A Guide to Migraine Treatment

What Causes Migraines? | Flow Osteopathy & Headache Clinic

Migraine is a common condition that can significantly impact a person’s quality of life. In addition to causing pain, migraines can also be accompanied by a variety of symptoms, such as nausea, sensitivity to light and sound, and visual disturbances amongst many others. Fortunately, there are many evidence-based treatments available that can help manage migraine. This guide will cover the most effective medications, natural treatments, at-home remedies, and future treatments for migraine.

 

Medication

Medications are an important piece of the treatment puzzle. There are several classes of medications that can be effective in reducing the frequency and severity of migraines. The use of certain classes of medications should be monitored as long-term use can lead to medication-adaptation headaches (Silberstein, 2015). Like many treatments, it is normal to go through a trial and error process when trying to find the most effective and best tolerated medications.

 

  1. Triptans: Triptans are a class of medications that are specifically designed to treat migraine. There are a variety of forms of triptans, including sumatriptan, maxalt, relpax among others. Depending on the type you take, they work by either narrowing blood vessels in the brain, reducing brainstem sensitivity or a combination of both. Triptans are available in oral, nasal spray, and injection forms (Loder et al., 2017)
  2. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen and naproxen, can be effective in reducing the pain and inflammation associated with migraines (Robbins et al., 2019).
  3. Anti-nausea medications: Medications such as metoclopramide and prochlorperazine can be effective in reducing nausea associated with migraines (Loder et al., 2017).
  4. Preventive medications: Certain medications, such as beta-blockers and antidepressants (amytriptaline is a common one), can be used to prevent migraines from occurring in the first place (American Migraine Foundation, 2021). There are newer preventative medications, known as CGRP inhibitors which we will discuss later in the article.

Natural Treatments

Supplements for Migraine

In addition to medication, there are several natural supplements that can be effective in reducing the frequency and severity of migraine. It is important that you discuss the use of supplements with a doctor as they can interact with some medications and may be inappropriate for people with certain conditions. A nutritional expert, such as a dietician can be an invaluable member of your team when it comes to choosing the best supplements and dosage. They can also look more broadly at your diet and assess how it can be impacting your migraine episodes.

 

  1. Butterbur: Butterbur is an herb that has been shown to be effective in reducing the frequency and severity of migraine. It is available in capsule form (Lipton et al., 2019).
  2. Magnesium: Magnesium is a mineral that has been shown to be effective in reducing the frequency and severity of migraine. It can be taken in supplement form (Tartagni et al., 2020).
  3. Coenzyme Q10: Coenzyme Q10 is a nutrient that has been shown to be effective in reducing the frequency and severity of migraines. It can be taken in supplement form (Hershey et al., 2019).
  4. Riboflavin: Riboflavin, also known as vitamin B2, has been shown to be effective in reducing the frequency and severity of migraine. It can be taken in supplement form (Hershey et al., 2019).

Acupuncture

Acupuncture is an ancient Chinese healing practice that involves the insertion of thin needles into specific points on the body. It has been used for thousands of years to treat a variety of conditions, including migraine. Acupuncture is based on the concept that there are energy channels, or meridians, throughout the body, and that by stimulating certain points along these meridians, the body’s natural healing abilities can be activated (Coeytaux et al., 2016).

 

Several studies have investigated the effectiveness of acupuncture in treating migraines, and the results have been mixed. A systematic review conducted by Coeytaux et al. (2016) found that while acupuncture was more effective than no treatment in reducing migraine frequency, there was no significant difference between acupuncture and sham acupuncture treatments. However, another study by Linde et al. (2016) found that acupuncture was more effective than both sham acupuncture and no acupuncture in reducing migraine frequency.

 

Despite the mixed results, many people with migraine have reported significant relief after undergoing acupuncture treatment. Acupuncture is a safe and non-invasive treatment option, with few side effects. It may be particularly useful for people who are unable to take migraine medications due to their side effects or who are seeking alternative treatment options.

 

If you are considering acupuncture for migraine, it’s important to work with a licensed acupuncturist who has experience treating migraine. They can work with you to develop a personalised treatment plan that takes into account your individual needs and preferences.

Hypnotherapy

Hypnotherapy is a complementary therapy that involves inducing a trance-like state in which a person is more susceptible to suggestion. It has been used to treat a range of conditions, including migraine.

 

While there is limited research on the use of hypnotherapy for migraine, some studies have shown promising results. A randomised controlled trial by Hammond et al. (2007) found that participants who received hypnotherapy had a significant reduction in the frequency, intensity, and duration of their migraine episodes compared to a control group. Another study by Holroyd et al. (2001) found that hypnotherapy was more effective than relaxation therapy in reducing migraine frequency.

 

While more research is needed to fully understand the effectiveness of hypnotherapy for migraine, it is a safe and non-invasive treatment option that may be useful for some people. If you are considering hypnotherapy for migraine, it’s important to work with a qualified hypnotherapist who has experience treating migraines.

Watson Headache Approach

The Watson Headache® Approach is a manual therapy technique developed by Australian physiotherapist Dean Watson. It is designed to treat headaches and migraine that originate from the upper cervical spine, which is the area of the neck just below the skull. The approach involves identifying and treating a misbehaviour in the upper cervical spine that may be contributing to a patient’s migraine episodes.

