Daily Mail

Has salami triggered my agonising migraines?

- DR MARTIN SCURR

QFOR two years I suffered throbbing migraines seven days a week. I went to two top doctors who prescribed tablets and I had 78 Botox injections. Nothing helped.

Earlier this year, I went on a cruise and my headache disappeare­d — but when I returned home, within days it was as bad as ever. I thought I must be doing something I did not do on board and the answer was eating salami. I had a few slices every day for about two years.

I Googled salami and found that processed foods could cause migraines. Is that right? Joy Shaw, by email.

AAs Anyone who experience­s them will know, migraines are more than ‘just’ a bad headache, and having daily migraines for those two years must have been a depressing and troubled time in your life.

Migraine is very common, affecting about 17 per cent of women and 6 per cent of men, but the causes are complex.

We used to think that migraine headaches were triggered when the blood vessels in the brain became dilated. However, it’s now thought the process begins with oversensit­ive nerve cells in the brain causing inflammato­ry changes in painsensit­ive tissues.

As well as a headache, some migraineur­s will have neurologic­al symptoms. These may be visual (for instance, seeing bright lights or shapes), auditory (a ringing or buzzing in the ear), a tingling or burning sensation in the face or limbs, or weakness of the hand or arm on one side. This is known as migraine with aura.

Most people find they have a key trigger for their migraines. In one recent study of nearly 2,000 migraineur­s, 75 per cent reported that they had at least one trigger for their attacks.

eighty per cent of these patients identified emotional stress as a trigger (with the migraine sometimes coming on as the stress lessened, rather than the stress itself triggering it). other common triggers they noted included hormonal changes (in women), missing meals, sleep problems, bright lights, alcohol, heat and exercise.

nitrates, the preservati­ves used in many processed meats, including salami, are a known trigger for migraines in some people.

Although avoiding salami has resulted in you now being migrainefr­ee, do bear in mind that nitrates and other preservati­ves used in salami can be found in other types of food. even a vegetable such as spinach contains nitrates, albeit in lower quantities.

My suggestion is that you consider yourself in remission rather than ‘ cured’: the point is you have an innate migraine tendency and, all too commonly, other triggers may begin to kickstart symptoms at some stage.

so I very much hope that your migraine experience remains in remission, but don’t be surprised if it comes back. In the meantime, make sure you eat regularly, get plenty of sleep, drink enough water and take some daily exercise. All are steps known to help prevent migraine.

QMY PREFERRED way to keep fit has been swimming (once or twice a week, normally). Usually I swim a leisurely breaststro­ke for an hour, ending with a few fast lengths.

But after one swim last June, I cricked my neck and still haven’t recovered. I don’t sleep well and wake up numb down my right leg and arm. I also feel queasy most of the day. I have been swimming a couple of times since, but felt worse afterwards. I will be 60

this June and wonder whether this is my body saying ‘Nice knowing you, but I’m packing in now’. Peter Russell, London.

ATHe neck — known medically as the cervical spine — is one of Mother nature’s worst design faults.

The human head weighs about 8kg, which is considerab­le given the seven cervical vertebrae that support it and act as a pivot to give it considerab­le movement.

The price of the head’s great mobility has been the loss of structural strength in the neck. This fragile structure also carries the spinal cord as it exits from the skull, via a channel known as the spinal canal.

your symptoms, now persisting for many months, give me cause for concern because you need a diagnosis. Pain, tingling or numbness in one arm or hand is a common problem with a variety of potential causes — although essentiall­y the nerves are compressed in some way.

Typically this is because of arthritic changes in the vertebrae, or even a bulging disc (the spongey ‘shock absorbers’ that sit between the vertebrae).

Less common is when one arm and the leg on that side are affected, as in your case (although again, the causes are likely to be a bulging disc or arthritic changes, which cause symptoms by pressing on the cord within the spinal canal rather than compressin­g nerves as they exit between the vertebrae).

Whatever the theory, the longevity of your symptoms calls for further investigat­ion at this stage. A physical examinatio­n to check for weakness (of arm or leg), and checks to detail whether there is impairment of sensation in each limb may provide some evidence for such a cause. But more clarificat­ion will come from a scan, ideally an MRI, of your neck.

There is nothing to be lost from consulting a physiother­apist pending further investigat­ion for advice about pillows (to adjust your sleeping position), as well as exercise activities, and that might prove helpful in reducing your symptoms.

swimming breaststro­ke involves the neck being extended and then cocked well back, and my physiother­apy colleagues mostly advise avoiding this stroke in patients with your combinatio­n of symptoms. It’s recommende­d that patients swim on their backs, with the neck flexed, chin on chest.

But the key is to see your GP once more to explain the months of persistent symptoms and to discuss the possibilit­y of getting a referral for a scan.

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