Surprising Triggers and Remedies for Migraine Headaches
There’s no misery quite like the deep throb of a migraine headache. Ready to hatch an escape plan? Here are the remedies that actually work.
A 2009 Neurology study found that the risk of migraines jumps by 8 percent with every rise of 9 degrees Fahrenheit in the air temperature relative to the usual temperature for that day of the week and month, even in winter. Experts are unsure why this happens, but weather has long been thought to contribute to migraines.
Loud sounds, strong aromas, dazzling visuals: It’s unclear why many migraine sufferers can’t tolerate high intensity of any sort, though it may be because the nervous system has trouble filtering out sensory input. A 2010 study published in the journal Nature Neuroscience also suggests that, in the case of visually charged migraine attacks, light activates a pathway of non-image-forming retinal neurons, which means that light can add to migraine pain, even in blind patients. While nothing practical will shield you from the noise and smell issues, you can don a pair of tinted glasses to tone down bright lights, which exacerbate migraine pain for more than 80 percent of sufferers. Wear the glasses when you’re out in the sun or in an office with harsh fluorescent bulbs. Models by TheraSpecs and Axon Optics are designed to minimize pressure on sensitive points of the face, and their specifically formulated rosy tint (called FL-41) blocks the blue-green light shown to trigger and worsen migraines. (Just don’t wear them while driving; they can make seeing traffic signals difficult, says Robert Cowan, M.D., the director of the headache and facial-pain program at the Stanford University School of Medicine.) A 1991 study conducted at the University of Birmingham, in England, found that the FL-41 tint decreased the average migraine frequency from 6.2 episodes a month to 1.6. While these tinted glasses don’t require a prescription, your insurance may require one for coverage.
The Best Medicines
These are most effective for episodic attacks, defined as less than 15 a month.
If you are new to migraines or suffer fewer than two attacks a week, nonprescription migraine-specific NSAIDs (nonsteroidal anti-inflammatory drugs) may be all you need. Their active ingredients are similar to those in non-migraine-specific drugs (such as regular Advil and aspirin). But they also contain substances thought to reduce nerve irritation (such as caffeine in Excedrin Migraine and potassium salt in Advil Migraine). You should be able to resume normal activities two hours after taking a dose. If you find that the medication brings little or no pain relief, or that the pain relapses or intensifies, make an appointment to see a headache specialist. Don’t pop extra pills. More than two doses a week can trigger an overuse headache (which feels identical to a migraine), as well as other side effects, like stomach ulcers.
Patients who don’t find relief with over-the-counter drugs typically turn to a class of prescription therapies known as triptans, which include sumatriptan and frovatriptan. Available as pills, injections, nasal sprays, and patches, these medications work best when taken at the first sign of pain. “When taking triptans, you shouldn’t wait to see if the headache is going to be a bad one,” says Cowan. How do they work? Triptans mimic the activity of serotonin at specific receptors on cells and release other substances that cause changes in certain nerves and help to relieve pain. The drugs are nondrowsy and nonaddictive, although patients may experience side effects, such as heaviness in the chest, tingling in the toes, and rapid heart rate.
Taken every day, regardless of whether you have an attack, these drugs are intended to reduce the frequency and the intensity of migraines and to improve your response to pain relievers like triptans. Typically geared to those suffering more than one or two episodes a week, the drugs fall into a variety of categories. Three of the most popular: beta-blockers (such as timolol), which target blood pressure; antiseizure drugs (like topiramate), which may calm overexcitable nerves in the brain; and antidepressants (such as amitriptyline), which activate serotonin receptors. Finding your best pain-reliever and pain-preventer combination can be a process of trial and error, says Paul-Henri Cesar, M.D., the director of headache medicine at New York–Presbyterian Hospital/Columbia University Medical Center, in New York City. “It may take several months,” says Cesar.