Are you having a throbbing headache, nausea, and sensitivity to light? Wonder if there is anything to do about this? Or will this ever go away? Migraines present with throbbing one-sided pain, with symptoms of nausea or sensitivity to sounds or light that can impact the daily function of life. The World Health Organization has placed migraines as one of the top 10 most disabling medical illnesses on earth. In the US, 73 million people are affected by migraines. This pain in the head has some solutions. I will focus on integrative modalities to help alleviate these symptoms in this article.
What causes migraines?
Simply put, migraines result from a complex pro-inflammatory response. There is a process in the brain called cortical spreading depression, which affects neurotransmitter release and pain receptors, leading to sensitization. Sensitization is when your brain becomes sensitive to triggers, resulting in more pain. If not treated, migraines can become progressively worse, so common triggers like stress, foods, or changes in weather can result in more intense or frequent migraines.
The goal then becomes to reduce neuro-inflammation and break the pain cycle. Therefore, a proactive approach can be beneficial both from an integrative primary care perspective and with the support of a neurologist for additional treatment modalities. This article aims to focus on preventative care management, reducing the frequency and duration of migraines to live a more resilient life.
Lifestyle interventions:
First and foremost is optimizing nutrition, movement, sleep, and stress management. Focusing on a plant-forward, anti-inflammatory nutrition plan, getting aerobic activity most days of the week, getting restful and consistent sleep, and having healthy coping strategies in the wake of stress are great starting points for reducing the inflammatory burden in the body. Working with our health coach to implement a lifestyle plan for accountability and reflection can help achieve lifestyle goals.
While lifestyle interventions can certainly alleviate symptoms, it is crucial to recognize that migraines are complex and multifactorial. Blaming oneself for being unable to control migraines through lifestyle is unfair and unrealistic. Focusing on fostering understanding, empathy, and effective management strategies to support oneself while going through a migraine attack can be substantial. I will highlight some quick tips below that may be beneficial during an acute attack.
Nutrition:
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- Plant-forward, Mediterranean-style diet
- Avoid foods that can trigger migraines, such as alcohol, aged cheeses, high amounts of caffeine, artificial sweeteners, and sulfites (found in wine, dried fruits, and pickled foods). Triggers are those that result in symptoms within 12 hours.
- Hydration! Staying well hydrated – at least ½ of your body weight in ounces
- Eating regular meals. Skipping meals can be a trigger.
- Check out our anti-inflammatory diet handout or lecture.
Exercises:
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- Aerobic exercise helps increase endorphins and reduces cortisol. Aim for 150 minutes of moderate-intensity cardiovascular activity per week.
- Stretching or yoga can be beneficial for releasing the fascia and tension from the body.
- Check out our past interview on “How to Keep Exercising“.
Sleep:
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- Create a relaxing ritual before bedtime
- Get at least 8 hours of sleep
- Practice sleep hygiene – dimming the lights and sleeping in a cool, pitch-black room can help support optimal sleep
- The Huberman Lab Toolkit for Sleep is a great resource.
Stress management:
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- Find a practice that resonates with you: Mindfulness, meditation, biofeedback
- Walk in nature
- Cognitive behavioral therapy or somatic experiencing can be great tools to address chronic pain
Other beneficial modalities:
Acupuncture: Acupuncture can help reduce migraines. Working with a traditional Chinese medicine practitioner may support your journey of dealing with migraines.
Magnesium: Some people with migraines have low magnesium levels. Doses around 400-800 mg have shown improvement in migraine severity and duration. Magnesium can cause loose stools, so talk to your medical provider if this is the right supplement to manage your migraine symptoms, as there are different formulations. Often, for those suffering from an acute attack, IV magnesium can help alleviate symptoms.
Transcutaneous stimulation: Devices like Cefaly are FDA-approved to reduce migraine symptoms. These devices can be used daily or with acute symptoms as well. While these devices can be pricey, most companies will offer a 90-day trial to see if they work for managing symptoms.
Medical interventions:
Your medical provider has additional tools in their toolkit, including preventative medications for those suffering from more than 14 migraines per month and abortive medications as needed. Please discuss ways to help reduce your symptoms with your healthcare team, whether working with our health coach or nutritionist to optimize your lifestyle or with the medical providers to use medications.
In summary, many resources and tools are available to support your journey to a healthier, pain-free you. Contact your integrative family medicine practitioner or health coach if you need additional support.
This blog post was written by Dr. Aneela Cox, a physician at Integrative Family Medicine of Asheville.
Citations:
- Yablon LA, Mauskop A. Magnesium in headache. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507271/