'A Good Migraine Can Floor Even The Toughest Person'
The Short Answer –
Migraine Relief Is Only Achieved By Understanding What A Migraine Is, What Triggers Your Migraine And What You Can Do To Relieve The Pain Of A Migraine.
Here We Look At All Your Migraine Relief Options…
Anybody who suffers with migraines knows just how disabling they are and just how important any form of migraine relief can be.
Most migraines are dealt with privately by the sufferer and, as a matter of fact, migraine sufferers are one of the biggest users of alternative therapies to achieve safe, long-term pain control.
in this article we consider when you should really go and see a doctor, because it might be more serious, the infinite benefits of keeping a migraine diary (or log), the commonly considered natural treatments for migraines and the medications that can be prescribed.
These medications can either help to prevent future attacks or dampen down the symptoms when you are in the midst of a migraine.
Finally we look other methods of how to prevent a migraine, including our other article on 33 potential migraine triggers to avoid.
When To See A Doctor With A Migraine
Migraines as a whole do not warrant going to see a doctor – as painful as they can be, they will normally just pass with time and treatment. However ‘when to see a doctor with a migraine’ is a popular question at our pain management groups and there are certain occasions when it is important.
If you are using the maximum dosage of painkillers to have an impact on your migraine, then you need to see you doctor. Painkillers have many side effects/ downsides – one of which is the likelihood that you will build up a tolerance to them. If this happens, your doctor is likely to want to suggest other options to avoid continued use at such high levels.
According to guidance issued by NHS England, if you are suffering with migraines for more than 5 days in a month, ‘even if they are controlled with medicine’, you should see a doctor as you may benefit from more preventative treatment.
If your migraine is accompanied by feverish symptoms, confusion, double vision or seizures, then its possible you may be about to suffer a stroke or disease such as meningitis. In both cases, it is far better to be safe than sorry and you should a doctor straight away.
Keeping A Migraine Diary Log
One of the best ways of preventing a migraine is to recognize your triggers early and start to proactively avoid them. After learning about the types of potential trigger, the next thing to do is to ‘study’ how they might affect you.
Every trigger affects different people in different ways and it is inevitable that, no matter how careful you are, you will come in to contact with some of the potential migraine triggers.
By keeping a detailed log of what you came in to contact with in the days prior to a migraine, you can start to look for patterns that will tell you just how you react to different stimuli.
There are various online ‘migraine diaries’ available but in reality you can use any normal diary or your phone – or any other device that is most convenient for you.
The most important point is that you use your migraine diary log to record all the important details around your attacks – from a week before to a couple of days after.
The Most Important Information To Record Can Be Summarized As Follows –
From the 1st sign of something changing to the end of your symptoms as you return to normal.
Both of your migraine’s duration and the first time you noticed early symptoms developing.
What you were doing when the migraine first began.
Environment up to 24hrs before your attack.
What was the weather, what were you doing, What did you eat/drink, what time did you sleep, did you exercise and anything different about the 24hrs before an attack than normal.
Any other warning signs or changes that you felt prior to your migraine.
How long your migraine lasted.
What specific symptoms you suffered with and rate their severity against previous migraines. Did you see an aura or not?
What drugs you took. Make sure to record honest doses in case your doctor needs to know. Remember we discussed here the dangers of taking high dose painkillers. Doctors will always want to keep you on the lowest dose possible and will suggest other methods if you are consistently on the highest dose of painkiller.
What other type of treatment did you try? Such as a cold compress or lying down in a dark room. Did you do anything different from previous times and, if so, did it work?
You will see the idea with a migraine diary log is to record as much detail as possible – even if you get a partner to help record information when you are ill, so that you can analyse it when you feel better.
By comparing it to previous migraines you effectively form your own clinical trial – working out what works well for you and what doesn’t. It is very important not to become too reliant on painkillers during your migraines – it is an easy trap to fall in to, but so many people build up a tolerance that they actually end up making their migraines much harder to treat and actually then start suffering from ‘medication overuse headaches’.
Unfortunately, there is no actual cure for migraines – if you suffer with them, then you are likely to be stuck doing so. However, there are a number of medications and non-medicinal treatments that can help to provide migraine relief.
Lying down in a dark room can help the symptoms to subside.
Eating something has been found to make some people feel better.
Drink a drink with caffeine in. In small quantities (ie not litres of drink), caffeine can both relieve early stage migraine pain or increase the efficacy of acetaminophen and aspirin in relieving your pain.
4) Temperature Therapy
Hot and cold compresses applied to your head and neck. Hot packs will ease muscle tension while cold compresses can have a numbing effect. One may work better for you than the other, but you lose nothing in trying both.
