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How to Manage Migraine Headaches

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

What Is a Migraine?

A migraine headache is typically felt on only one side of the head, and it may cause severe throbbing or a pulsing pain. Approximately 38 million Americans get migraine headaches yearly with women getting three times more migraines than men.

Symptoms are frequently accompanied by vomiting, nausea and a strong sensitivity to light and noise. They may last for hours or even days. This pain often begins in childhood, adolescence or early adulthood.

While migraines are related to changes in the brain, the doctors do not know the actual cause. A migraine begins when overactive nerve cells send out signals activating the trigeminal nerve that supplies sensations to the head and face. When this nerve is activated, there is a release of serotonin and calcitonin gene-related peptide (CGRP). This causes the blood vessels in the lining of the brain to swell.

The migraine may progress through the following four stages:

  1. Prodrome: the beginning of the headache
  2. Aura: some may also experience an aura
  3. Attack: the peak of the migraine symptoms
  4. Postdrome: lingering effects

Not everyone will experience all of these stages every time.

How to Tell If You're Getting a Migraine

Some people have subtle warnings a day of two before they get a migraine. These warnings include:

  • Food cravings
  • Constipation
  • Changing Moods, possible depression or euphoria
  • Neck stiffness
  • Increased thirst and urination
  • Frequent yawning

Migraines without an aura are more common, although there are people who have an aura before or during a migraine. Auras occur in about one out of three people. Auras are typically visual, but they may include other disturbances caused by reversible effects on the nervous system. A symptom will begin gradually over several minutes and will last for twenty to sixty minutes.

Common examples of migraine aura symptoms:

  • Pins and needle sensations in an arm or leg
  • Weakness or numbness in the face or one side of the body
  • Visual phenomena, like see various shapes, zigzag lines, bright spots or flashes
  • Vision loss
  • Difficulty speaking
  • Hearing noises or music
  • Ringing in the ears

Uncommon aura symptoms:

  • Having a hard time understanding people or confusion
  • Muscle weakness
  • Noises or music in your head that is not really there
  • Speech problems where you know what you want to say but you cannot form the words
  • Uncontrollable movements or jerking

If the cause of your migraines still cannot be determined, an MRI or a CT scan may be warranted. The MRI will give you a detailed image of the brain and the blood vessels.

Migraines and Vertigo - Mayo Clinic

What Medications Can Treat Migraines?

There are two approaches to treating migraine headaches.

  1. Abortive medications: They are taken at the first sign of a migraine. These medications are given to stop the migraine or at least reduce the symptoms that include the pain, nausea, vomiting or light sensitivity.
  2. Preventive (prophylactic) medications: Given for more severe migraines, occurring more than four times monthly and that interfere with normal activities. These medications are taken daily to prevent the frequency of the migraines.

Over-the-Counter Pain Relievers

Pain relieving medications include over-the-counter medications, such as: Advil, Motrin, Tylenol, etc. The combination of caffeine, aspirin, and acetaminophen (Excedrin Migraine) can also be helpful, but usually only against mild migraines.

Prescription Pain Relievers

The following medications relieve many migraine symptoms as they block the pain pathways in the brain.

  • Sumatriptan (Imitrex, Tosyma) or rizatriptan (Maxalt): These medications may not be safe for anyone at risk of a heart attack or a stroke.
  • Dihydroergotamine (D.H.E. 45, Migranal): available as an injection or a nasal spray. This medication should be taken shortly after the start of migraine symptoms. The side effects include possible worsening of migraine-related nausea and vomiting. If you have coronary artery disease, high blood pressure, kidney or liver disease, this medication should be avoided.
  • Lasmiditan (Reyvow): A newer medication which is approved for migraine with or without an aura. The clinical trials show his medication to be very effective for pain and for nausea. This medication can have a sedative effect, so you are asked not to drive for eight hours after taking Lasmiditan.
  • Ubrogepant (Ubrelvy): An oral calcitonin gene-related peptide antagonist that is approved for acute migraines with or without an aura. This medication reduced pain and was effective against other migraine symptoms, such as sensitivity to light. Dry mouth, nausea and sleepiness are common side effects.

Some people do not tolerate other migraine medications, so they take opioid medications. Due to the addictive nature of these drugs, they are only prescribed when a patient cannot find relief from other treatments.

Anti-nausea drugs may be beneficial for a patient whose migraine is accompanied by nausea and vomiting. These drugs are prescribed along with a pain medication. The anti-nausea drugs include chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro).

