Deal With Migraines

Fevers, the flu, sinus infections, stress and tension can all trigger headaches, which cause a dull throb in your head. However, migraine headaches are different. Physicians describe them as recurrent headaches with additional symptoms which can include dizziness, visual disturbances, tingling in the face or extremities, nausea and sensitivity to light, sound and smells.[1] They can be debilitating, causing students to miss school and adults to miss work. In fact, nearly one in every four US households has someone who suffers from migraine headaches.[1] Learn how to deal with a migraine so that you will know what to do the next time you get one.

Steps

Reducing Pain and Severity

  1. Prevent a migraine from getting worse. It is important to take immediate action to prevent a migraine from becoming worse. Once a migraine has started there a few things you can do to reduce the severity and help deal with the headache.[2]
    • Find a calm environment and retreat from your daily challenges as much as possible.
    • Dim the lights in the room
    • Lie down or use a reclining chair if possible.
    • Relax in a dark quiet room and try to sleep if you can.
  2. Take an over the counter painkiller. Over-the-counter acetaminophen or ibuprofen can help to relieve the pain of a migraine for some people. However, it is important to be aware that these medications can also damage your liver and kidneys when used often over a long period of time.
    • Ibuprofen and acetaminophen doses are listed on the bottle. Do not use more than the dose on the bottle. Talk to your physician to make sure that there are no interactions with other medications you are already taking or with an underlying medical condition.
    • Overdoses of either of these over-the-counter pain medications can be life threatening, causing significant liver or kidney damage. If you have taken too much, seek emergency medical care immediately.
  3. Apply a hot or cold compress. Some migraine headaches respond to heat or cold. Test your migraines with either a cold compress or hot compress over the area of your head that hurts and see which feels better. To make a hot or cold compress, run very hot or very cold water over a washcloth, then ring out the excess water and place the cloth over your head.[2]
    • Leave the compress on for up to 15 minutes.

Using Medications and Herbs

  1. Talk to your doctor about prescription medications to prevent migraine headaches. Your physician can prescribe preventive medication to reduce the number and severity of your migraines. There are several different preventative medications that your physician may suggest. Preventive medications are meant to be taken daily and can include:[3]
    • Beta blockers, which are also used to treat heart disease. Although the reason they work is not clear, doctors believe it may be that they keep blood vessels from constricting and dilating in the brain. Beta blockers include atenolol (Tenormin), metoprolol (Lopressor), propranolol (Inderal).
    • Calcium channel blockers are another type of heart medication that have been found to reduce the number and duration of migraine headaches. These medications include verapamil (Calan) or diltiazem (Cardizem).
    • Tricyclic antidepressants help prevent other kinds of headaches as well as migraines. Medications include amitriptyline(Elavil), nortriptyline (Pamelor), doxepin (Sinequan), imipramine (Tofranil).
    • Some anticonvulsant medications will also prevent migraine headaches, although physicians are not sure why. Some anticonvulsants that have been effective include divalproex sodium (Depakote), gabapentin (Neurontin), topiramate (Topamax).
    • Botox injections have been approved by the Federal Drug Administration (FDA) to treat migraines. The medication helps some people and is injected in a series in the forehead, temples, back of the neck and shoulders about every three months.
  2. Discuss acute or abortive medications with your doctor. Acute or abortive medications are designed to stop the headache you currently have. Acute or abortive medications are given when the symptoms first appear. Different medications are used to treat either the pain or the associated symptoms.[3]
    • Triptans are some of the first medications prescribed to relieve pain, nausea, and sensitivity to light, sounds, and smells. Triptan medications include: almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), zolmitriptan (Zomig).
    • Ergots work by constricting the blood vessels but have more side effects than triptans. These are the second type of medications used to help relieve pain and the associated symptoms, which can be worse than the headache itself. These medications include dihydroergotamine (Migranal) and ergotamine (Ergomar).
    • Isometheptene, dichloralphenazone, and acetaminophen, known as Midrin, combines a pain reliever, sedative, and medication that also constricts blood vessels to address the needs of someone with a headache.
    • Narcotics, such as codeine, are used for people who can’t take triptans or ergots because of side effects, allergic reactions, or interactions with other medications. But keep in mind that narcotics may also cause dependency and rebound headaches.
  3. Try feverfew. Consider using feverfew daily to prevent migraines or reduce the severity of migraine headaches. This is not proven to reduce the severity or the number of headaches from which you suffer. However, there is anecdotal evidence that suggests some effect, so it is worth considering.
    • Freeze dried capsules are recommended because the tea is bitter and can irritate the mucous membranes in your mouth.[4]
    • Speak to your physician and pharmacist about integrating feverfew into your daily routine before starting.[4] Feverfew can interact with other medications you may already be taking.
    • Do not take feverfew if you are pregnant or want to become pregnant, are breastfeeding, or taking another nonsteroidal anti-inflammatory medication, such as aspirin or ibuprofen.
    • Taper off slowly if you decide to quit taking feverfew. Stopping feverfew quickly can result in the return of migraine headaches with more symptoms, such as increased nausea, and vomiting.
  4. Consider butterbur to help reduce the severity and number of your migraines.[3][5]Butterbur can be taken on a regular basis for up to four months, though again its helpfulness is based on anecdotal evidence and is not scientifically proven. Ask your doctor what extract and dose would be appropriate for your circumstances, including your weight, age, and any underlying medical conditions.
    • Keep in mind that if you are allergic to ragweed, then you may be sensitive to butterbur.
    • Women who are pregnant, nursing, or want to become pregnant should not take butterbur.

