Top Tips for Treating Migraines

Woman lying on the couch suffering from a migraine.

Painful, throbbing, debilitating…that’s how the pain is described by those who suffer from migraines.  Yet in 56 percent of the population, migraines go undiagnosed. Adam Sprouse Blum, MD, a headache specialist at the University of Vermont Medical Center’s Headache Clinic, explains how to combat this mysterious disease.

What are the symptoms of migraine?

As Dr. Sprouse Blum explains: “When most people think about migraine, they think about head pain. But all of the symptoms of migraine are just as much migraine. And you can even have migraine with no head pain at all.” Other commons symptoms of migraine include sensitivity to light, noise or smell, nausea, dizziness, and pain in the mid-face or upper neck/base of skull. Some patients with migraine experience aura, often at the beginning of an attack, which may consist of a visual disturbance (e.g. spots, wavy lines or flashing lights), problems speaking, or tingling numbness affecting the hands, arms and face. 

What are common triggers of migraine?

There are a number of environmental and physical triggers, including: 

  • Times of increased stress
  • Hormonal changes, such as menses 
  • Changes in barometric pressure
  • Sleep impairments
  • Certain foods (e.g. alcohol, MSG (monosodium glutamate), nitrites and nitrates commonly found in processed meats)

 “Migraines tend to pop up or shift around hormonal milestones, such as onset of menses, birth of a child or menopause,” says Dr. Sprouse Blum.

Who experiences migraine?

Migraine disproportionally affects women. In fact, 1 in 5 women experience migraine while 1 in 16 men experience migraine.

What are the best ways to treat migraine?

Migraine cannot be cured, but it can typically be effectively treated. 

Migraine treatment is often broken down into prevention (which is meant to decrease migraine frequency and severity, but does nothing when you have an attacks), and acute treatment (which is meant to abort an attack when it occurs).

There are a variety of preventive and acute treatments now available, including both pharmaceutical and non-pharmaceutical options.

Pharmaceuticals

There are a variety of pharmaceutical options now available for both migraine prevention and acute treatment, including several newer medications that are quite effective and have excellent safety profiles. Ask your care team for guidance in choosing what’s right for you.

Supplements

Several supplements have evidence for use in migraine prevention, including magnesium (400-600 mg/day), riboflavin (400 mg/day), Coenzyme Q10 (300 mg/day) and feverfew (50-300 mg/day). 

Tip: Migraine prevention does not work quickly, so give yourself 1-2 months at these doses before giving up on them.

Non-Medication Treatments

Several behavioral therapies, including cognitive behavioral therapybiofeedback, and relaxation training have Grade A evidence in migraine.

There are also several medical devices that have been cleared by the FDA for both preventive and acute treatment of migraine.

What should I do if I feel a migraine starting?

Migraine is best treated early. If you wait for migraine to get bad, it can be hard to reverse its course. 

Treat based on the severity of the attack. If you’re having a mild attack, an over-the-counter agent may be appropriate. If you suspect a more severe attack, an over the counter agent plus a prescription, migraine-specific abortive is the way to go. 

If you are experiencing migraine or frequent headaches, contact your care team for help.