Guest article, written by Jennifer from MigraineStrong
When asked for tips to reduce migraine attacks, I usually have to first clarify exactly what migraine is all about. If asked, many people would likely describe migraine as a bad headache, but those with the disease know that it’s so much more. Head pain is just one in a long list of symptoms that make up the neurological condition called migraine. Extreme sensitivity to light, sound, scents and movement, neck and face pain, nausea, vomiting, anxiety, dizziness, fatigue, blurry vision, and brain fog often come along with the intense pain of a migraine attack.
Along with our long list of symptoms, most don’t realize that even when we’re not experiencing an attack, migraine is still always there in the background. As someone with chronic vestibular migraine, I describe migraine as the brain’s hyper-sensitive, over-reactive, inappropriate response to stimulus. We have a difference in the electrical signals in our brain so even between attacks we must work to keep our stimulus, also known as our trigger load, low. Read on for my favorite tips and tricks to help reduce our trigger load and reduce migraine attacks.
Try A Recommended Supplement for Migraine
I will sing the praises of magnesium for migraine for as long as I’m breathing. Seriously, I can’t tell you strongly enough how much this simple mineral has helped me. If that’s not enough to convince you, it has great studies backing its efficacy for migraine prevention too. Magnesium works because it is naturally calming and helps calm down hyper-responsive migraine brains. It’s also a natural pain reliever. My neurotologist even prescribes magnesium to many of his patients after surgery because of its calming and pain relieving effects. Taking a magnesium supplement for migraine prevention is not just about fulfilling a deficiency.
At the 2019 Migraine World Summit, Dr. Andreou taught me that magnesium is actually a blocker of one of the glutamate receptors. Glutamate is the molecule in the brain that drives the pain system, so magnesium blocks that excited pain pathway. It reduces pain signals allowing us to recover from excessive pain while calming the nervous system. Johns Hopkins Headache Center recommends 400mg two times a day for those with migraine. I use magnesium glycinate because it’s the least likely to cause tummy trouble at the dose we need. You can learn more about Magnesium supplement for migraine here.
Another powerful pain fighting supplement with moderate evidence behind its use for migraine prevention is ginger. Ginger is gastric calming which helps to ease nausea and vomiting, is a natural antihistamine and is anti-inflammatory making it an attractive option in migraine prevention. It's one of my favorite tips to help reduce migraine.
At the first annual Migraine World Summit Dr. Michael Greger presented a small study that showed ginger to be as effective as Sumatriptan in aborting a Migraine attack. All you need is 1/8 of a teaspoon of powdered ginger found at your local supermarket mixed with water for relief.
I personally found the powdered spice pretty strong and difficult to palate so I prefer ginger capsules instead. I like Gaia Herbs Ginger Supreme and Pure Encapsulations Ginger (taken as directed on the bottle) but any clean capsule will do. Making ginger tea from fresh sliced ginger works for many as well. Some even buy ginger powder in bulk and press it into capsules themselves to save a little money. I take ginger with my lunch every single day as a preventative and take a second capsule at the first sign of an attack as an abortive. When I catch it early enough, it works! You can learn more about Ginger as a migraine supplement here.
Consider A Migraine Diet
I hope I’m not losing you here. I know this is likely one of the most difficult lifestyle changes to make and I completely understand that treatment strategies like supplements and migraine diets do not have double blinded, peer reviewed research proving their efficacy as treatment for migraine. But, they do have many small studies backing them and interest in this area seems to be growing. We see many of the leading migraine experts encourage patients to try migraine centered diets as a first line of treatment.
If you buy the definition that migraine is a hyper-responsive inappropriate reaction to stimuli and that our brain’s electrical activity is different, then it makes perfect sense how diet can help calm down our cranky migraine brain neurons. Elimination diets like Heal Your Headache and Charleston focus on eliminating amines like tyramine and histamine along with other chemicals found naturally in foods (like caffeine) that can excite neurons and feed the excited pain pathway. Minimizing them allows these neurons to recover from being continually bombarded with excitement.
Another migraine diet option is the Ketogenic diet which switches your system to burn fat rather than carbs for energy. While researchers don’t seem to know exactly how, the state of ketosis does offer brain protecting benefits and reduced attacks. You’ll certainly find anecdotal evidence all over migraine support groups because when you try them and they work for you, you can’t wait to tell others about your success in an effort to help others improve too. My best advice here is to review the most common recommended diets mentioned above and choose the one that you’re most likely to stick to. Don’t overwhelm yourself by trying to avoid every caution from every migraine diet list. Pick just one diet and give it your best.
Engage in Exercise
Exercise can do a lot to help your body manage pain and the more you move the fewer attacks you’ll have. Yet far too often, people with migraine exercise less than the general population. It makes sense because the more migraine attacks a person experiences, the less likely they are to engage in movement because they’re in pain. So this is a strategy we’ll need to try in spite of that pain. Movement that increases your heart rate is an effective prevention method and has a protective effect on migraine. So protective, Angel Morena of the UCLA Migraine Program says it can be as powerful as the medication topiramate, but without the side effects.