Making Lifestyle Changes

  1. Go to bed and get up at the same time each day. One of the triggers for migraines are hormonal fluctuations. Your body will manufacture and release hormones such as melatonin and cortisol in response to the number of hours of sleep you get and when you get them. These fluctuations, along with sleep deprivation, can trigger migraine headaches.[6]
  2. Limit your alcohol and caffeine intake. Alcohol and caffeine affect your neuroregulatory system. Although the exact cause of migraine headaches has not yet been identified, most physicians agree that migraines can be triggered by changes to the neurological system.[6]
    • In small amounts caffeine can increase the effects of acetaminophen when taken at the beginning of a headache. One cup of coffee with acetaminophen is often enough. If you drink too much caffeine, over two cups, you can get a rebound headache later on.
  3. Manage your stress. Stress triggers the release of hormones that may affect your neurological system, which can trigger migraine headaches.[6] Not all stress reduction strategies work for everyone, so it’s important to find something that works for you.[7]
    • Prioritize what has to be done, take one challenge at a time and move on. Try not to get overwhelmed by the tasks that you have to complete.
    • Practice deep breathing. Deep breathing can lower your heart rate and reduce your stress. Positive self-talk will help to reduce your stress levels.
    • Get regular exercise. Exercise will reduce stress, improve your mood and enhance your self-esteem. Take a 15 minute walk after each meal, go swimming at the local YMCA, go jogging in the evening after work, or take to the bike trails with your friends.
    • Get plenty of sleep. Lack of sleep will not only affect your hormone levels but also your stress levels. In a study done at the University of Pennsylvania researchers found that losing just a few hours of sleep will increase feelings of sadness, stress, anger and exhaustion.[8] Aim for seven to eight hours of sleep per night.
  4. Quit smoking. The Michigan Headache and Neurological Institute recommends that you quit smoking to reduce your migraines and their severity.[9] Tobacco triggers migraines three different ways. Smoking:
    • Raises the carbon monoxide levels in the blood and brain
    • Reduces oxygen levels in the blood and brain
    • Has a toxic effect on the brain and alters liver metabolism, reducing the effectiveness of migraine prevention medications
  5. Include daily supplements to help prevent your migraine headaches. Talk with your doctor before adding any supplements to your daily regimen.[3]
    • Magnesium can help to reduce migraines that are associated with a woman’s menstrual period or in people who have abnormally low levels of magnesium. Potential side effects include diarrhea and low blood pressure.
    • 5-HTP is an amino acid that converts into serotonin in your body. Some of the prescription drugs used to treat migraines affect the serotonin levels in the body. If you already take an antidepressant or natural herbal supplement, such as St. John’s Wort, are pregnant, nursing or plan to become pregnant, you should not use 5-HTP.
    • Vitamin B2, also known as riboflavin, can reduce the number and severity of migraines. However, if you already take tricyclic antidepressants or anticholinergic medications, do not add vitamin B2 to your daily regimen.