Preventative Medications

Preventative medications are aimed at reducing the severity of the migraine and for how long they last. These medications include:

  • Blood pressure-lowering medications that include beta blockers like propranolol (Inderal, Innopran XL) and metoprolol tartrate (Lopressor). Also, calcium channel blockers, such as verapamil (Tarka, Verelan) can also help prevent migraines.
  • Tricyclic antidepressant (amitriptyline) can also help prevent migraines.
  • Anti-seizure medications Valproate and topiramate (Topamax)may lessen the number of migraines you have but the side effects are dizziness, weight changes and more.
  • Injections of onabotulinumtoxinA (Botox) every twelve weeks is used to prevent migraines in adults.
  • Other monthly injections include Calcitonin gene-related peptide (CGRP) monoclonal antibodies (Erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy) and galcanezumab-gnlm (Emgality) with few side effects.

Alternative Medicine Treatments

There are some alternative medicines that may help treat migraines, although more studies need to be done to determine their effectiveness and establish best practices. Because they are not established treatment options, discuss them with your doctor before starting.

  • Acupuncture has been shown to be helpful for any headache pain.
  • Biofeedback has in some cases been effective in relieving migraine pain. Relaxation techniques use specific equipment to teach you a way to monitor and then control particular physical responses that are related to stress.
  • Cognitive behavioral therapy may benefit some patients with migraines. This technique teaches behaviors and thoughts that may affect how you actually perceive pain.
  • Herbs, vitamins and minerals may help. Some evidence has shown that feverfew and butternut may prevent migraines or even reduce their severity.
migrain-headaches-treatments

Ways to Manage Your Migraines

In addition to medications, there are a few other ways you can manage your migraines, including:

  • Resting in a dark, quiet cool room
  • Massaging your scalp
  • Applying pressure in a circular motion to your temples
  • Using a cool compress or washcloth to your forehead or behind your neck
  • Keeping yourself in a calm state
  • Meditating or start using biofeedback methods
  • Getting seven to nine hours of sleep each night
  • Eating each meal without skipping any meals
  • Exercising regularly and keeping a healthy weight
  • Drinking plenty of water
  • Talking to your physician about hormone therapy if your migraines seem to be linked to your menstrual cycle

It is a good idea to keep a migraine diary, which might help you find triggers for your migraines.

University of Michigan Medicine: Treating Migraine

Final Thoughts

Migraine headaches can be very difficult. Each person is a bit different, so the medication that works for one may not work for another. Getting a good doctor to determine the best medication for each individual is important. There are several ways to deal with migraine headaches.

References

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2020 Pamela Oglesby

Comments

Pamela Oglesby (author) from Sunny Florida on July 17, 2020:

Hi Anupam,

I am so glad there are more ways to control a migraine now as compared to 20 years ago. Thanks si much for your very nice comments.

Anupam Mitu from MUMBAI on July 17, 2020:

So much of the research you have made Pamela for this helpful article. It will definitely help many people who are troubled by migration. Thank you dear.

Pamela Oglesby (author) from Sunny Florida on June 19, 2020:

Hi Maria,

I use to have these headaches but they have stopped. I thought it was due to aging. I was amazed at the large number of new medications. I appreciate your comments.

Love, Pam

Maria Jordan from Jeffersonville PA on June 18, 2020:

Dear Pamela,

I have great empathy for those who suffer with migraine headaches.

I am fortunate to no longer get them. I do believe mostly limiting processed foods has helped.

Excellent article - especially outlining all the available medications.

Love,

Maria

Pamela Oglesby (author) from Sunny Florida on June 09, 2020:

Hi Patricia,

I am glad your migraines are less frequet. As I aged my migraines went totally away, so I hope that will be the case for you. I would think your vertigo is connected to the eardrum, but I don't know that for sure.

I pray the vertigo goes away also. I haven't seen you very often lately, so I hope you have been well otherwise.

God Bless you, Patricia.

Patricia Scott from North Central Florida on June 09, 2020:

Good morning..very interesting. I have vertigo and migraines. However have not had borh at once. I was on inderal for years to help control migraines...and about 10 years ago was weaned off it. Thankfully I do not have migraines often ..maybe every few months. I do have vertigo much more iften than I care to ( obviously my preference would be to have it not at all). I had a mastoidectomy when I was 12 years old and then I had a new eardrum made in 1980. And have been told that that is a link to my vertigo. Hoping all is good with you and yours. Stay well and safe. Angels are headed your way this morning. PS

Pamela Oglesby (author) from Sunny Florida on June 04, 2020:

Hi Lisha,

It is hard to deal with pain and not take something to stop the pain or at least reduce it. If your doctor has prescribed a pain medication for your migraines be sure to ask the doctor if you can get addicted to the medication. Some mediations are easier to become addicted to than others.

