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    What's the Best Way to Alleviate Migraine Pain? Experts Weigh in

    by Kristine Cannon - March 12 , 2018


    Photo Credit: by Asdrubal luna on Unsplash
    Photo Credit: by Asdrubal luna on Unsplash, in the public domain

    Seemingly everyone suffers from headaches, but how do you know when you’ve crossed into migraine territory?

    For 39 million Americans and one billion people worldwide, migraine attacks include nausea and vomiting, dizziness, an acute, throbbing headache, sensitivity to light, smell or touch and even distorted vision — symptoms that are far from a headache one could alleviate with an ibuprofen or two. Plus, attacks can last anywhere from four to 72 hours!

    And for two percent of people, their migraines are even worse. According to Elizabeth Seng, PhD, assistant professor at Yeshiva University in New York who specializes in the study and treatment of headache and chronic pain, this percentage of people suffer from chronic daily migraines for 15 or more days each month.

    The pain is so debilitating, more than 90 percent of migraine sufferers are unable to function normally during their migraine, according to the Migraine Research Foundation.

    In terms of relieving migraine pain, turning to over-the-counter medications like Excedrin Migraine, Advil and Motrin Migraine or Naproxen can help. However, according to Dr. Christian Whitney, a board certified anesthesiologist and pain management consultant, one of the best ways to relieve the pain is through lifestyle change.

    “While medication can be effective, healthy lifestyle choices can be preventative and reduce the frequency and severity of migraines when they do occur,” he says.

    Healthy lifestyle choices include getting adequate sleep and avoiding caffeine in the evenings, eating well, exercising, taking care of your emotional well-being and even adjusting the lighting — or simply turning off the lights — in your home. Making said changes can help avoid triggering or worsening your migraines.

    Let’s start with the importance of one’s sleep hygiene.

    “There's an undeniable link between migraines and sleep,” certified Sleep Science Coach at SleepZoo, Chris Brantner, says. “Failing to get enough sleep can trigger migraines.” He adds that migraines can also, in turn, make it more difficult to sleep. “It can become a vicious cycle,” he says. “Whichever comes first, there are studies that show improving your sleep is likely to reduce frequency of migraines.”

    To help with one’s sleep cycle, Brantner offers a few tips, starting with avoiding substances that can affect one’s sleep, such as caffeine.

    “Caffeine in the afternoon might seem necessary to make it through the day, but it can ruin the first half of sleep,” he says. “And alcohol, which seems to make it easier to sleep, can actually act as a stimulant halfway through the night, ruining the second half of your sleep. Your best bet is to avoid both.”

    Owner and physician at Preferred Injury Physicians, Dr. Travis Utter, recommends taking melatonin before sleeping. “Roughly 66 percent of people who took melatonin prior to going to sleep each night for three months also managed to reduce migraine frequency by around 50 percent,” he says.

    As far as the bedroom goes, make it relaxing — having a good mattress and pillow and sheets — and keep your cell phone out of the bedroom, or put it on silent.

    During the day, though, get a dose of natural light. “The sun helps reset your circadian rhythm and helps the body distinguish between night or day,” Brantner says. “If you work indoors, this can prove difficult, but get outside whenever you can, and try to get natural light through windows if you can't get outside.”

    While it’s recommended to get natural light, light can be another factor that can trigger or worsen migraine attacks — particularly to those with light sensitivity.

    “Light is a huge problem for people with migraine,” TheraSpecs’ Gregory Bullock says. “Eighty to 90 percent of patients have reported light sensitivity as a symptom of their attacks and anywhere between one-third to two-thirds are actually triggered upon exposure to certain light.”

    The TheraSpecs team conducted a survey of more than 300 people with migraine-related light sensitivity. Results showed that 88 percent believed light was responsible for the onset of their attacks. One way to combat light sensitivity is by wearing tinted glasses.

    “FL-41 tinted glasses are actually supported by clinical research as one of the most effective ways to reduce light-sensitive migraine attacks, in some cases by as much as 74 percent,” Bullock says. “This is due to their filtering properties — the tint blocks certain wavelengths of blue-green light, which have been shown to be one of the main catalysts of migraine attacks.” Bullock adds that these particular glasses are more effective than wearing sunglasses indoors, which many migraine sufferers tend to do.

