How to Prevent and Treat Migraines

This debilitating condition can affect your quality of life. Here’s how to manage it.

When you’ve got a migraine, it can feel like the world stops, especially since you can’t be sure how long it will last.

For some people, it happens more than 15 days per month—a condition called chronic migraine. And use of pain medications like analgesics can sometimes make the problem worse instead of better. Talk about rubbing salt into the wound!

Here’s a closer look at some of the symptoms, treatment strategies, and prevention tactics you can use to keep migraines from affecting your quality of life.

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Is It Really a Migraine?

Your head feels like it’s in a vice, and it’s so intense you think it must be a migraine. However, that might not be the case.

There are several types of headaches, and knowing which one you have is key for effectively treating it. Consider these common migraine symptoms:

• Extreme fatigue, usually a day or two before the actual migraine
• Intense pain on one side of the head
• Pain that causes a throbbing, pounding, or pulsating sensation
• Nausea or vomiting
• Increased sensitivity to light
• Oversensitivity to smells or sound
• Dizziness or feeling lightheaded
• Changes in vision, like blurred vision, blind spots, or seeing flashing lights

Other types of headaches include those related to tension or stress, sinus pain, poor posture, allergies, or a jaw issue like TMJ.

A good strategy for identifying your type is to write down your symptoms—even if you think they’re unrelated to your headache—as well as tracking frequency, duration, and intensity. That way, you and your doctor can begin to see patterns and identify possible causes if you are in fact dealing with migraines.

Once it’s no longer a question, migraine treatment falls into two camps: acute and preventive. Acute treatments, like over-the-counter (OTC) pain relievers or prescription medications, are used when you’re experiencing an attack to stop the migraine from getting worse. Preventive treatment, on the other hand, aims to reduce frequency, severity, and length of migraines. This can include medication and lifestyle changes.

The best treatment approach varies from person to person, so you and doctor will work together to monitor the success of treatment and adjust as needed. That said, there are some prevention strategies recommended for any migraine sufferer. Here are four such examples.

Migraine Prevention Strategy #1: Pinpoint Your Triggers

Identifying migraine triggers can be a huge help, says Ilan Danan, M.D., a pain management specialist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.

“There are many possible causes for chronic migraines, and although there can be a genetic or hormonal component, it might be related to a lifestyle habit,” he says.

Addressing those triggers and habits—an approach called “headache hygiene” by the American Migraine Foundation (AMF)—may help reduce the risk of severe attacks.

Try this: After you’ve had a migraine or feel one coming on, take a moment to think about what happened just before the episode. Some common triggers include:

• Stress
• Changes to your normal sleep schedule
• Caffeine or alcohol consumption
• Dehydration
• Weather changes, like storms or excessive heat
• Natural light, especially strong sunlight
• Strong smells, like cologne, perfume, or cigarette smoke
• Blood sugar changes, often from skipping a meal
• Specific foods, like chocolate, processed meats, or cheese
• Artificial sweeteners

Once you know your trigger, you can take steps to avoid it in the future, Dr. Danan says. That may include cutting down on highly processed food, limiting alcohol, staying hydrated, or prioritizing quality sleep. Lifestyle changes may not replace your need for medication completely, but it could cut down on migraine prevalence, he says.

Migraine Prevention Strategy #2: Reduce Stress as Much as Possible

There’s a reason stress is at the top of the trigger list above. One study found nearly 80 percent of people with migraines with identifiable triggers reported that stress is a common one.

It may take a little more time than, say, avoiding cheese or another trigger food, but keeping stress in check is an important prevention strategy. And practices like deep breathing, yoga, or meditation may prove well worth the effort. Research in JAMA Internal Medicine found meditation not only helped improve pain regulation in migraine sufferers, but it also helped reduce depression and boosted quality of life.

“Something like mindfulness meditation may not change how often you get migraines, but it could lower your pain level,” Dr.Danan says. “Also, sometimes feeling a migraine come on can cause stress, and that can make symptoms worse. Anything that can alleviate that stress is helpful.”

For more ideas on how to find your calm, check out these mindfulness tips for taming stress.

Migraine Prevention Strategy #3: Never Skip a Meal (or Always Carry Snacks)

According to the AMF, long periods of time between meals can trigger attacks or cause migraines to be more severe due to low blood sugar. The longer you go without eating, the higher your risk.

Eating regular meals and snacks is the best way to keep blood sugar in check. Ideally, you won’t go more than three hours without eating something.

It’s also smart to pay attention to the quality of your food. Protein, whole grains, and high-fiber foods like fruit and vegetables take longer for your body to break down, which helps keep blood sugar levels more consistent, compared to eating sweets. Alcohol can also cause low blood sugar, especially on an empty stomach. If you choose to imbibe, do so in moderation and always consume it with food.

Migraine Prevention Strategy #4: Keep Your Doctor in the Loop

Even with lifestyle changes in place, it’s important to check in with your doctor and talk about medications that may be able to help, suggests Medhat Mikhael, M.D., pain management specialist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

“Keeping on top of your migraine patterns with your doctor can help because you may need to switch medications, or there could be other issues going on,” he says. For example, numbness in the face or arm weakness is a sign of neurological concerns that should prompt deeper examination of causes.”

Also, he adds, major changes like getting migraines more frequently or experiencing more intense symptoms should get checked out right away.

If you continue to have ongoing migraines, you may also want to check in with a headache specialist. Ask your primary care doctor for a recommendation.

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