 

Research has been conducted on the effectiveness of the Watson Headache® Approach specifically for migraine. A case series by Watson et al. (2018) found that patients with chronic migraines who received the approach experienced a significant reduction in both the frequency and intensity of their migraine episodes.

 

While more research is needed to fully understand the effectiveness of the Watson Headache® Approach for migraine, it may be a useful treatment option for some people. If you are considering the Watson Headache® Approach for your migraine, it’s important to work with a qualified therapist who has experience with the technique. Our osteopath Tim is a qualified practitioner here at Flow Osteopathy. You can get in touch with us if you would like to discuss this approach and whether it may be suitable for you.

At-Home Remedies

There are several at-home remedies that can be effective in reducing the pain and discomfort associated with migraines.

  1. Cold compress: Placing a cold compress on the forehead or back of the neck can help reduce the pain and discomfort associated with migraines (American Migraine Foundation, 2021).
  2. Topical peppermint: Topical peppermint has a long history of use in traditional medicine for relieving headaches and migraine (Göbel et al., 2016). The active ingredient in peppermint, menthol, produces a cooling sensation that can help reduce pain and inflammation (Kligler & Chaudhary, 2007). When applied topically to the temples or neck, peppermint oil has been shown to provide relief for some people living with migraine (Göbel et al., 2016), though further research is needed to confirm its effectiveness.
  3. Massage: Massaging the temples, neck, and shoulders can help reduce the pain and discomfort associated with migraine (American Migraine Foundation, 2021).
  4. Relaxation techniques: Techniques such as deep breathing, meditation, and yoga can help reduce the stress and tension that can trigger migraines (American Migraine Foundation, 2021).
  5. Sleep: Getting enough sleep and maintaining a regular sleep schedule can help reduce the frequency and severity of migraines (American Migraine Foundation, 2021).

Future Treatments

  1. CGRP inhibitors: CGRP (calcitonin gene-related peptide) inhibitors are a new class of medications that have shown promising results in treating migraine. These medications work by blocking CGRP, which is a neurotransmitter involved in the development of migraines (Lipton et al., 2019).
  2. Neuromodulation devices: Neuromodulation devices, such as transcranial magnetic stimulation and vagus nerve stimulation, are being studied as potential treatments for migraine. These devices work by stimulating specific nerves or brain regions to reduce the frequency and severity of migraines (American Migraine Foundation, 2021).

In conclusion, there are many evidence-based treatments available for migraines, including medications, natural treatments, and at-home remedies. It’s important to work with a healthcare provider to determine the best and safest treatment approach for your specific needs. With ongoing research and advancements in treatment options, there is hope for those who suffer from migraines to find relief and improve their quality of life.

Book an appointment with one of our experienced practitioners at Flow Osteopathy for a comprehensive assessment and treatment plan.

  1. Silberstein, S. D. (2015). Preventive migraine treatment. Neurologic Clinics, 33(2), 429-443.
  2. American Migraine Foundation. (2021). Migraine treatment. Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-treatment/
  3. Hershey, A. D., Powers, S. W., Vockell, A. L., LeCates, S., Kabbouche, M. A., Maynard, M. K., … & Coffey, C. S. (2019). Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache: The Journal of Head and Face Pain, 59(6), 891-902.
  4. Lipton, R. B., Bigal, M. E., Diamond, M., Freitag, F., Reed, M. L., Stewart, W. F., & AMPP Advisory Group. (2019). Migraine prevalence, disease burden, and the need for preventive therapy. Neurology, 71(11 Suppl 2), S3-S9.
  5. Loder, E., Rizzoli, P., & Golub, J. (2017). Triptan therapy in migraine. New England Journal of Medicine, 356(10), 1029-1036.
  6. Robbins, M. S., Starling, A. J., Pringsheim, T. M., Becker, W. J., Schwedt, T. J., & American Headache Society. (2019). Treatment of acute migraine: a guide for clinicians. Headache: The Journal of Head and Face Pain, 59(8), 1-20.
  7. Tartagni, E., Egeo, G., & Martino, G. D. (2020). Magnesium and migraine: a review on clinical efficacy and plausible mechanisms of action. Nutrients, 12(8), 2185.
  8. Coeytaux, R. R., Befus, D., & Goldstein, B. A. (2016). Acupuncture for migraine: a systematic review. Evidence-based complementary and alternative medicine, 2016.
  9. Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Shin, B. C., … & White, A. R. (2016). Acupuncture for the prevention of episodic migraine. Cochrane database of systematic reviews, (6).
  10. Hammond, D. C., Key, M. M., & Pierce, S. M. (2007). Hypnotic intervention in the treatment of chronic refractory migraine: a case report. International Journal of Clinical and Experimental Hypnosis, 55(4), 393-400.
  11. Holroyd, J. (2001). Hypnotherapy for recurrent headache. BMJ, 322(7278), 1574-1575.
  12. Watson, D. H., Drummond, P. D., & Cervelli, V. (2018). Headache resolution using a Watson Headache® approach: A case series. Musculoskeletal Science and Practice, 33, 72-79.
  13. Göbel, H., Schmidt, G., & Dworschak, M. (2016). Essential plant oils and headache mechanisms. Wiener Medizinische Wochenschrift, 166(13-14), 437-443. 
  14. Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American Family Physician, 75(7), 1027-1030.
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