    Another common trigger is having a poor diet. Cheese, chocolate and alcohol can all trigger migraines. Dr. Whitney suggests keeping a food journal to identify your migraine-triggering foods.

    “A consistent, balanced diet that includes fresh fruit and vegetables and minimal amounts of processed food is essential for preventing migraines and improving your health,” he says. “Nuts contain salicin, which is also found in many medications and have been found to be helpful for migraine symptoms.”

    And with a proper diet comes exercise, which releases endorphins, “your body’s natural pain killers,” Dr. Whitney says.

    “Additionally, exercise relieves anxiety and depression which increase the risk for migraines,” he adds. “Always ask your doctor before starting an exercise program.”

    Yoga and meditation are also great ways to not only get exercise, but also practice stress management.

    “Stress is one of the major triggers for migraines,” Dr. Whitney says. “Practicing self-care and performing behavioral management techniques that decrease and manage stress, such as yoga, meditation and making time for relaxation, are essential for the prevention of migraines.”

    But what do you do when you’ve taken all these preventative measures and your migraines persist? Your doctor may recommend Botox injections.

    According to board-certified head and neck surgeon, Dr. Jonathan Cabin, most migraine patients have trigger nerves in the face and/or neck that send faulty signal into the brain. This sets off a domino effect that ends in a migraine.

    That’s where Botox comes in.

    “Botox reduces the frequency, duration and intensity of migraines by relaxing the muscles surrounding these nerves, causing them to less prone to abnormal signaling,” Dr. Cabin says. “There is also evidence demonstrating that Botox works on the nerve itself, reducing neurotransmitter signaling directly.”

    About 50 percent of Dr. Cabin’s migraine patients come in for Botox and return for treatments every two to four months, depending on the patient.

    “When it comes to migraines, Botox is a prophylactic treatment, meaning that regular injections help to prevent migraines,” Dr. Cabin says. “On the other hand, Botox, if injected at the time of an active migraine, is not useful in directly reducing pain. Targeted Botox works well for nearly all migraine sufferers who have one or more trigger site.”

    One misconception about Botox injections for migraines, Dr. Cabin adds, is that patients are told they need over 30 individual injections of 155 units of Botox, regardless of the type of migraine they have. But he assures most patients do not need such a large dose.

    “Studies show that most migraine patients who qualify for Botox can get the same relief with a smaller, more customized treatment,” he says. “This information is important, as many who could feel significant relief from Botox avoid treatment because of the discomfort and/or expense of this full protocol.”

    Now, what do you do a migraine attack hits? A few ways to alleviate the symptoms include turning off the lights and applying hot/cold packs, according to Dr. Whitney. Or, you may turn to homeopathic remedies, such as ginger root. “Ginger is also helpful in the treatment of nausea that is often associated with migraines,” he says. “Peppermint and cayenne are also natural pain killers that may also be helpful.”

    Dr. Utter adds that Vitamin B2 and magnesium tablets have helped his patients.

    “Belgian research was able to show that in individuals who took 400mg of Vitamin B2 per day, 60 percent of them saw their number of migraines cut in half,” he says. As far as magnesium tablets go, “studies have shown that they are virtually ineffective for treating migraines, despite some people still suggesting them as a solution,” Dr. Utter says.

    If you do turn to over-the-counter medications, though, be cautious of overuse. “‘Rebound’ headaches can also occur when OTC medications are overused and when withdrawal from these medications occurs,” Dr. Whitney says. According to the Migraine Research Foundation, medication overuse is the most common reason why episodic migraines turn chronic.

    For more information about migraines, visit American Headache & Migraine Association, American Migraine Foundation and the many other resources found on the Migraine Research Foundation’s website.

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    Kristine Cannon is a professional writer and editor. You can find her work on Canadian Pharmacy online, SheKnows, Taste Company, Alternative Press, Scottsdale Living, AZRE Magazine, AZ Business Magazine and Experience AZ.


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