Chronic Migraine Treatments
End Your Aura, Reduce Your Migraines...
The Short Answer
There are subtle differences in the focus and goals of treating chronic migraines that need to be considered when picking out potentially successful chronic migraine treatments.
Drugs, for example, can not play the same role as normal and their should be an increased focus on the relaxation and fast recovery.
Chronic Migraine Treatments – Is There Any Difference?
The World Health Organisation rates chronic migraines as a ‘disability class 7’ (the highest) – meaning they rate chronic migraines as more disabling than blindness, paraplegia, down syndrome, rheumatoid arthritis or below-the-knee amputation (to list just a few).
Any time you spend at least 15 days in a month suffering with a migraine or headache – for a period of at least 3 consecutive months, you will be considered as suffering from ‘chronic migraines’
Chronic migraine treatments are, in theory, basically the same as would be tried for episodic (occasional) migraines.
The big difference however lies in the effect on sufferers of the sheer frequency of attacks – one after another after another.
“Perhaps the hardest part of living with chronic migraines is the lack of recovery time.”
Having a series of migraines in a short period of time can leave you unable to recover properly, before the next migraine begins. As a result, a major focus of chronic migraine treatments should be the facilitation of quicker recovery.
The faster you can recover, the stronger the likelihood of putting back your next migraine.
As with many pain relief treatments, the secret is to find a combination of therapies that really work for you. In the case of chronic migraines however, the focus should be very strongly away from pain relief drugs and more towards relaxing natural therapies that relax you and speed up your recovery.
A greater focus on a fast recovery isn’t the only difference in treating them however – there are 3 important considerations –
- The End Goal. How to reduce the frequency of migraines
- The Danger Of Medications. They may actually increase your headaches
- The Difficulty of Recognising Your Triggers. Over-lapping of migraines makes them much harder to spot.
1. A Different Goal With Chronic Migraines…
Given that a chronic migraine is defined by it’s frequency, the primary goal is then to reduce the number of migraines down until your suffering can be considered occasional or ‘episodic’ rather than chronic.
Just as many people manage to regress their headaches to the point that can be reclassified as episodic, so others see their migraines progress until they are so frequent that they too become sufferers of chronic migraines.
This is because chronic migraines are referred to as ‘progressive’ – meaning that they are capable of both developing from normal migraines and also regressing back to the more normal, episodic migraines (hopefully!)
If you were not suffering migraines that regularly, but the incidence has increased, despite attempts to treat them, then it is important that you go to see a neurologist.
They can at the very least, rule out other potentially fatal causes and help with a realistic treatment plan.
Thankfully, it is also possible for some chronic migraine sufferers to transition back to just having sporadic migraines of shorter total duration and frequency.
2. Rebound Headaches – When The Drugs Really Don’t Work
The second difference with chronic migraine treatments is the effectiveness of medications to control your symptoms.
Unfortunately, in a lot of cases most normal migraine drugs don’t have the same impact on the symptoms of chronic migraines as they do on episodic ones.
This is because the body soon develops a tolerance to the frequent use of painkillers leading to higher doses being needed to get the same effect until those doses become too high to be safe.
3. The Conundrum Of Over-Lapping Triggers
The third key difference when considering how to treat chronic migraines is that, when they occur so frequently it can be difficult to establish what is triggering them.
With normal migraines, you will have a period of peace between as you almost build up to another migraine. During this time, by keeping a diary, you can normally identify several potential triggers.
Move forward several migraines later (with weeks or even months in between) and you can see a pattern with certain triggers that suggest you are particularly vulnerable to those particular actions.
By cutting out those triggers, you can then extend the periods in between attacks to months and, in some cases, years.
With chronic migraines however, this is often much more difficult as the migraines can happen almost simultaneously.
When they happen one after another, reading a diary and trying to work out whether more migraines happen on a Sunday (following a change in waking/ sleeping times due to not working) or if drinking too many soft drinks is causing havoc, becomes practically impossible.
It’s not impossible of course – you just need to be clear on what your likely triggers are and experiment for a month at a time with them, taking a more long-term view.