Strangely enough, quite a few people actually prefer to be sick, having reported much relief afterwards.
Acupuncture has been linked with greatly reduced symptoms when you do have a migraine. It is less suitable in the full throws of a migraine, but if you get a session in the early symptoms, then it can be effective in prevention.
Research has shown that low levels of magnesium are a contributory factor towards migraines so supplementing your levels logically will help to mitigate their effects.
However, you should speak with your doctor before artificially altering your magnesium levels as going too high can have serious consequences.
8) Transcranial Magnetic Stimulation
In 2014 NICE (National Insititue for Health And Care Excellence) in England gave it’s approval to the use of transcranial magnetic stimulation for the treatment of migraines.
However, studies have yet to show how it helps migraines, except that there is a link between TMS therapy at the start of the migraine and the severity of the migraine itself.
In other words, transcranial magnetic stimulation wont stop your migraine but it might reduce it’s strength if treated this way in the early stages. Unfortunately, the effectiveness of TMS is limited to those that suffer with migraines with aura.
There is also no data on the long-term effects of such treatment, so it is recommended that it is only ever conducted by a ‘headache specialist’ in a specialist centre.
9) Relaxation Techniques
Meditation and biofeedback are two techniques that will help you relax and find better ways of dealing with stress. Cognitive Behavioral Therapy (CBT) is scientifically proven to help your brain to deal with stressful problems better through a structured approach. We covered this at length here.
If you feel the very early changes of a potential migraine, then relaxation techniques may help to turn it around. If you are already in the full throws of one, then I’m afraid they will only help for avoiding one next time.
10) Vitamin Supplements. Some people report that vitamin supplements (most popular are riboflavin or Coenzyme Q10)
A relatively new concept involving putting pressure on certain parts of your body (such as pinching a pressure point on your hand) to relieve tension pain in other areas.
11) Essential Oils
Lavender oil in particular is recommended as a remedy for headaches and stress in general. One small study in ‘European Neurology’ found that inhaling lavender oil did actually reduce the severity of migraine headaches in some of the people studied.
Massage has been proven to relieve tense muscles around the neck and shoulders. These tense muscles are major ingredients for a bad migraine and a professional massage around the time that you are exposed to trigger factors might be just enough to reduce the severity.
Feverfew and Butterbur have both been linked to reducing migraine frequency and pain. According to the American Migraine Foundation, 150mg of butterbur was proven to effectively lower migraine frequency.
14) Peppermint Oil
Peppermint oil contains a menthol that it has been found can reduce migraine-associated pain, by applying it to your forehead.
Drugs That Can Help At The Start Of A Migraine.
The following are examples of what could be taken prior to a migraine attack. It is important to see your doctor the first time and take their advice on which drugs to try, although the over-the-counter options are relatively safe providing they are taken within the dosage guidelines.
Whatever you decide, it is vital to try and take them AS SOON AS you start to feel the first sign of symptoms coming on. Leaving them until you in the throws of a full-blown migraine will weaken their impact and most likely end with you taking even higher doses without any benefit.
If it is getting later in a migraine attack, then consider taking soluble painkillers as these will enter your blood stream faster.
Alternatively, if you can not take the painkillers at all because you are starting to feel sick, then another option may be a suppository. These are tablets that are popped inside your bum and dissolve in to your bloodstream from there. The advantage is they wont make you wretch or vomit.
These are typically the over-the-counter types such as paracetamol. Ibuprofen or aspirin. They are NOT recommended for anyone that has suffered with stomach ulcer, kidney problems or cardiovascular issues such as stroke.
These are drugs designed to reverse the chemical changes in your brain that are thought to be a cause of your migraine in the first place. They work by trying to widen the blood vessels around the brain. This is believed to counteract the migraine that it is believed is caused by a narrowing of the same blood vessels.
Migraines cause the blood supply around the brain to reduce (hence the headaches), so by using Triptans to re-open the blood vessels, then many of the symptoms will be lessened.
These need to be prescribed by a doctor, who will often consider the need to administer these in combination with an anti-emetic as below.
Triptans unfortunately also come with their own book of side effects, the most common including feelings of ‘heaviness in the face’, which can extend to the chest or even limbs. Other side effects include tightness, tingling and warm flushes.
These are basically anti-nausea drugs designed to stop you feeling sick. As with the other medications, these are most effective when taken at the first sign of an upcoming attack.
If you cant take them orally because the sickness is your first symptoms and swallowing a pill will most likely make you vomit, then suppositories for insertion in your anus are available.
