If you've ever had a migraine, you know it's very painful and lasts for hours, even days. A throbbing pain on one side of the head, possible nausea and vomiting, blurred vision, and high sensitivity to light and sound can sometimes make us unable to function. Fortunately, migraines can be treated with natural means and the use of medication. You can also learn to avoid headache triggers.
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Method 1 of 5: Confirming the Diagnosis
Step 1. Distinguish the symptoms of migraines and other headaches
Before trying to deal with a migraine, make sure that you have a migraine, not a regular headache. Migraines are generally a painful throbbing on one side of the head accompanied by nausea or vomiting, and/or sensitivity to light and sound, although migraines may not be accompanied by headaches. You may feel signs an hour or two before a migraine strikes, such as dark vision, seeing auras, flashes of light, weakness, tingling, or difficulty speaking. These symptoms usually last 72 hours and get worse with activity. Know the following signs of a headache, and think about whether your symptoms are more like migraines:
- Tension headaches feel like there is a tight rope around the head or a weight on the head, usually accompanied by tension in the neck and/or shoulders. Tension headaches are accompanied by throbbing, nausea, or changes in vision. This is the most common type of headache that causes mild to moderate pain.
- Cluster headaches cause extreme pain that is usually felt in one eye, temple, or forehead. The pain comes on quickly, lasts for 5 to 60 minutes, then disappears for some time before coming back again. Sometimes, watery eyes or a runny nose on the same side as the headache. This is the rarest type of headache.
Step 2. Visit your doctor for a referral to a neurologist
If you have frequent severe headaches, your doctor may refer you to a neurologist. A neurologist can diagnose headaches through a physical exam, discuss your symptoms, and discuss your family history. Usually, that's enough to diagnose migraines or other types of headaches. If the headache is severe or abnormal, your doctor may order tests that are rarely given, such as:
- MRI (magnetic resonance imaging) or CT (computerized tomography) to see if there is a tumor, bleeding, or other problem in the brain
- Blood tests to check for toxins or infections in the body
- A lumbar puncture (or spinal tap) to check the pressure in the skull and see if there are other problems
Step 3. Know the signs of an emergency
Even if you have frequent migraines, don't ignore signs of a more serious problem. Some types of headaches indicate a dangerous medical condition. See a doctor immediately or go to the ER if you experience any of the following symptoms:
- A severe headache that comes on suddenly and feels like the worst headache you've ever had.
- Headache accompanied by stiff neck, fever, confusion, seizures, weakness, or difficulty speaking
- Headache after a head injury, especially if it keeps getting worse
- Headaches that don't go away and get worse if you move fast, cough or strain
- Headaches that are felt for the first time after the age of 50
Method 2 of 5: Coping with Migraine with Medication
Step 1. Take the medicine as soon as possible
As soon as you feel the symptoms of a migraine, take medication immediately. Then, lie down in the dark room.
Step 2. Try an over-the-counter pain reliever
If your migraines are mild, try aspirin or ibuprofen such as Advil or Motrin. For some people, acetaminophen (Tylenol) also helps. For moderate migraines, try an over-the-counter migraine headache remedy that contains aspirin, acetaminophen, and a small amount of caffeine.
- Talk to your doctor before taking medication. Long-term or excessive use of over-the-counter medications (nonsteroidal anti-inflammatory drugs or NSAIDs) can cause stomach bleeding, peptic ulcers, and other problems.
- Always follow the dosage instructions on the package.
Step 3. Ask for a prescription for indomethacin
Indomethacin (Indocin or Tivorbex) is an NSAID like aspirin and ibuprofen. However, this drug is available in the form of a suppository (not swallowed, but inserted into the rectum). Indomethacin is especially helpful if you experience severe nausea or vomiting during a migraine. Visit a doctor and ask if you can get a prescription.
Step 4. Try a prescription triptan medication
Triptans such as sumatriptan (Imitrex) and zolmitriptan (Zomig) are prescription medications for migraines. Triptans relieve migraines by blocking pain pathways in the brain and constricting blood vessels, and are available in pill, nasal spray, or injection form. Your doctor may prescribe this medication if your migraines are frequent or severe.
- Do not use triptans if you have had a heart attack or stroke.
- Taking a triptan and an SSRI (selective serotonin reuptake inhibitor) or an SNRI (serotonin norepinephrine reuptake inhibitor) together can cause a serious medical problem called serotonin syndrome. If you are taking an antidepressant such as Zoloft or Cymbalta, talk to your doctor about using a triptan. You can use both if you know what symptoms to look out for, but your doctor may want to prescribe a different medication.
- The drug Treximet combines two pain relievers called sumatriptan and naproxen, which appear to be very effective.
