Migraine Mitigation

Sufferers describe migraines in different ways—everything from feeling like their head is on fire to throbbing “brain pain.” “These headaches are intense,” says Vinita Singh, associate professor of anesthesiology at Emory School of Medicine and pain medicine specialist with Emory Healthcare. “They’re incapacitating. They can stop you from doing anything at all.”

Singh answers Emory Health Digest’s four questions about migraines:

Can I predict when a migraine is coming on?

Insome cases, but not all, a migraine is preceded by an aura. Auras are experiences such as visual disturbances, sensitivity to light or sound, or nausea. Some people feel odd sensations or have problems with speech. If you can predict a headache is about to start, it’s often a sign of a migraine. Usually, these headaches come and go. They might last a few hours or even a few days, but the pain disappears, at least for a while. 

How can I help my doctor better understand my personal migraines?

The pattern of your migraines can guide treatment decisions, so keep track of symptoms, triggers and impacts in a diary. Each time you have a headache, note:

• When your headache started and its duration
• Your pain and its severity
• What you ate before
• Where you went that day
• How well you slept
• How much water you drank
• What the weather was like
• Exposure to something out of the ordinary, like flashing lights
• Treatments you’ve tried
• Activities your headache prevented

Also, tell your doctor if migraines run in your family.

Is there anything I can do to prevent migraines?

Another unique thing about migraines is that they have triggers. The American Migraine Foundation lists a wide range of factors that can trigger a migraine including: certain smells; dehydration; specific foods, such as chocolate or aged cheese; alcohol and caffeine; stress; weather changes; menstrual cycle.

Are there different treatment plans for different types of migraines?

Your treatment plan will take into account how many migraine-free days you have each month. If you have just a few headache days—let’s say you’re headache-free 25 days a month—then we would treat your headaches when they occur. If you take certain medicines more than 10 days a month, they can actually cause more frequent headaches or make them worse. If you have a headache more frequently, the focus turns to prevention. Doctors typically start with the most conservative therapies. If they don’t provide relief, other options are considered:

VITAMINS AND SUPPLEMENTS 

Research shows vitamins such as riboflavin and supplements like magnesium, butterbur and feverfew may help prevent migraines. It’s important to talk with your primary care provider before taking herbs or supplements on your own.

MEDICATIONS

Nerve stabilizers, such as gabapentin and topiramate, help calm abnormal excitement in your brain. Calcitonin gene-related peptide (CGRP) inhibitors include several newer drugs specifically developed to prevent migraines.

NERVE BLOCKS

Doctors inject medication near certain nerves to block pain signals.

BOTULINUM TOXIN

Doctors use it to treat frequent migraines, but usually only as a last resort. When injected near nerve endings, botulinum toxin interferes with pain signals.

 

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