There are now a whole range of combination medicines available over the counter that combine a pain killer and an anti-sickness drug. This can be more convenient, especially for carrying around with you. Speak with your pharmacist if you need advice on taking one of these combinations instead.
In extreme cases, opioids may be considered for controlling migraines. However, this has to a last resort as there are significant downsides including addiction and withdrawal that is itself a major trigger for migraines.
Medications To Prevent Migraines In The Future
If you continue to suffer severe migraines despite identifying and trying to avoid your various triggers, then your doctor may consider prescribing you a drug to help reduce the number of attacks you suffer.
These were originally designed to reduce the number of seizures in people suffering epilepsy. More recently however, it has been found to be effective in preventing migraines and is used more commonly for this purpose.
Topiramate medications can be taken in tablet form, but directly reduce the effectiveness of contraceptives, so alternative methods may need to be considered for women using such drugs.
Ironically, the biggest side effects with Topiramate are sickness, diarrheoa, decreased appetite and dizziness – some of the main symptoms of a migraine in the first place. Another option of the same type is Valproate.
Another medication that was originally used to treat something else – in this case High Blood Pressure and Angina, that has also subsequently been found to be effective in preventing migraines.
Side effects can include pins and needles, issues with sleeping and cold hands/ feet
Propranolol should be used with caution in patients with diabetes and never in patients with asthma, some heart problems or COPD (chronic obstructive pulmonary disease).
Once again, this medication was principally created to treat depression, but as a side impact has been found to be effective in treating migraines. Again, it needs to be prescribed by a doctor, and it is not without it’s side effects – those including dizziness, dry mouth, a headache (weirdly!!!), constipation and a trouble peeing.
The other element with amitriptyline is that it may take up to six weeks, before you feel the full benefit of the medication so is very much a long-term preventative measure.
Regular injections of onabotulinumtoxinA approx. every 12 weeks has been found to be effective in some people.
Preventing Menstrual-Related Migraines.
Because menstrual-related migraines occur 2 days before to 3 days after your period, it is relatively easy to estimate when they are likely to start and therefore take preventative steps to avoid them.
As well as the standard treatments (Painkillers/ Triptans), there are a range of hormonal treatments that can be recommended, many that will stop your period and therefore stop the hormonal changes that are likely to cause you a migraine.
How To Prevent A Migraine.
Learning how to prevent a migraine is technically an almost impossible task – nobody is entirely sure what causes one in the first place, so preventing them altogether is simply not possible. However, there are certain steps that can be taken to dramatically reduce the number of migraines you suffer with and the severity of the ones you can’t avoid.
Avoid your Triggers.
We looked here at a whole range of potential triggers for migraines. It stands to reason then that the first key to how to prevent a migraine is to avoid those triggers that have affected you in the past.
Whether it is not visiting smoky bars or making sure you follow a regular eating/ sleeping pattern, understanding the triggers that affect you most and taking active planning steps to avoid them is essential.
This is where effective use of your migraine diary, as discussed above, is absolutely essential.
Living a healthy and particularly a fit lifestyle will have a huge range of benefits including being less stressed and having a stronger body. Fitness is also connected to less incidence of migraine attacks.
In a trial by Kisan et al, yoga was tested with traditional migraine treatments against just the same treatments on their own. The result was that patients that did the yoga as well reported noticeably less severe migraines.
The Final Word –
To date, there is no known cure-all for migraines. However, if you learn what migraine triggers affect you, then you can take real steps to cutting down their frequency.
Furthermore, if you take some of the tips from our migraine relief section, then as soon as you start to recognise the oncoming of a migraine, then you can take further preventative action to reduce the impact as much as possible.
With both diligence beforehand and swift action at the first signs of a migraine, you might not be able to cut them out altogether, but you can certainly gain some migraine relief and reduce their impact of your quality of life.
Frequently Asked Questions
A migraine with ‘aura’ has been shown to create tiny ‘white spots’ on your brain, but no significant damage has been reported following migraines.
No – a lot of people assume chocolate is a trigger for their migraine because they crave it in the early stages. However, the truth is it is more likely that a low blood sugar level or dehydration is triggering your migraine and the thirst for chocolate is the bodies response. This is very different to chocolate being the actual cause. Indeed sometimes eating chocolate can actually help with reducing your symptoms.
In theory yes. CBD oil has not been officially tried with migraines, but it is very good at controlling the brain’s transmission of pain signals. So in summary, yes it should work.
Yes. Kidney failure is ultimately caused by kidney disease. Kidney disease is both a mjor reason for Gout AND something that can be caused by a blockage caused by a build-up of urate crystals. In this sense, the major contributor to Gout (urate crystals) can damage the kidneys – so Yes is the answer.
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