As appears in: Everyday Health by Beth W. Orenstein
Keeping a diary of your triggers is one way to minimize your risk of a migraine. Find out what else you can do.
Do migraines wreak havoc on your life? They do for more than 38 million Americans, or 13 percent of the U.S. population, according to the American Migraine Foundation.
Migraines are defined as intense, pulsing, or throbbing pain in one area of the head. Other symptoms may include nausea, vomiting, and sensitivity to both light and sound, according to the National Institute of Neurological Disorders and Stroke. If that sounds bad, the American Migraine Foundation notes that chronic migraine, which affects four million people in the United States, is defined as 15 or more headache days per month with eight of those days meeting criteria for migraine.
Maybe you get a migraine the day you plan to entertain out-of-town guests. Or perhaps your migraine invariably starts on a holiday weekend, on the first day of a new project, or at the start of a family vacation. Migraines happen abruptly, are unpredictable, and can disrupt even the best-laid plans.
There are ways to lessen your chance of migraine if you are aware of your migraine triggers. While the causes of migraine are not well understood, researchers know that genetics and environment play a role. Knowing your migraine triggers can allow you to change those you can control, helping to reduce the impact of migraine on your active life.
A number of factors may trigger migraines, according to the Mayo Clinic, including:
While you can’t change your family history or your age, knowing your personal migraine triggers can help you take preventive steps to make sure you’re managing your migraines instead of adding fuel to the fire.
Here are 10 things that you can do:
“Keeping a headache diary is a good way to figure out the association between migraine triggers, your lifestyle, and headache,” says Robert Cowan, MD, professor of neurology and chief of the division of headache medicine at Stanford University in California. “With a headache diary, you’ll start to see a pattern, such as you get migraines on weekends or in the afternoon. If you take migraine medication, you record this in your diary.”
Dr. Cowan recommends using a free headache diary app to keep track of migraines and triggers. He and two colleagues created the free app BonTriage, which is available in the App Store.
“Migraine is a problem between you and your environment,” says Cowan. “And my migraine patients who do the best take their lifestyle habits seriously.”
“This means eating meals the same time every day and going to bed and waking up at the same time,” Cowan adds. “Be regular and consistent with your exercise. These are the things that set the patterns for the brain to know what’s coming: sleep, wake up, eat, exercise.”
Migraines hate change. Being consistent reassures your brain that everything is okay.
“I also tell my patients they have to take a holistic approach to managing migraine,” Cowan says. “I believe it takes a village to raze a headache, and this means using a multidisciplinary approach.”
One way of doing this is to pay attention to your life. Cowan recommends, “Don’t let the clutter pile up. If you didn’t sleep well one night, avoid wine that day.”
He also adds, “You can’t live in a cave with migraine. You take the precautions you can, and then live your life.”
It’s important to eat natural whole foods to prevent migraines.
Meredith Barad, MD, clinical associate professor of anesthesiology, perioperative, and pain medicine at Stanford University, recommends “Minimizing caffeine and sugar. Minimize processed foods in your diet, and avoid chemical triggers like MSG and nitrites, which may trigger migraine in some people.”
Additionally, Dr. Barad says, “Stay away from carbs and sugar. Instead, eat a protein and veggie when you’re hungry. And if you don’t recognize an ingredient on a food label, do not put it in your body!”
“Migraine is a chronic medical condition that’s not going away, so you have to live as healthy of a lifestyle as possible,” says Barad. “Along with understanding your migraine triggers, learning how to cope and manage stress is vital,” she adds. She recommends eating and sleeping right, and psychotherapy, which can be more effective than a pill for treating depression and anxiety with migraine.
Cowan suggests trying acupuncture, herbal remedies, and moxibustion, a therapy that involves burning herbs on targeted parts of the body. “If you use traditional Chinese medicine (TCM), make sure the physician is certified and licensed. While Western medicine has been around for just 250 years, TCM has been around 2,500 years and Ayurvedic for 5,000 years in India. Just be smart and check credentials.”
For frequent migraines, your doctor may prescribe a neuromodulation device as a way to reduce the attacks. Lisa Coohill, MD, a neurologist for Summit Medical Group in Berkeley Heights, New Jersey, suggests a device such as Cefaly may be used to prevent migraine.
“Cefaly is a trigeminal nerve [or fifth cranial nerve] stimulator,” Dr. Coohill explains. “Using this 20 minutes before bedtime and during a migraine may help with headache management.”
Other neuromodulation devices that have been approved by the U.S. Food and Drug Administration (FDA), according to the American Migraine Foundation, include the sTMS, or single-pulse transcranial magnetic stimulator, and the gammaCore, which stimulates the vagus nerve.
Natural dietary supplements, such as those indicated for migraine by the University of Michigan, are available over the counter at most pharmacies. It is best to discuss with your primary care doctor or neurologist before starting supplements for long-term use.
If there are migraine triggers you can’t change, such as a sensitivity to weather or barometer changes, talk with your doctor about preventive medicines.
According to Coohill, the newer preventive migraine drugs can be life-changing. “Especially if your migraines are frequent, these medications may ease the pain and frequency of migraine."
Coohill adds, “We typically use medicine for people who have a migraine a week or more. It’s important not to take acute migraine medication daily as that can lead to rebound headaches.”
If you’re in doubt about your migraine triggers, symptoms, or treatment, talk to your primary care physician or neurologist. Your doctor can prescribe acute or preventive medication and talk to you about your personal health history and migraine triggers.