Migraine Management (October 2023)

I’ve been a migraine sufferer for years and over that time I’ve tried my best to find ways to manage them. I’ve had 100’s of suggestions from people, with mixed results. I’ve tried everything from ginger tea, aspirin, ice packs, massage, acupuncture and so I thought I’d share what’s worked for me.

First thing is to work out what is triggering you and get an idea of how migraines work. There’s a great book called How to Heal Your Headache by David Bucholz MD that explains the whole process. I found it incredibly helpful to understand that we all have a certain tolerance for triggers, but that a few combined can push you over the limit and trigger a headache. Learning to manage these is a great step forward.

Once you know what foods to avoid, then the next step is to learn how to best take care of yourself on a day-to-day basis. Tiredness and upsetting sleep patterns, stress and anxiety, lack of exercise, poor diet (big sugar intake) leading to inflammation in the body, all add to the likelihood of setting yourself off.

Then there’s the actual event and how to manage it. Neurologists will tell you that the moment you start getting symptoms to take your prescribed medication. Tryptans are the drugs of choice and can be used alongside aspirin or paracetamol. There are different types of Tryptans, some work faster and shorter, others work slower and longer. It’s important to be assessed by a specialist who can advise you on the best options. Sometimes it’s trial and error. I found that the standard OTC options worked for me at first, but then after a couple of years they stopped. My migraines had changed and needed a slower, longer acting drug.

Most importantly, I wasn’t initially warned about pain cycles! If you are having regular migraines (more than twice a month), you should not be taking your Tryptans every time. If you do, you will get into a pain cycle where the med’s will be triggering your next migraine. They should only be used twice a month at maximum. Just know that there might be times when you can only use painkillers.

So what else can you do? Firstly, quick action can alleviate the situation before it escalates. The best thing for me is to get into a darkened room, with some ginger tea (if I’m feeling nauseous), use an ice pack on my neck and back of my head. Then make sure I’m away from strong smells, noise and am warm and comfortably lying down. Sleep usually helps a lot. It also helps if I get a massage on my shoulders and neck area and around the shoulder blades. This can help stop the pain escalating. It’s vital to stay away from devices like phones and computers; blue screens are going to make things worse.

Part of the discomfort with migraines is that my back, neck and shoulders get extremely tense and knotted. I often get help after a migraine from the Osteopath, Physiotherapist or a great massage therapist. This does help to alleviate muscle tension. More recently I found a physio called Nathan at PhysioEdge in Wandsworth London who does a combination of standard physio techniques combined with Chinese medicine called Be Activated. This system was developed by a South African physio called Douglas Heel. I’ve had 4 sessions and am now having migraines once every 6 weeks as opposed to every 2 weeks.

This is progress, but I want to understand why I still hold on to this process. There is a question around what I get from my migraines. What would I be without them? Do I use them to switch off from the world and nurture myself? This is a spiritual enquiry that is still being worked on. I know that my body has the power to heal entirely, so let the work continue. I’m heading in the right direction.