In a letter Wagner penned to fellow composer Franz Liszt in 1857, while Wagner was working on the opera Siegfried, he wrote, “...for ten days, after I had finished the sketch for the first act of Siegfried, I was literally not able to write a single bar without being driven away from my work by most tremulous headaches...this is a life fit for a dog.”

Now, researchers at the Kiel Headache and Pain Centre in Kiel, Germany, have analyzed Siegfried to see how Wagner's debilitating headaches shaped his famous opera, which is still performed around the world today.

“When you have a migraine, you really can’t do anything else, and people are totally dysfunctional. Besides being light and sound sensitive, they also get worse with movement,” said Dr. Mark Green, a professor of neurology, anesthesiology, and rehabilitation medicine and Director of Headache and Pain Medicine at the Icahn School of Medicine at Mount Sinai Medical Center. “There are also a lot of cognitive problems with migraine—they become very tired and can’t think clearly.”

Green said about 12 percent of the world population suffers from migraines. In 2001, the World Health Organization found that migraines are the 19th leading cause of disability worldwide.

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Singing Through the Pain

The Kiel researchers argue, in a paper published last week in BMJ and in an accompanying video, that Siegfried is full of clues to Wagner's suffering.

In the opening of Siegfried, the music gradually builds to a pulsating crescendo until the character Mime cries out, “Compulsive plague! Pain without end!”

The researchers also say that in the third scene of the opera's first act, Wagner's music perfectly mirrors the visual disturbances of a migraine aura. Violins and violas play a fast, scintillating melody at about 16Hz, close to the 17.8Hz measured in a 2001 study of the rate of flicker during a migraine aura. 

In frustration, Mime sings, “Loathsome light! Is the air aflame? What is it flaring and flashing, glittering and whirring, what is swirling and whirling there and flickering around?” 

“Auras are seen in about 20 percent of people with migraines. With visual auras, we often see something bright and flashing and some blind spot,” Green said. “Commonly, you get a headache that follows, but migraines are ‘sick headaches,’ meaning that people are sick with it and are very sensitive to lights and sounds.”

Wagner's headaches were so severe that he was forced to take a 12-year break while composinthe second act of Siegfried

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Migraine Treatments, Then and Now

Wagner was said to wear a hat wherever he went, even indoors, which the researchers say was a recommended treatment for headaches in the mid-1800s. 

In ancient Egypt, people bound their heads with tight linen bands to help relieve some symptoms caused by enlarged arteries in the scalp. On some Caribbean islands, they still treat headaches this way.

Now though, doctors like Green have more options to treat migraines, including a class of medications called triptans. Green advises his patients to take their medication as early as possible during a migraine attack to help head it off, and says there are maintenance medications available to provide some relief of frequent attacks.

Last week, the FDA announced approval of the first commercial device to treat migraine headaches using magnetic stimulation. The Cerena Transcranial Magnetic Stimulator is designed to relieve severe migraine pain, though it doesn't reduce nausea or light sensitivity, which are requirements for migraine medications. 

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And new research from Tel Aviv University in Israel shows that there may be an easier and less expensive way to relieve migraine pain: They report that children and teens with chronic tension and migraine headaches got significant relief when they stopped chewing gum. 

The theory is that gum chewing puts stress on the temporomandibular joint (TMJ) that connects the jaw with the rest of the skull. Between talking and chewing (and opera singing), the TMJ is among the hardest-working joints in the human body.

According to Green, TMJ dysfunction is blamed for headaches far more often than is warranted, but he says that not chewing gum might provide a small measure of headache relief.