Your doctor should tell you about side effects of medications if you ask. Over-the-counter medications do not cause any addiction as far as I know. I hope your migraines go away as you get older as it is very common for these headaches to start when you are young. Thank you for your comments. They are appreciated.

Lisha C on June 04, 2020:

Thank you for this very informative article.

I often get bad migraines but usually try to manage without medication. Is it okay to take such medications regularly?

I have been getting them since I was a kid, so whenever I do, I always end up worrying about the last time I took medication. Only if a considerable time has passed do I take another one. And this is with normal over-the-counter medication.

Pamela Oglesby (author) from Sunny Florida on June 03, 2020:

Hi Lori,

Your history sounds just like mine as I had a hysterectormy and the migraines stopped. I didn't think anyone had a migraine every day but I could be wrong.

Thank you so much for your very kind comments, Lori.

Lori Colbo from Pacific Northwest on June 02, 2020:

This was very thorough, as all your articles are. I have many people in my life who have them. I have a family member who claims to have a migraine every day. Yet she's up and around with the kids, driving them here and there, laughing, etc. I'd like to give her the benefit of the doubt but she does have a tendency to self-diagnose. I don't doubt she has headaches but migraines seem debilitating where you can't function. She has sought much medical treatment and I have not had an update in a very long time.

I used to get migraines when I menstruated in the last several years before getting a hysterectomy. I had to go to bed in a dark room with a cold cloth. Thanks for covering topics so prominent in our lives.

Pamela Oglesby (author) from Sunny Florida on June 02, 2020:

Hi Robert,

I appreciate your comments Robert.

Robert Sacchi on June 02, 2020:

Thank you for posting yet another informative medical article.

Pamela Oglesby (author) from Sunny Florida on June 02, 2020:

Hi Jason,

I am sorry to hear you suffer from migraines. My brother has suffered with these headaches also and it is hard. I am glad you found my article helpful. Thank you for your comments.

Jason Nicolosi from AZ on June 02, 2020:

I have suffered from migraine headaches for most of my life. Certain lights or smells usually trigger them for me. I especially get them when the sky is hazy and overcast.

Great article Pamela. Tons of helpful information here. Thanks. Stay safe and healthy.

Pamela Oglesby (author) from Sunny Florida on June 02, 2020:

Hi Devika,

I am glad you like this article. i appreciate your comments, as always.

Devika Primić from Dubrovnik, Croatia on June 02, 2020:

Pamela Oglesby information of the Migraine headaches is important. Sometimes such symptoms can be ignored. Your research is accurate and worth a read.

Pamela Oglesby (author) from Sunny Florida on June 02, 2020:

Hi Yves,

It sounds like your mother's migraines were very debilitating. Alternative treatments probably would not work for someone like her, but some people have milder migraines. Thank you for your comments.

Yves on June 02, 2020:

Very informative. I wish my mother had access to migraine medication when she was alive. Her migraine attacks were severe and lengthy.

It is difficult for me to imagine alternative treatments as a relief, but perhaps they works for some..

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on June 02, 2020:

Pamela, you're welcomed. Enjoy the week.

Pamela Oglesby (author) from Sunny Florida on June 01, 2020:

Hi Midbakagh,

Yes, alternative treatment can take many forms. Thank you for your comments.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on June 01, 2020:

Pamela, the alternative treatment can take many forms like physiotherapy, physical exercise, isometrics, and others where accumputure cannot realised. At times it is adviceable one follow up with orthodox treatment. Thanks for the story.

Pamela Oglesby (author) from Sunny Florida on June 01, 2020:

Hi Ms Dora,

Migraines are really tough and you are fortunate not to have them. I think alternative treatments are important to try first as they do work some of the time. I appreciate your comments. Have a wonderful week.

Dora Weithers from The Caribbean on June 01, 2020:

I've heard that migraines are very uncomfortable and can be very painful. Thanks for the suggestions to manage them, and the alternative treatments. Good to know.

Pamela Oglesby (author) from Sunny Florida on June 01, 2020:

Hi Carolina,

I try to be thorough when writing this type of article. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on June 01, 2020:

Hi Peggy,

I hope your friend is helped by this article as migraines are so debilitating. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on June 01, 2020:

Hi Umesh,

Thank you for your comments.