Step 5. Try ergot
Ergot is a prescription medication that doesn't seem to be as effective as triptans, but is good if your migraines have lasted more than 2 days. The commonly used option is Ergotamine although for some people it makes nausea worse. Ergot is usually combined with caffeine, as in the drugs Migergot and Cafergot. Migranal is also pretty much the same, with fewer side effects than nasal sprays or injections.
To maximize its effectiveness, use ergot as soon as possible as soon as migraine symptoms begin
Step 6. Treat nausea
Ask your doctor for nausea medication if your migraine symptoms are often accompanied by nausea and vomiting. Commonly prescribed medications are chlorpromazine, metoclopramide (Reglan), and prochlorperazine.
Step 7. Ask about opioids or steroids as a last resort
Opioids are sometimes used to treat very painful migraines, but because they contain narcotics, they can be habit-forming and are only used when other medications have not worked. Your doctor may give you a glucocorticoid, such as prednisone or dexamethasone, in combination with other medications to relieve pain, but it's not recommended to use it frequently because of these side effects.
Opioids are prescribed only in minimal amounts because they are addictive or can be abused, and should be discontinued slowly. Steroid drugs should also be discontinued gradually, not all at once
Method 3 of 5: Overcome Migraines Naturally
Step 1. Recognize the signs of an impending migraine
Some people experience an "aura" that appears as a flash of light or reduced vision before the migraine begins. You may experience darkening of your vision on the side of your head, a tingling sensation on one side of your face, arm, or leg, weakness, or difficulty speaking. If you recognize the early signs of a migraine, you can try ways to prevent it from getting worse or to relieve the symptoms.
Some people also experience the so-called prodrome phase a day or two before the headache. This phase includes mood swings (sadder or happier than usual), a strong urge to eat certain foods, constipation, frequent yawning, stiff neck, or more frequent urination and increased thirst
Step 2. Minimize sensory stimulation around you
Bright light, strong smells, and loud noises usually make migraine symptoms worse. When you recognize the signs of an impending migraine, turn off all sensory stimuli, if possible. Lie down in a dark and quiet place to rest.
Step 3. Use relaxation techniques
Stress and muscle tension can make migraines worse, and severe stress can trigger migraines too. Use relaxation techniques regularly to reduce stress levels, and during migraine attacks. Try meditation or deep breathing exercises when you have a headache, while resting in a dark place. Do sensitivity exercises, take walks in nature, listen to music, and anything else that helps you relax.
Step 4. Try a hot or cold compress
Place a hot or cold compress on the neck or head to numb the pain. If you don't have a compress, fill a plastic bag with ice and wrap it in a thin towel to prevent damage to the skin from direct contact with the ice. You can also try heating pads that relax tense muscles and may reduce migraine pain.
Step 5. Try a massage
The effect of massage on tense and stressed muscles can reduce the frequency of migraines. More studies are needed to prove its efficacy, but some people find their migraines reduced with massage therapy. If you don't have a professional masseuse, try massaging yourself. Press the temples and scalp with fingertips in a circular motion or back and forth. Don't let your fingers slide across the skin, try to rub the muscles underneath.
Step 6. Consider studying biofeedback treatments
Biofeedback is effective for reducing migraine pain. Professional biofeedback healers use special tools during the relaxation process to teach you how to recognize and control the body's psychological response to stress. Learning to identify the stressors that trigger migraines can help you avoid or change these situations. If the migraine comes on slowly, you can use biofeedback to avoid a full-blown attack.
Step 7. Consider cognitive behavioral therapy (CBT)
CBT is a psychiatric tool that teaches how to change thinking and behavior patterns. You can work with a professional therapist to learn CBT. The way this therapy works is similar to biofeedback, but CBT uses mental processes, not physical ones. CBT can help relieve or prevent migraine symptoms.
Step 8. Try acupuncture
Studies show that acupuncture is a very helpful therapy in dealing with migraines. Professional acupuncturists will insert small needles into the skin at specific points in order to minimize pain. Consider trying acupuncture for migraines naturally.
Step 9. Try the feverfew herb with caution
Some studies show that feverfew can reduce the intensity or prevent migraines although this is not scientifically proven. Feverfew is usually available in capsule form containing dried herbs and can be purchased at pharmacies or drug stores.
Ask your doctor about herbal remedies. Do not use feverfew if you are pregnant or breastfeeding, and do not give it to children under 2 years of age
Method 4 of 5: Minimizing Triggers
Step 1. Avoid triggers from food and choose regular foods
Fasting or not eating can trigger migraines for some people. Old cheeses and salty processed foods can also trigger. Reduce salt intake by avoiding chips and other snacks, seasoning foods with herbs and spices instead of table salt. Avoid packaged and frozen foods, as well as fast food.