Armed with this information, it’s important to be more intentional about engaging in gentle movement activities especially when we have chronic or episodic migraine. You don’t have to do strenuous exercise for long periods of time. Just 20 to 30 minutes a day of gentle movement that increases your heart rate a few times a week is generally very tolerable and will help you see and feel the benefits.
Get Adequate Hydration
Consistent hydration is one of the best strategies we can implement to avoid attacks. One study published in Neurology showed when people with migraine increase their water intake by just four cups a day they had 21 fewer hours of pain over a two-week period than those who did not increase their water intake. In addition to migraine prevention, drinking throughout the day can help decrease medication side effects like dry mouth as well.
If staying hydrated reduces your risk of an attack, dehydration increases your risk for one. And remember that hyper-responsive brain I mentioned earlier? People with migraine may be more susceptible to the effects of dehydration than others making it one of the top migraine triggers. Feeling thirsty is not the only sign of dehydration. Other signs include fatigue, dizziness, head pain, dry lips, dark urine and irritability. To avoid dehydration, increase your water intake and spread it out throughout the day and avoid fluids containing caffeine and alcohol. Drinking is not the only way to meet your hydration needs, eating a variety of foods with a high water content such as cucumbers, strawberries, soup and watermelon will help you maintain a healthy hydration level and fend off attacks as well. Following these hydration tips will help to reduce your migraine attacks.
Practice Good Sleep Hygiene
If you want to feel good and stay free of painful attacks, restful sleep is critically important. The better quality of sleep you get the more your migraine symptoms will improve resulting in fewer attacks. Conversely, when you don’t sleep well, you are more vulnerable to attacks and increasing the amount of them you experience each month. Lack of restful sleep makes it harder for your treatments to be effective in improving your migraine and you’ll have trouble controlling your pain and turning off your attack too. According to The American Migraine Foundation people living with migraine are up to eight times more likely to have sleep problems than the general population making poor sleep a real risk factor. So setting good, quality sleep habits might just be the best and most overlooked natural treatment for migraine.
The National Sleep Foundation defines sleep hygiene as a variety of practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness. Just a few simple changes can mean the difference between a delightful day vs a symptom filled attack day. One of the most important sleep hygiene practices is to find your perfect sleep sweet spot. Since sleeping too little and sleeping too much can both trigger an attack you want to make sure you’re spending the ideal amount of time in bed. This may differ from person to person. Migraine brains love routine so once you find your perfect number of hours each night, set your bedtime and wake routine and stick to it like glue! Check out my healthy sleep hygiene habits here.
Focus on Prevention
If you experience 15 or more head pain (or symptom) days per month then you likely have chronic (as opposed to episodic) migraine and should consider talking with your doctor about the best preventative medication options for you. This includes a variety of prescription medications that are used off label to prevent attacks such as antidepressants, anticonvulsants and blood pressure medications. Botox, trigger point injections and new CGRP medications are other options to consider. You can learn more about common migraine prescription medications to discuss with your doctor here.
Preventive medications may also be what you need to get relief from frequent attacks and keep you from getting to the point where you are considered chronic. Everything mentioned above falls into the prevention category as well. Supplements, diet, hydration, sleep, exercise and tips not mentioned above like caring for your mental well-being all work together to help prevent and reduce migraine attacks. Cognitive behavior therapy, engaging in creative activities, spending time in nature and working to reduce stress can reduce attacks by calming down your hyper-responsive migraine brain. Mastering calmness is your goal in life to kick frequent attack days.
Try Hot or Cold Therapy
Warm or cold compresses can be quite soothing and help you survive a bad migraine. Sometimes, if used early enough, cold or hot therapy may even help you avoid a full-blown, level 10 migraine. Our new Huggaroo Eye Mask can provide both hot or cold therapy and comes in unscented and aromatherapy versions. If you prefer cold treatments, consider the Huggaroo Gel Ice Pack Migraine Wrap. If warmth gives you comfort, we recommend the Huggaroo Hot Headache Wrap or one of Huggaroo's Neck and Shoulder Wrap models.
Consider a Multi-Modal Approach
I can’t leave you without saying, if you’re out there suffering, feeling defeated and like you’ve tried everything, please don’t give up. The right combination of treatment strategies is out there and often you have to throw a multitude of treatment strategies together to begin to see signs of improvement. For me personally it took all of the strategies I mentioned above to pull me out of a chronic housebound state and up into a controlled state.
If you’d like support as you learn more about managing your symptoms and reducing your number of migraine attacks per month, come find us at Migraine Strong on Facebook and Instagram. We discuss these and many more tips to reduce migraine every day.
Note- Any mention of medical intervention is based on my own personal experience in finding control over my once daily symptoms. Please consult your doctor before trying any new treatments. Jennifer from MigraineStrong.