Pamela Oglesby (author) from Sunny Florida on June 01, 2020:

Hi Genna,

That headache when you were pregnant must have been awful and of course you can't take a medication when you are pregnant. Thanks so much for your very nice comments.

Genna East from Massachusetts, USA on June 01, 2020:

Migraines can be terrible. I've only ever had them once and that was when I was pregnant with my son. Just awful, as I couldn't take anything for them. Your research and attention to detail with your article is, as usual, just superb. Thank you.

Umesh Chandra Bhatt from Kharghar, Navi Mumbai, India on June 01, 2020:

Exhaustive and very informative. Well presented.

Peggy Woods from Houston, Texas on May 31, 2020:

Hi Pamela,

You have shed light on this debilitating type of headache and possible ways to head it off or treat it with medications as well as other forms of treatment. I am pinning this to my health board and plan to share it with a person that suffers from migraines. Thanks for writing this.

Carolina Dursina from Spring Green WI on May 31, 2020:

Thank you for the article, you really put a lot of research time on it!

Pamela Oglesby (author) from Sunny Florida on May 31, 2020:

Hi Lora,

I am glad you have a friend that might find some help from the article. I know migraines can be debilitating and if someone could find help with herbal remedies that would be a healthy choice. I appreciate you very nice comments.

Lora Hollings on May 31, 2020:

This is a great in-depth article on migraines, their causes, and current treatments. I'm glad that I don't have these kind of headaches. I know people who've had these and they are very debilitating. I think the alternative medicine treatments could prevent people from having to use some strong medications with very adverse side effects. I'm sure many migraine sufferers will find this article very useful and would like to try some of the herbal remedies that you mention such as feverfew and butternut. Acupuncture, biofeedback, and cognitive behavior therapy all sound very promising in treating these severe headaches too. I have an acquaintance who suffers with migraines and I'll forward the link to your excellent article to her which would serve as a wonderful resource. Thanks for sharing, Pamela.

Pamela Oglesby (author) from Sunny Florida on May 31, 2020:

Hi Alyssa,

I'm glad you don't have migraines on a regular basis. I am glad you found this article interesting and you will know more about treatments if the migraines return. I appreciate your generous comments.

Alyssa from Ohio on May 31, 2020:

I feel very fortunate to only have had a few migraines in my life. It was incredibly debilitating. I can't imagine having to deal with the pain on a regular basis. This was very informative and interesting! It seems like there are a lot of treatments to try. Hopefully more research can be done in the future to try to understand the causes behind them.

Pamela Oglesby (author) from Sunny Florida on May 31, 2020:

Hi Rajan,

Thank you so much for your comments.

Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on May 31, 2020:

Thanks for this informative write-up on migraine and how to go about getting relief from it.

Pamela Oglesby (author) from Sunny Florida on May 31, 2020:

Hi Clive.

Thanks for your comments and for sharing your unique remedy.

Pamela Oglesby (author) from Sunny Florida on May 31, 2020:

Hi Linda,

Some people have a very difficult time. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on May 31, 2020:

Hi Flourish,

Your story is like others I hav heard as everybody is different and it takes a while to find the medications that work. Thank you for sharing your experience.

FlourishAnyway from USA on May 31, 2020:

I have had migraines for 20 years and find that Topamax works for me to help prevent them and Relpax (eletriptan) helps for breakthrough migraines. For the rare occipital migraines, I have to get injections By a pain specialist or my neurologist at the base of my neck. It’s taken a long time to find a combination that works. Early on I was prescribed several meds that didn’t work and one called Zomig that made me so ill that my migraine was dwarfed by the side effects. I don’t know what was in that medicine.

Linda Crampton from British Columbia, Canada on May 30, 2020:

Thanks for sharing the detailed information, Pamela. Migraines can be difficult to deal with. The facts that you've shared are important.

Clive Williams from Jamaica on May 30, 2020:

My Remedy...Garlic boiled with Ganja

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Cheryl,

I am sorry to hear your daughter has migraine and I hope this article helps her. Thank you for your comments. Have a nice weekend.

Cheryl E Preston from Roanoke on May 30, 2020:

I will share with my daughter who gets migraines. Thank you.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi MG,

Aspirin probably isn't strong enough to stop a migraine but I guess anything is worth a try, I appreciate your comments.

MG Singh emge from Singapore on May 30, 2020:

A wealth of information. Is Aspro or Aspirin a good short term remedy?

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Ruby,

I am glad you do not haveor your migraine headaches. Thank you so much for your comments. Have a nice weekend.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Linda,

I am glad to hear you do not have migraine headaches. I appreciate your comment, as always. Have a nice weekend.

