Your migraine treatment options will depend on your diagnosis. There are a number of things to consider like: your health history, what meds you are already on and your unique symptoms.
While triptans are now the most effective medication I have found, your specialist may suggest other daily prophylactics or acute medications first.
Keeping a headache journal is essential. Your doctor will ask you to keep track of everything you do. Everything you eat, when your migraines hit, how long they last, and anything else you can think of that may be related to the cause of your headaches is important.
When compiling your diary, also include anything you have tried to ease the pain, and how well those pain relievers or techniques worked. Plus, it will help you learn to be able to recognize any patterns when a migraine headache might strike.
This is a good first step to take so you can be better prepared for your doctor too. Oh - and get to your doctor ASAP.
Migraines are not just the headaches themselves. The headache is the most painful and most noticeable phase, but there are four phases in total and many other symptoms related to the condition.
The other symptoms can be quite similar to common ailments that everyone experiences at one time or another like: a sinus attack, head cold and runny nose, fatigue, food cravings, blurry vision and or unexplained bouts of mood swings.
The intense pain phase, however, will not be similar! The stand out symptoms for me are nausea, vomiting, vertigo, cognitive impairment (can't speak or find my words) and head splitting pain.
For more specifics, read the post on migraine symptoms.
Finding the right, most effective, treatment can be a bit of trial and error, I am sorry to say. There is no one size fits all when it comes to migraines.
Try these treatments to help reduce or completely eliminate your attacks:
• How to treat a migraine with ice and heat at the same time
• What you need to know about botox for migraine headaches
• The procedure details on botox injection for migraine
Prevent vs Abort! Reducing the risk of another attack is different to stopping an attack. I see one as my lifestyle choices which I have control over.
And I see stopping an attack as actions I take immediately like: taking my abortive medications and using my comfort aids at the exact time I need to.
Avoiding migraine triggers will not necessarily prevent every migraine, but that is the first course of action I think we take instinctively. I never need to eat chocolate again, that's for sure. Anything you can do to reduce the risk of an attack will help.
In order to reduce the number of migraine headaches you have, I believe it is crucial to make some lifestyle changes, if you haven't already.
It's very important to try to reduce stress at work and at home, eat at the same time every day and to sleep the same number of hours every night.
Sticking to a strict routine is never easy. Some days you may experience more stress, which could trigger a migraine headache, result in a poor night's sleep or poor eating habits. All migraine triggers in themselves.
Maintaining a regular exercise program will also help keep your eating and sleeping habits regular, as well as reduce stress, or at least the way you deal with sticky situations. When your body is well fed, well rested and well toned, you reduce migraine triggers and are able to deal with minor upsets more easily.
Other relaxation techniques such as meditation, yoga and biofeedback techniques can also be very helpful. If none of these methods ease the pain or lessen the frequency, your doctor may suggest medication as the migraine treatment for you.
Migraine medication falls into two basic categories: abortive and prophylactic.
Which type you are prescribed will depend on the severity of your attacks, how often they occur and other medical problems you may have.
Read my article Migraine Specialist for some emergency care tips.
• over the counter painkillers containing either ibuprofen, acetaminophen, ASA or naproxen, usually used for mild to moderate headaches
• ergot formulations such as ergotamine or dihydroergotamine (DHE) which prevent blood vessels from swelling
• triptans, such as eletriptan, frovatriptan, almotriptan, rizatriptan, sumatriptan and naratriptan, which imitate the chemical pain messenger, serotonin, and constrict blood vessels to reduce headache pain
• sometimes metoclopramide (treats nausea), chlorpromazine (treats mental issues), prochlorperazine (decreases brain hyperactivity), and dimenhydrinate (controls nausea) medications are used
• medications developed to prevent seizures such as topiramate, gabapentin, divalproex sodium and valproic acid, which may prevent hypersensitivity in the brain and stabilize the nerves that trigger a migraine
• medications developed to control blood pressure such as beta-blockers, which stabilize blood vessels
• vitamins, in particular riboflavin (vitamin B2), co-enzyme Q10, or magnesium (glycinate), which is the common migraine treatment for people concerned about the side effects associated with medication
• pizotifen, a serotonin blocker has proven effective in some cases
• tricyclic antidepressants such as nortriptyline and amitriptyline work to suppress the pain and increase brain chemical levels
• herbal remedies such as butterbur, which may prevent the frequency of migraines
• relaxation techniques and biofeedback to help you control stress
• behavioral therapies, which involves avoiding behavior known to trigger a migraine attack, such as poor sleep habits and not eating properly
Prevention is often recommended as the number one migraine treatment, or treatment for any ailment, but this is not as easy as it sounds.
If you have pinpointed every trigger you have ever experienced and are able to avoid these triggers, you may be able to reduce the frequency, but preventing every migraine attack is highly unlikely. Also, triggers can change over time as your hormones or allergies change.
On the other hand, doctors consider reducing the frequency, intensity and duration of a migraine attack as successful treatment. So, even though migraines can not be cured, you will be able to deal with the episodes better once you get a good pain management plan in place. I broke it down step by step in my migraine pain management course. Have a look, the first module is free.
Botox has been found effective for chronic migraine sufferers, but not
for episodic migraines. Chronic migraines occur more than once per
month, while episodic migraines occur a few times per year.
Episodic migraines can be more difficult to treat, because you never know when one might strike, whereas chronic migraines are bit more predictable. For example - occurring during a woman's menstrual cycle when estrogen levels are at their lowest.
Butterbur root (Petasites hybridus) is often recommended to people with chronic migraine headaches since it is a preventive treatment.
You may find it effective if you:
• have frequent attacks – more than two per month with disability lasting three or more days
• experience recurring migraines that significantly interfere with daily routines
• overuse pain medications – more than twice a week
• pain medications are ineffective, or not tolerated
Acupuncture is often effective for episodic migraines because the pain can be relieved instantly. There is no evidence that “true” acupuncture is any more effective than ‘sham’ acupuncture.
However, both types give greater relief than routine care, and patients experience fewer adverse side effects than with prophylactic medication treatment.
Relaxation therapies such as chiropractic manipulation, relaxation, massage and physiotherapy are considered as effective in preventing migraine attacks as Propranolol or Topiramate. There were some issues with the methods used during research, which left the data inconclusive. Many doctors do not recommend chiropractic treatment to reduce migraines.
Click here for more on alternative treatment for migraines.
Biofeedback uses external instruments to monitor brainwaves and pain perception. It is designed to help people become aware of physiological factors in order to help them control migraine triggers and relax.
Neurostimulators are battery powered pulse generators implanted under the collar bone. They send electrical stimulation to the brain.
You can read this post on electric migraine relief devices for more information.
In extreme cases, surgery may be the only migraine treatment that works for certain people. The operation involves decompressing certain nerves around the brain and head. Please read the guest post on migraine surgery.
Doctors will usually try all other methods before resorting to surgery.
#1 is my Naratriptan acute medication, and these are my essentials that all help:
• Ice packs for migraine relief
• My DIY pressure point routine you can do at home
Until next time,
Know Your Migraine Treatment Options