10 Ways To Manage Migraines
Learn your personal triggers (with the idea of eliminating them!) by jotting key clues in a headache diary. Wear prescription sunglasses while driving in the day and anti-glare glasses in the night or while working on a computer. Eat meals on a regular schedule and don't let yourself get dehydrated. Downsize your stress and be sure to get a good night's rest.
Migraine has a special place in the headache lexicon simply for the hardship it puts the sufferer through. In the Global Burden of Diseases study in 2013, migraine was found to be the sixth highest cause worldwide of years lost to disability.1
A migraine is a neurological disease affecting 38 million Americans and 1 billion worldwide. It is so prevalent in the US that a survey has found 1 in 4 American homes has at least one person with a migraine. It was also found that 18 percent of American women, 6 percent of men and 10 percent children experience migraine. It also tends to run in families with 90 percent of sufferers found to have inherited it from a family member.2
So What Is A Migraine? How Is It Different From Other Headaches?
A migraine is triggered by the stimulation of a mechanism deep in the brain that leads to the release of pain-causing inflammatory substances surrounding the nerves and blood vessels of the head. It is a recurrent headache and is different from other headaches in that it is one-sided and pulsating in quality with nausea often accompanying the headache. The frequency of a migraine attack varies from once a week to once a year.3
Can A Migraine Be Treated?
While painkillers such as aspirin and paracetamol are advised in case of an attack to ease it, there is no definite cure for a migraine. It has also been suggested that trying to sleep or lying in a dark place at the first sign of an attack helps alleviate the severity of the attack.4 Then how does one deal with a migraine? Well, prevention and management are the only ways to keep a migraine in check.
How Does One Manage Migraine?
In the case of migraine management, identifying the triggers is half the battle won. Most patients seem to identify the triggers with time. In fact, in a study at the City of London Migraine Clinic, 79 percent of patients were found to know what triggered the attack.5
A migraine can be triggered by anything from hormonal, physical, and dietary to emotional, environmental and medicinal factors.6
At times, the triggers can be confusing as a potential trigger may not result in an attack. That’s because every patient has what is called a “migraine threshold” that allows him/her to tolerate its effect to an extent without actually having to go through an attack. Only when the effect of the trigger or triggers crosses the threshold, it becomes an attack.7
The Importance Of A Change In Lifestyle
Managing a migraine calls for many lifestyle changes. Reducing stress levels, losing weight, having a regular exercise regime, among others, have found to be beneficial in managing a migraine. If the migraine is linked to the menstrual cycle in women, hormone therapy may help.8
Understanding triggers to avoid them forms the major part of the lifestyle changes. Any change in the environment or the body function sets a migraine patient up for an attack. Some common triggers for a migraine are skipped meals, irregular caffeine intake and sleep, the hormonal changes that come with the menstrual cycle in women, changes in the weather, air travel, and stress.9
10 Lifestyle Changes To Manage Migraine Easily
1) The First Step To Migraine Management? Keep A Diary
So have all this information about migraine triggers left you confused? Keep a diary. Why the diary, you may ask. It is to keep a track of your migraine patterns and pin your triggers down. Your migraine diary should ideally have details such as the onset of pain, the frequency, the duration of an attack, the location of the pain, its nature and the accompanying symptoms. These details will help you understand your migraine better and also to help your doctor make a firm diagnosis.10
2) Reduce Your Stress Levels
The importance of reducing stress in alleviating a migraine cannot be undermined simply because studies show stress and mental tension as the most conspicuous precipitating factors of a migraine.11 Relaxation is important and anything like yoga and meditation that can reduce your stress levels should be included in your daily routine.
In a study conducted to understand the effect of an 8-week mindfulness-based stress reduction in individuals with migraines, the intervention was found to beneficial in reducing the headache duration, disability, self-efficacy, and mindfulness.12
The International Headache Society lists migraine as one of the primary headaches which are not associated with any pre-existing medical conditions. Only about half of all migraineurs are found to show clinically positive responses to medications. So what is left is expert management, and yoga is found to score a point here–not just for the muscle relaxation it provides but for the integration of breathing into the system.13
3) Get Adequate Amount Of Sleep Each Night
Sleep deprivation, or sometimes even a change in sleep pattern can trigger a migraine attack. In a cross-sectional epidemiological study on precipitating factors of headaches, both migraine and tension-type headaches were found to get precipitated with the change in sleep pattern.14
In a study conducted to specifically understand the effect of the change in sleep patterns on the severity and frequency of headaches, 1283 migraineurs and 1480 headache sufferers were studied. Almost 38 percent of those studied reported chronically shortened sleep patterns, sleeping an average of 6 hours per night. Sleep disturbance triggered migraines in 50 percent of them; 71 percent reported headaches awakening them from sleep; 85 percent migraineurs chose to sleep in case of a headache; 75 percent were forced to sleep because of a headache. More significantly, chronic migraineurs reported shorter nightly sleep than those with an episodic migraine. Short sleepers with average sleep hours of just 6 hours exhibited more severe headaches than individuals who slept longer.15
4) Avoid Foods That Trigger A Migraine
Chocolates, nuts, fermented foods — a host food triggers have been identified for a migraine. Though it is not necessary to completely eliminate them from the diet, it is important to have them in moderation. It is interesting to note that a food item may not always trigger an attack, but a combination of various triggers would. For example, while a glass of wine may not always precipitate migraine, skipping meals and having wine and cheese on an empty stomach could result in an attack.