- Additives such as aspartame (artificial sweetener) and MSG can trigger migraines in some people. Avoid additives by using natural sweeteners and ask the restaurant if they use MSG, and if so, ask that your food is not added MSG.
- Nitrates are also a fairly common migraine trigger and are found in processed meats such as pepperoni, hot dogs, and ground meats that are often used as fillings for sandwiches and hamburgers.
Step 2. Minimize alcohol intake
Alcohol, especially wine, can trigger migraines. Stop drinking alcohol or limit it to moderate amounts, which is 1 drink a day for women and men over the age of 65, and 2 drinks a day for men under the age of 65.
Step 3. Don't drink too much caffeine
Drinks high in caffeine content such as coffee and sports drinks can trigger migraines because of the caffeine crash effect that occurs several hours later. A sudden drop in caffeine levels has the potential to trigger migraines. If possible, drink tea instead of coffee, and try to keep your caffeine intake to a minimum.
If you drink a lot of coffee, don't stop right away as it can cause headaches and other withdrawal effects. Stop slowly. For example, if you currently drink 2 cups of coffee a day, reduce to 1 cup for a week or two, then drink half-caff (half regular, half decaf)
Step 4. Set a sleep schedule
For some people, migraines strike when they change their sleep schedule, and when they don't get enough or even too much sleep. If you are prone to migraines, create a bedtime and wake schedule so that you get about 8 hours of sleep each night.
Jet lag can also trigger migraines. If you're flying to a place with a time zone that's vastly different, try as much as possible to minimize disruption to your sleep schedule
Step 5. Ask your doctor about birth control pills and heart medications you are taking
Vasodilator drugs such as nitroglycerin can make migraines worse, as can the contraceptive pill. Medicines are important. So don't stop using it right away. Talk to your doctor first, maybe your medication can be replaced with another medication that doesn't trigger migraines.
Step 6. Keep a headache journal
Migraine triggers are sometimes difficult to pinpoint if you don't pay attention and note what happens before the migraine strikes. Take a notebook, and when you get a headache, jot down what you did that day, what you ate in the last 12 hours, and any other stimuli (a strong smell of perfume, lack of sleep, etc.). A journal can help you identify migraine patterns so that triggers can be avoided in the future.
Method 5 of 5: Preventing Migraines
Step 1. Ask your doctor if you can take migraine-preventing medication
Preventive drugs are given for severe migraine cases and are difficult to treat because they have quite severe side effects. However, if migraines are frequent and affect your quality of life, talk to your doctor. Preventive medications can shorten migraine attacks, shorten their duration, or reduce their intensity. You may be allowed to use preventive medicine if:
- Migraines usually last more than 12 hours.
- Migraines strike four or more times each month.
- The pain doesn't go away with medicine
- You experience an aura accompanied by numbness or weakness.
Step 2. Consider heart medication
Cardiovascular drugs that usually treat high blood pressure are sometimes used to prevent migraines. The drugs most commonly used are beta blockers such as metoprolol and others, the calcium channel blocker verapamil, and the ACE inhibitor lisinopril.
These medications are not a good option if you have heart problems, smoke, or are over 60 years old. Your doctor will study your medical history and discuss the risks and benefits of other medications
Step 3. Try a tricyclic antidepressant
The drug amitriptyline has been shown to help prevent migraines. Other types of tricyclics are also sometimes used because they have fewer side effects (dry mouth, constipation, fatigue, and weight gain). Your doctor will help you weigh the risks and benefits of using the drug.
Venlafaxine (Effexor XR) is an SNRI that can help prevent migraines
Step 4. Consider anticonvulsant medication
Anticonvulsants such as valproate and topiramate (Topamax) can reduce the frequency of migraine attacks. However, this drug can cause serious side effects. Valporate should not be taken by pregnant women.
Step 5. Ask about botox injections
Botox, or onabotulinumtoxinA, has been shown to be effective in helping prevent migraines in adults. Botox is injected into the neck and forehead muscles every 12 weeks for it to function properly. If you suffer from chronic migraines, discuss this option with your doctor.
Tips
- Be aware that hormonal changes such as menopause or before your period can trigger migraines. There's almost nothing that can be done in this case, and hormonal treatments have not proven effective, but you can be more vigilant and try to prevent other triggers.
- Changes in weather, such as before a storm, also have the same effect.
Warning
- Use migraine medications as directed by your doctor or pharmacist.
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Visit the ER if you experience the following symptoms:
- A high-intensity headache that comes on suddenly and feels like the worst headache of your life
- Headache accompanied by stiff neck, fever, confusion, convulsions, weakness, or difficulty speaking
- Headache after a head injury, especially if it gets worse over time
- Headaches that don't go away and get worse if you move fast, cough or strain
- You had your first headache after the age of 50
