It’s been many years since I went through the more formal channels with my migraine diagnosis and one thing stands out to me as a glaring difference between what I experience and what I presumed my doctors were asking me about.

Migraine has been in my chart since middle school and prior to graduating high school diagnostic criteria wasn’t really brought up all that much. I’d seen a few different primary care doctors and eventually would land with a Neurologist who would provide the bulk of my care for the last decade.

But in this time the only symptoms that came up surrounded aura.

Migraine with aura is perhaps the most recognized medically presentation of migraine with signature symptoms such as blind spots, flashes of light, and a sort of tingling or numbness. The presence of visual auras impact what kind of medicines you can be on, especially birth control, and it’s believed that those who do experience aura may be more prone to experiencing strokes or cardiovascular complications.

And maybe those added complications are why doctors tend to pay a little more attention.

In college I finally got to see one of the 400 some Headache Specialists in the country.

These doctors are considered the gold standard of care since typical neurologists and doctors may receive on average less than 10 hours of headache specific education while in school, if they receive any. Headache Specialists have vastly more training and knowledge on migraine and headache specific disorders.

By the time I was getting to my Headache Specialist my MIDAS score (a migraine specific quality of life tool) was as high as they got indicating I was severely disabled by migraine.

I remember the intake paperwork being the most excruciating packet of information and I was mind boggled that they hadn’t bothered to mail it to me. I sat in the Headache Clinic’s extremely well lit waiting room with a brutal migraine struggling to put down all of this information.

The paperwork consisted of a full migraine history including all medicines and treatments and non-traditional therapies, pain types and associated symptoms, a migraine life impact assessment analyzing how my personal and work/school life was impacted by migraine, their version of a MIDAS score, and a depression and anxiety screening.

Getting into the actual appointment it was clear this was a different kind of doctor than I’d ever worked with. Normally those long forms get taken by the nurse, filed in your chart and never utilized. The nurse went over the basics and some of my goals for the appointment, not getting too much into the paperwork. The doctor however went through almost every part of the form throughout his hour and a half long assessment.

The symptoms part is what stood out to me the most. I knew at that point things like aphasia and nausea and sensitivity to light and sound were all migraine related and all things that I had. But he asked about more symptoms. Everything from mood swings to frequent urination to yawning.

The one that stood out the most: pins and needles.

When he asked me if I ever experienced a pins and needles sensation, I said no.

I’ve had multiple tattoos and had been on the depo shot long enough that getting a needle plunged into my arm was a regular and non-eventful occurrence, but one I was very familiar with. And at no point during any migraine attack did I get a sensation like that all over my body.

Perhaps the closest thing I could compare it to was allodynia, the painful sensation people tend to get on their scalp during a migraine attack. I get this all over my body from time to time, but even though it’s painful, it isn’t quite like pins and needles.

That appointment was four years ago.

And I’m realizing now that I’ve had the pins and needles sensation the entire time, the problem is that no one ever really explained it to me in a way that made any sense.

Spoiler alert: migraine pins and needles feel absolutely nothing like the constant sensation of a tattoo gun beating against your skin.

I find them to actually be kind of pleasant? Dare I say even therapeutic?

For me, I experience pins and needles usually deep into the throes of a migraine attack or when my acute migraine meds start to kick in and I can feel them vibrating through my body.

It’s kind of like this shiver that goes down your back when you’re cold or when your body temperature changes and you feel a little flush. Perhaps chills would be a better way to describe it than pins, but without the deep shakes one may experience with the actual chills.

Often when the pain is at worst and all I can do is lay as still as possible, trying to relax my neck and keep the tension in my forehead, jaw, and shoulders released from the deepest parts of my body this rolling sensation will begin. It’ll roll across my face, my forehead and my temples, roll down my neck, my shoulders and arms. If it’s a really good one, it’ll roll all the way down to my toes. Wrapping up entire body in a Reiki like gentle massage, only the tips of my hair follicles engaged soothing and cooling my body and my head.

A lot of times when this sensation begins, I know my attack may be winding down. Either I’ll shortly fall asleep, or the sensation will ease my body into a place of less pain and I might have just enough in me to eat some dinner and relax for the rest of the evening.

Sometimes I try and use soft piano music to provoke this reaction in my body. Pins and needles to me feels like putting my body into a soft meditative state, even if it’s an illusion or trance, it is often a sort of reprieve I’ve been unable to achieve through acute meds.

Years before I used to achieve this same sensation when my acute med Fioricet would kick in. It was very strong and pronounced when I’d take that med and often that’s how I knew it was working. I’d take my meds, lay down in agony and within an hour my body seemed to leave the physical plane, being gently massaged on a cellular level as the pain meds worked to stop the pain. Typically when it was over, my pain would be leaving.

That of course is a very strong drug, my other meds produce a much more milder version if it happens at all.

I wonder too about a the similar ask of “do you experience numbness and tingling?” but when I think of that I imagine more of the sensation that comes from having sat on my foot too long and it fell asleep. Which is much more of an active nerve sensation than these pins and needles I described.

And so, after all these years, it clicked for me that this state I try to put myself into isn’t really a meditative one after all, but rather a symptom my doctor had asked about.

It sounded painful and unpleasant.

But my experience tells a very different story than what I expected from that conversation in the doctor’s office.

I doubt I ever would have connected the dots between my sensation and this symptom in a clinical setting.

And so, I leave on a curious note. Do you experience a pins and needles sensation with your migraine attacks? Is it similar to mine or do you find yours is different or even unpleasant? Drop a comment below!

A.