In other words, ‘soft drinks are bad – yes or no’ may take five months to decide, because you’ll need to count the number (and mark the severity) of each migraine over two months.
Then you’ll need to give up soft drinks for one month as your body adjusts and probably increases the number of migraines as it withdraws.
And then finally count the number of migraines over the next two months, to compare it to the first two months.
Another way of doing it is just to cut out all the very likely triggers of migraines that you can and accept that one of two may not have affected you anyway.
But it is nowhere near as easy to test triggers when your migraines are bunched up and as frequent as chronic migraines.
Chronic Migraine Treatments – Your Basic Options
The key to battling chronic migraines lies in a combination of using the natural treatments to relax/ recover fast after an attack and then to rest as much as possible between attacks, being prepared for the next one when it arrives.
This focus on relaxing as fast as possible is essential if you going to avoid the continuous vicious cycle of migraine after migraine.
I have covered all of the potential treatments for migraines in previous articles.
The basic treatments can be broken down into the following basic migraine treatment options –
- Anti-Emetics (anti-nausea drugs to stop you feeling sick)
- Combination Medicines (painkillers with an anti-sickness drug)
- Opioids (In extreme cases)
Drugs To Reduce The Number Of Migraines In Future…
- Botox Injections (clinically trialled as effective by Diener et al in Cephalalgia: An International Journal of Headache)
Avoiding Your Common Migraine Triggers.
A full list is available of 33 potential ‘migraine triggers’ here. The most common triggers include –
- Hormonal Changes
- Sudden Changes
- Sharp Smells/ Tastes
- Acupuncture (For pain relief, although evidence on effectiveness is very mixed)
- Hypnosis (Great for pain relief)
- Meditation (Great for relaxation)
- Silence (It’s golden, so they say)
- Temperature Therapy (Hot and Cold Therapy helps blood flow and eases pain)
- Relaxation techniques (To reduce your stress levels and recover faster)
- Aromatherapy (Peppermint oil has been clinically proven to work)
- Massage (To relieve stress in neck and shoulder muscles)
- Acceptance and Commitment Therapy (see here).
- Exercise More
- Stop Smoking
- Eat Better (particularly avoiding strong cheeses, fizzy drinks etc)
- Yoga (clinically proven to reduce migraines, possibly due to strengthening muscles.
A number of sufferers have reported reducing their migraines by having botox injected into their forehead.
There is clinical evidence behind it’s use, but many countries (including the UK) still haven’t ‘licensed’ it’s use. This doesn’t mean it wont work – just that pain relief from migraines isn’t the original path that botox was intended for.
I will put up a much more detailed article about its use soon (autumn 2020) as there are very specific conditions behind it’s use and it is not ideal for everyone. However, in certain circumstances injections of ‘Botulinum toxin’ can prove effective in the treatment of migraine headaches.
The Final Word –
Treating chronic migraines requires a specialised approach, subtly moving the focus from emergency ‘relief’ medications to more of the natural therapies.
This has to be done like this to avoid developing either a tolerance towards the drugs or a reliance on them.
The focus then has to shift towards achieving a state of balance and relaxation as quick as possible. This is more vital when considering chronic migraine treatments because you have to recover to have any chance of fighting the next one.
The sad reality however is that if you suffer with chronic migraines, it can feel like no treatment can do any good – and this can lead, not surprisingly, to depression and a downward spiral.
The only solution then is to keep trying natural treatments until you find some that have an effect, avoid the common triggers as much as possible and, most importantly, never give up.
The answer for you is still out there, somewhere.
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References Used –
1. Rowan H. Harwood, Avan Aihie Sayer & Miriam Hirschfeld. (2004). Current and Future Worldwide revalence of Dependency, its Relationship to Total Population, and Dependency Ratios. World Health Organisation Bulletin.
2. H C Diener, D W Dodick, S K Aurora, C C Turkel, R E DeGryse, R B Lipton, S D Silberstein, M F Brin. (March 2010). OnabotulinumtoxinA for Treatment of Chronic Migraine: Results From the Double-Blind, Randomized, Placebo-Controlled Phase of the PREEMPT 2 Trial. Cephalalgia: An International Journal of Headache.
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