IF you experience migraines, you’ll know how debilitating they can be.
You’ve likely spent hours, days or even weeks waiting for the pain and other symptoms of migraine – like aura, dizziness and nausea - to subside.
In the meantime, all you can do is lie in bed in the dark and keep the noise down.
Although migraines can feel very isolating, if you suffer, you are not alone.
Almost 9 million people in the UK – 14 per cent of the population - suffer from migraines with around 200,000 migraines being experienced every day.
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Migraine is a leading cause of disability worldwide and the highest in the working population.
So, if you suffer from migraines what does the latest research say about your best treatment options and what does the future hold?
What is a migraine?
Migraine is not an ordinary headache, it’s a neuro-vascular disorder.
Migraine can be hereditary – meaning if one or both of your parents suffer, it’s very likely you will too, though you can still get migraine even if your parents don’t have them.
According to the Cleveland Clinic, migraines occur when specific nerves in blood vessels release substances that send pain signals to the brain.
What we don’t fully understand yet, is why they do that. This is one area where further research is ongoing with treatments aiming to prevent the release of these pain signals.
Research is made harder because there are hundreds of different types and symptom variations for headaches and migraines, and over 200 different genetic variations associated with migraines.
So, identifying the underlying causes and best treatment for your particular migraines is a bit like finding a needle in a haystack.
Keeping a migraine diary either on paper or using an app is a great way for you to notice patterns.
If you need a bit more help and support in identifying the particular triggers and treatments for your migraines, I’d recommend you see a healthcare professional who specialises in this condition – osteopaths, medical acupuncturists and chiropractors are all good options.
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While everyone’s migraine experience is unique, researchers are increasingly identifying factors that seem to help or hinder groups of migraine symptoms.
Although it’s a bit of trial and error, it’s worth trying these research-backed tips to see if your migraines improve…
Newer treatment ideas you might not have tried:
1. Botulinum toxin aka Botox
Otherwise known as Botox this treatment isn’t just for wrinkles.
It can also be used to reduce activity and tension of the muscles in the face, head and neck which can lead to migraines and headaches.
Botox is useful for chronic migraine (headache on more than 15 days in a month and at least eight of them migraine headaches) but isn't proven to work on the more usual episodic migraines.
It can also be helpful if your headaches are being caused by jaw disorders - there is a subcategory of headache caused by Temporomandibular disorder (TMJ) which affects the jaw, and they would also have a good response to Botox.
Results last for three to six months but can also help sufferers to ‘break the cycle’ of migraines so that you experience fewer episodes over time.
This treatment option is especially helpful with chronic migraines, which can be hard to manage with medication alone.
2. Wearable devices
Migraine devices are being approved that are worn on different areas of the body (like the forehead, neck, arm, or head).
They work by delivering electrical pulses to nerves that can cause migraine which changes the signals the nerves send to the brain and the brain’s response.
You can combine these devices together because they have different mechanisms.
Research is always underway for new medications to help prevent and treat migraines but there can be adverse effects of long-term medication use including side-effects and dependency.
If you can find ways to reduce the occurrence and severity of your migraines by monitoring your migraine patterns and testing the impact of making changes to your lifestyle, you’ll be improving your overall health as well as hopefully improving your migraines.
3. LED (light emitting diode) light therapy
Usually used during facials, there is some evidence that light therapy masks can reduce migraine pain and frequency.
Specifically, green light therapy seems to reduce the impact of other lighting on the retina, which can be very triggering for migraines caused by light sensitivity.
Although further research is needed, individuals who have tried LED light therapy have reported promising results.
LED therapy devices aren’t cheap but if migraines have a big effect on your life, they may be worth a try.
4. Daith piercing or acupuncture
There is promising evidence showing a reduction in migraines in the months following a piercing of the daith part of your ear (the middle bit that sticks out), but the effect seems to fade over time.
An alternative is to try acupuncture to the daith area, which is a traditional acupuncture point.