Getting Medical Help

  1. Recognize when your headache requires medical care. A true migraine headache is not caused by a tumor or other structural change in your brain. However, only your medical physician can determine if your headache is the result of a migraine or something else.[10] Seek emergency medical care if you:[11]
    • Are confused or have trouble understanding what is being said to you
    • Feel faint
    • Have a fever greater than 102°F (38.9°C)
    • Have numbness, weakness or paralysis
    • Have a stiff neck
    • Have trouble seeing, speaking, or walking
    • Loss of consciousness
  2. Talk to your doctor about recurring migraines. For some people, migraines are a common occurrence and may even be severe. You should see your doctor if your headaches:
    • Occur more frequently than they had before
    • Are more severe than usual for you
    • Don’t get better with over-the-counter medications or medications your physician has prescribed
    • Prevent you from working, sleeping, or socializing
  3. Keep a headache diary to help identify your triggers.[10] Record your meals, menstrual period (women), exposure to chemicals [room fresheners, cleaning chemicals at home or work], caffeine intake, sleep patterns, and weather changes. Use the diary to help you and your doctor to determine what causes your migraines. After you identify your triggers, try to avoid them as much as possible. Some common triggers include:[12][10]
    • Stress
    • Hormonal fluctuations (during a woman’s menstrual cycle)
    • Skipping meals
    • Too much caffeine
    • Certain foods, such as cheese, pizza, chocolate, ice cream, fried foods, lunch meats, hot dogs, yogurt, aspartame, and anything with MSG
    • Alcohol, especially red wine
    • Sudden changes in sleep patterns
    • Smoking
    • Barometric weather changes
    • Caffeine withdrawal
    • Heavy workouts
    • Loud noises and bright lights
    • Odors or perfumes

Tips

  • Migraine headaches are common and debilitating. To decrease the number you suffer from, keep a headache diary and watch for changes or substances that may be triggering your headaches.
  • Use preventive measures, such as reducing your exposure to triggers, getting enough sleep and reducing your stress levels, to reduce the number of headaches from which you suffer.
  • If your preventive measures at home are not successful, you should see your physician for medications that can both prevent and treat.

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 http://www.migraineresearchfoundation.org/fact-sheet.html
  2. ↑ 2.0 2.1 http://www.mayoclinic.org/diseases-conditions/migraine-headache/in-depth/migraines/art-20047242
  3. ↑ 3.0 3.1 3.2 3.3 https://umm.edu/health/medical/altmed/condition/migraine-headache
  4. ↑ 4.0 4.1 http://www.migrainetrust.org/factsheet-feverfew-and-migraine-10904
  5. ↑ http://www.berkeleywellness.com/supplements/article/can-butterbur-fight-migraines
  6. ↑ 6.0 6.1 6.2 http://womenshealth.gov/publications/our-publications/fact-sheet/migraine.html#g
  7. ↑ https://www.psychologytoday.com/blog/finding-cloud9/201308/5-quick-tips-reduce-stress-and-stop-anxiety
  8. ↑ http://www.ncbi.nlm.nih.gov/pubmed/9231952
  9. ↑ http://www.mhni.com/headache-pain-faq/content-disclaimer/non-drug-treatment-alternatives/smoking-cessation
  10. ↑ 10.0 10.1 10.2 https://www.nlm.nih.gov/medlineplus/ency/article/000709.htm
  11. ↑ http://www.mayoclinic.org/symptoms/headache/basics/when-to-see-doctor/sym-20050800
  12. ↑ http://kidshealth.org/teen/diseases_conditions/brain_nervous/migraines.html#
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