Migraines are an extremely painful medical condition affecting approximately 6 million people in the UK, yet they can often be managed effectively through taking preventive medicine and making lifestyle adjustments.
Identification and avoidance are the keys to migraine relief, and keeping a diary may prove especially helpful in tracking them.
Medications
Many medications exist to assist in managing migraine headaches, both during an episode and to prevent future ones. Individuals will find different solutions work better for them; others may discover identifying triggers can help manage migraine headaches without medication at all.
Acute treatments aim to stop an active migraine attack from happening; they may also help alleviate symptoms (nausea, light sensitivity or throbbing pain). Abortive medications include NSAIDs/acetaminophen and triptans which are most effective if taken early during an attack49.
Preventive migraine treatments aim to decrease both the frequency and severity of migraine attacks without intolerable side effects. Beta blockers with no inherent sympathomimetic activity (atenolol, bisoprolol or metoprolol), topiramate and candesartan63-64 are among the first-line preventive drugs available; others such as the CGRP monoclonal antibodies erenumab, fremanezumab and galcanezumab have also proven their efficacy for migraine prevention when administered monthly by injection64-65
Self-care
Migraines can be debilitating and have a devastating impact on quality of life, social relationships, work performance and emotional well-being. But taking proactive steps toward managing self-care habits may help avoid or at least lessen migraine attacks and their severity.
Staying hydrated is one of the key preventive strategies, as is eating regularly scheduled meals without missing them, avoiding caffeinated beverages and getting sufficient sleep–even on weekends. A diary may also help identify triggers.
Start slow when adding self-care into your daily routine – even just one or two things could help make a difference in managing migraines! Pick something or two you would like to incorporate and work towards making them part of your lifestyle, then eventually they’ll become second nature and will help manage migraines more effectively. Cathy Cassata is a freelance writer specializing in stories related to health, wellness and human behavior who contributes regularly to VeryWell Mind podcast as well as numerous publications including New York Times Women’s Health Magazine and AARP The Magazine among others.
Lifestyle changes
Lifestyle changes may help reduce migraine frequency and severity, identify triggers more easily, and may allow medications to work more effectively.
Doctors typically advise consuming foods low in processed food, artificial additives and known triggers like alcohol and chocolate. Furthermore, they advise against skipping meals or fasting and encourage regular physical activity, hydration and stress management practices such as meditation or yoga to manage stress effectively.
Dr. Starling advises those having difficulty sleeping to create a consistent bedtime routine and keep a sleep diary, using her green, yellow and red system for measuring efficiency (Ctrl M Health has published an invaluable patient handout on migraine sleep issues here).
Exercise can help release endorphins that reduce stress and block pain signals in the brain, yet still give a workout benefit. Starting small may be best; an enjoyable 20-minute walk or swimming session a few times each week would do wonders for health and well-being.
Talk to your doctor
Migraines can be debilitating, and it’s essential that you inform your physician of how many migraine attacks you experience each month. Visit either your primary care doctor or neurologist who specializes in headaches for advice; be prepared with documentation of medications you have tried as well as their effects and potential side effects.
Your doctor will want to discuss how often and for how long migraines occur in your life. They’ll ask about any family histories of migraines as well as any major life stresses or changes which might have contributed to them, including any major stresses or changes you’ve undergone since.
Your doctor may also ask you to keep a migraine diary or log, which will allow them to identify potential triggers and determine which medications will work best for you. They’ll likely have you try several types of preventive meds and rescue medicines before settling on one for yourself.
