending on the person, with patterns such as what is called
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liver fire, or liver yang rising. And I really want to make this practical. What does that mean?
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When traditional Chinese medicine speaks of liver yang rising, it often refers to energy moving
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upward too strongly. So in everyday language, this may look like pressure rising to the head,
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irritability, heat, tight neck and shoulders, red eyes, dizziness, or throwing pain. And the scalp
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may feel too reactive because the upper body is already in a state of pressure and intensity.
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And so inside your Migraine Heroes app, this is what we refer to as state of tension and
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overload. I don't know if you've seen this. And that's how we decided to call it. The reason why
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we wrote that is because liver in Chinese does not mean liver. And sometimes I might have someone
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tell me, oh, but according to my blood test, my liver function is not great, but it's still in
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range. So in Chinese, liver, which is called gan, does not mean liver. It means the liver system,
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and so therefore all of the organs which are part of that given system, for example, your
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gallbladder, all of your female hormones, your breast, your uterus, just to name a few. And so
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the liver meridian finishes at the top of the brain, hence the scalp pain. So some people are
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going to have scalp pain. Some people are going to have top of the head migraine. The people who
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have the scalp pain will tend to have also the top of the head migraine. Now, the reason why I'm
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writing this podcast is because last week I had a call with a woman. She had found our app through
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the podcast and she's based in Ireland. She recognized me speaking and we were having a call
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and she mentioned how much pain her scalp was in. And so that pushed me to write this one. I thought,
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oh, what a great one. I've never done it before. And as I wrote the podcast, I just sent her a few
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words of encouragement, encouraged her to double down on her actions to take that pain away.
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And it may seem insignificant, but this is her life. It's her comfort. And you know what? Also,
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I find her sanity because her pain is downplayed. It's downplayed by so many people that are super
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well-intended, but really not understanding what she's going through and what she's talking about.
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So even though you may feel super isolated, you're not alone. So now Ayurveda might describe a
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similar experience through the lens of Vata aggravation, where the nervous system becomes
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dry, mobile, irregular, hypersensitive. And when Vata is high, light touch may feel irritating.
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Sleep may become fragile. Digestion may become irregular, and the mind may feel restless. And a
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painful scalp from this perspective is not isolated. It's part of a wider state of nervous
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system agitation. Again, that state of tension and overload we refer to inside the eye.
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Now, what I love about Eastern medicine is that it asks a different kind of question. Western
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science says, which pathway is sensitized? And Eastern medicine asks, why has the body lost its
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sense of smooth flow? And both questions matter. One gives us precision. The other one gives us
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relationship. So what can you do today at home? Today, I would like you to try something simple.
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A warm foot soak, or feet soak, I should say. You place your feet in warm water for 5 to 10
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minutes. Not boiling, not intense, just comfortably warm. From a traditional Chinese
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medicine perspective, this is a way of inviting the body's energy to move downward, away from the
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crowded, painful, oversensitized head, back into the lower body. From a nervous system perspective,
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it also gives your brain a different signal to pay attention to, warmth, grounding, safety.
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You're not forcing the margain to disappear. You're gently changing the conversation inside
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the body, from everything is happening in my head, to I can come back down into my feet.
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Now, I want to be mindful. I'm in New Zealand, this is winter, so it's my foot bath season.
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You're most likely in summer, as you listen to me. So maybe just putting, you know, walking in
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wet grass in the morning might do it a better job right now. So just things that attract your
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sensations in your feet, that your brain has to process things in your feet and then send a lot
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of energy in your feet. Another way is just to think about your feet. Just try to attract the
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attention, or have a foot massage. And remember, every small step you take moves you closer to
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freedom. You are powerful, you are resilient, and you are not alone. Keep rising, margain hero.