That way treatment can be redelivered when the benefits start to wear off.
5. Blue light filter glasses
If you’re on screens a lot, blue light filter glasses can help to reduce light stimulation and can also help with your circadian rhythm and help with sleep.
Although these aren't a direct solution for migraines and won't help as much as regular sunglasses if you have photophobia, if you are making multiple lifestyle changes to help your migraines, blue light filter glasses may be helpful for you.
Lifestyle habits with proven benefits:
6. Diet
The best current evidence is around eating a balanced diet and keeping blood sugars stable.
A lot of sufferers saw improvements while keto was a craze.
Keto is too strict to be sustainable for most people, but the lower carbohydrate content of it was good for preventing the yoyos in blood glucose that can be triggering for migraine.
Following a low carb higher fibre diet and swapping out highly processed food like white bread and frozen pizzas for healthier carbs like wholemeal bread and sweet potato is great for your overall health as well as your migraines.
Caffeine and alcohol consumption can also be triggering.
7. Supplements
With busy lives, rising food prices and the gradual reduction in the levels of vitamins in our food, it can be a good idea to supplement your diet (check with your doctor or nutrition professional if you are pregnant or have a health condition).
There is good evidence for riboflavin (B2), co-enzyme Q10 and magnesium for migraines.
Magnesium needs to be combined with other B group vitamins and minerals (B3, B6 and zinc) known as co-factors for it to enter the bloodstream.
Other supplements sometimes suggested for migraines include melatonin, vitamins B6, B9 and B12, vitamin E and vitamin C but more research is needed on these.
8. Sleep
Migraine is a brain disorder and people with brain disorders need plenty of sleep.
While you are asleep your glymphatic system is active and filtering toxins from the brain.
You need to aim to get eight hours of sleep a night. If you are way off this, you need to increase your time spent asleep gradually.
Many people find having a lie in or suddenly getting more sleep than usual is triggering, so try to make a gradual shift.
If sleep is a big issue for you, look at sleep hygiene information to help you drift off more easily.
9. Exercise
Regular, moderate intensity exercise like a brisk walk is good for migraine sufferers but some people find strenuous exercise triggering.
If you want to do more strenuous exercises as a migraine sufferer, it needs to be worked up to gradually, to keep it minimally triggering.
10. Spend time in nature
Great for exercising and mental health.
Research into trigger factors and protective factors for migraine have identified time spent outside to be helpful in reducing migraine attacks.
In warmer months I often recommend that people have their meals or breaks outside.
Where possible, go for walks in more natural environments.
11. Mental health support and relaxation
Stress can be triggering for migraines but unfortunately, it’s a part of life and can't just be eliminated.
Therefore, we need to be proactive in minimising the effect stress has on us.
We need to work out where the most stress in our lives is coming from and try to develop strategies to manage it.
This might be trying to make practical changes to reduce stress – like changing your work patterns or dealing with relationship issues.
It could mean finding ways to process the stresses – like going for walks to clear your mind, journalling to process your emotions and reflect on your stressors, getting psychotherapy, getting reiki or massages.
It may also mean starting medications to help you get through your stresses.
There is no perfect remedy to stress, but you need some strategies in place to cope.
12. Stimulants
If you suffer with migraines and also have ADHD, recent research shows that the stimulant type medication (amphetamines) sometimes used to manage ADHD could also be beneficial for your migraines.
Stimulants can also be beneficial if you suffer with depression or chronic fatigue as well as migraines.
13. Painkillers
Migraine sufferers can get through a lot of over the counter or prescription medication.
Long term use of these meds can cause unwanted side effects including dependency and they can even re-trigger migraines or headaches.
For these reasons it’s not ideal to use these kinds of medications on an ongoing basis.
A combination of lifestyle changes and complementary therapies are likely to benefit your overall health and help you achieve a reduction in your migraines to the point where you’ll be less reliant on painkillers.
Katie North is an osteopath with a special interest in headache disorders and migraines at coreclinics.co.uk