Linda Lum from Washington State, USA on May 30, 2020:

A lot of very good, concise information here. Thank goodness I've never had migraines, but my next-door neighbor did and had regular treatments with Botox.

Ruby Jean Richert from Southern Illinois on May 30, 2020:

Very concise and up to date article. I have never had migraine headaches, but I have friends who do. Thanks for sharing.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Eric,

You have an amazing story really. Your cancer was accidently discovered, but I would say that is God looking after you. My husband had a fractured leg and they accidetly discovered an aortic aneurysm, which saved his life. So, are both off these incidents an acciden? I think maybe they were both God saving your lives.

I am sorry you have migraines and I hope they will go away. Thanks for your comments. Stay safe and be healthy.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Rosina,

You could easily know someone with migraines as they are so common. I am glad you found the article interesting.

I appreciate your comments. Have a nice weekend.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Miebakagh,

There are sme lifestyle changes you can make to reduce your stress and that may help. Thank you for your comments.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on May 30, 2020:

Pamela, as serious as the disease is, it always needs a doctors attention and treatment. Thanks for the lots of information you provide therein. Happy weekend.

Rosina S Khan on May 30, 2020:

Thank you, Pamela, for such a well-packed informative article on migraines along with their warning signs and treatments. Although I never had migraines, I found the article useful to pass it to others who would benefit from it.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Linda,

I am glad your migraine are gone as they sound miserable. Thank you so much for your comments.

Linda Chechar from Arizona on May 30, 2020:

I had migraines in college. It was horrible pain that lasted almost 12 to 24 hours. I had the aura and nausea. I wonder if it caused hormones. The migraines finally went away and I never had then ever again.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Chitrangada,

A lifestyle change and a homeopathic treatment is the best way to treat any disease. I am glad you sister-in-law is not suffering any longer. I appreciate your comments.

Chitrangada Sharan from New Delhi, India on May 30, 2020:

Well written article about Migraine, with all the relevant information.

My sister-in-law used to suffer from this, frequently. We were really concerned for her, whenever she suffered from the unbearable pain. No medicine used to work. Thankfully, now she doesn’t suffer due to this. What really worked for her, is the lifestyle changes, and some homeopathic medicines. I am forwarding this useful information to some of my friends.

Thank you for sharing your knowledge.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Manatita,

I am glad you have a medication that helps you in several areas. I appreciate your very nice comments.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Bill,

As less men than women get migraines, you are in that fortunate group. Thank you for your comments. Have a nice weekend, Bill.

Eric Dierker from Spring Valley, CA. U.S.A. on May 30, 2020:

How very interesting. Mine are physically caused by a tension running up into the region associated with these problems.

Here is what I think a very fun one. They could not figure out the cause of my issues. So they had me do a CT Scan. Somehow the technician accidentally went too far down into the abdomen. My cancer was accidentally discovered in a very early stage -- yahoo for accidents :-)

We found the cause and now while I get the migraines I can reduce the problems and pain.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Lorna,

I had them as a young adult but it has been years since I have had one now, thank goodness. I am glad yours are gone most of the time also. I do think meditation is one good way to have better health in many ways. Thank you for your comments.

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Louise,

It is good that your haven't had migraines. I appreciate all of your comments.

Louise Powles from Norfolk, England on May 30, 2020:

Thankfully I have never suffered with migraines. I know people that do suffer with them though so know how horrid they can be.

Lorna Lamon on May 30, 2020:

I used to suffer with migraine headaches as a teenager. However, I rarely have them now. The only thing that would help was lying in a dark room. Since practicing meditation I find that on the rare occasion I do experience one, it does not last as long. This is such a useful article Pamela which you have covered really well. Thank you for sharing.

Bill Holland from Olympia, WA on May 30, 2020:

A regular headache can stop me in my tracks. I can't imagine a migraine. I am just thankful I never had one. :) Thanks for the information.

manatita44 from london on May 30, 2020:

A very thorough and well researched report. I take Naproxen which is mentioned in the video. It has anti-inflamatory uses as well. So it helps my eyes, kidneys and sciatical back pains.

You have spent some time and done an awesome job here. Great!

Pamela Oglesby (author) from Sunny Florida on May 30, 2020:

Hi Liz,

Thank you for your very nice comments, Liz. I am honred that you would like to collect my articles.

Liz Westwood from UK on May 30, 2020:

Migraines are debilitating and affect a lot of people. As usual you have covered the subject very well, explaining the symptoms and possible treatments. I feel like I need to collect your articles together for future reference.

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