Caffeine has a special place in a migraineur’s diary as it can be both a treatment and a trigger for a migraine. At the peak of an attack, caffeine may help alleviate the pain but caffeine itself could start one. But if you cannot live without your daily dose of coffee, stick to that dose consistently.16
5) Eat Meals On A Regular Schedule
Once you’ve eliminated migraine triggers from your diet, it is important to stick to an eating schedule. Fasting or skipping meals is not a great idea if you are prone to migraine attacks because skipping meals has been proven to be a migraine trigger.17 Though several hypotheses exist, the real mechanism behind fasting-induced headaches is unclear.18
6) Maintain A Healthy Weight
There is research suggesting migraine and obesity could be directly linked with evidence showing higher migraine prevalence in the obese population. For this reason, behavioral weight loss intervention is considered useful in migraine management.19
7) Drink Plenty Of Water
Drinking plenty of fluids help to keep migraine at bay. In two different studies, 34 out of 95 migraineurs said dehydration provoked migraine attacks in them though this precipitant is not recognized by medical professionals. Patients with migraine across the world believe dehydration is a trigger. If you are not convinced, check back on your diary.20
8) Avoid Direct Light
Exposure to direct sunlight or any other light almost always triggers a migraine. Wear protective sunglasses when you step out on a hot, sunny day. Always wear prescription sunglasses while driving in the day and antiglare glasses in the night or while working on a computer.21
A new threat to migraine sufferers all over the world is the popularity of Compact Fluorescent Lights or CFLs that are replacing traditional incandescent ones for their ability to use less energy. CFLs emit light in a different spectrum that may not be noticeable to the naked eye but it is a well-documented problem among migraineurs. The Health Protection Agency in the UK recommends CFLs of encapsulated variety that looks more like the traditional ones over the single envelop variety that looks like coils or prongs.22
9) Avoid Alcohol Or Have It In Moderation
Experts differ on the effect of alcohol consumption on migraine. Studies show that though alcohol is a trigger, the risk is overstated and if it doesn’t trigger an attack, a small dose of alcohol–like a 5-ounce glass of wine–can be had. Over consumption of alcohol, however, can trigger an attack either immediately or as a delayed hangover headache.Though red wine is considered the worst culprit, studies show it is the alcohol content and not the type of drink that triggers the attack.23
10) Exercise Helps Reduce Frequency
While migraineurs often avoid taking up any exercise because of the tiredness that comes from frequent migraine attacks, it has been found that aerobic exercises can reduce the frequency and severity of attacks. Here, too, consistency is the key.24
How To Manage Menstrual Migraine In Women
Women migraineurs far surpass men in numbers all over the world. It is no surprise then that there is something called menstrual migraine exists. More than 50 percent of women with a migraine reports an association between menstruation and migraine.25 And this menstrual migraine due to hormonal changes during menstruation is very common among women. If you have headaches that occur two days before menstruation and the first three days during the flow, chances are that it is menstrual migraine. You would also notice these headaches to be stronger and that you are being more sensitive to light during this period.26 If the migraine is menstruation related, the lifestyle tips mentioned above may not help manage it. Various hormonal and medical interventions are advised depending on the severity of the condition.
A migraine is a debilitating condition. What’s worse is there is no definite cure for it. But managing it is possible. Start with keeping a migraine diary.
References [ + ]
|1, 3.||↑||Headache Disorders. WHO.|
|2.||↑||Migraine Facts. Migraine Research Foundation.|
|5, 7.||↑||Migraine Triggers. National Migraine Centre.|
|9, 16, 24.||↑||Migraine Handout. UCLA.|
|10.||↑||Migraine Disorders. The Migraine Trust.|
|11, 14.||↑||Rasmussen, Birthe Krogh. “Migraine and tension-type headache in a general population: precipitating factors, female hormones, sleep pattern and relation to lifestyle.” Pain 53, no. 1 (1993): 65-72.|
|12.||↑||Wells, Rebecca Erwin, Rebecca Burch, Randall H. Paulsen, Peter M. Wayne, Timothy T. Houle, and Elizabeth Loder. “Meditation for migraines: a pilot randomized controlled trial.” Headache: The Journal of Head and Face Pain 54, no. 9 (2014): 1484-1495.|
|13.||↑||Kim, Sang-Dol. “Effects of yoga exercises for headaches: a systematic review of randomized controlled trials.” Journal of physical therapy science 27, no. 7 (2015): 2377.|
|15.||↑||Kelman, Leslie, and Jeanetta C. Rains. “Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs.” Headache: The Journal of Head and Face Pain 45, no. 7 (2005): 904-910.|
|17.||↑||Wöber, Christian, and Çiçek Wöber-Bingöl. “Triggers of migraine and tension-type headache.” Handbook of clinical neurology 97 (2010): 161-172.|
|18.||↑||Dalkara, Turgay, and Kıvılcım Kılıç. “How does fasting trigger migraine? A hypothesis.” Current pain and headache reports 17, no. 10 (2013): 1-7.|
|19.||↑||Bond, Dale S., Julie Roth, Justin M. Nash, and Rena R. Wing. “Migraine and obesity: epidemiology, possible mechanisms and the potential role of weight loss treatment.” Obesity Reviews 12, no. 5 (2011): e362-e371.|
|20.||↑||Blau, Joseph N. “Water deprivation: a new migraine precipitant.” Headache: The Journal of Head and Face Pain 45, no. 6 (2005): 757-759.|
|21.||↑||Designing migraine-free lifestyle. Brain Institute – Oregon Health & Science University.|
|22.||↑||Migraine and light sensitivity. NHS.|
|23.||↑||Alcohol and migraine. American Migraine Foundation.|
|25.||↑||MacGregor, E. Anne. “Menstrual migraine: therapeutic approaches.” Therapeutic advances in neurological disorders (2009).|
|26.||↑||Menstrual Migraine. American Headache Society.|