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Migraines affect more than 37 million people globally. They cause physical symptoms like nausea, vomiting, sensitivity to light (photophobia) and sensitivity to sound (phonophobia). In some instances, migraine symptoms escalate over time, resulting in chronic migraine pain.
Migraines are problematic, but they are treatable. However, there is no one-size-fits-all treatment to address all migraines, at all times. To determine the best course of action to relieve migraine pain, an individual must consider all of the treatment options at his or her disposal.
In this white paper, we’ll examine migraine treatments, how they work and their benefits. We’ll also explain how Dr. Jonathan Cabin of The Migraine Institute uses personalized treatments to help chronic migraine patients achieve long-lasting pain relief.
Migraine Medications: What Are They, and Are They Effective?
Migraine medications are commonly used to manage migraine pain. They are available across three categories:
Preventative migraine medications help stop migraines before they start. Common preventative migraine medications include:
- Anticonvulsants: Reduce or prevent seizures; doctors sometimes prescribe the anticonvulsants topiramate or valproic acid to treat migraines.
- Antidepressants: Help lower the frequency and severity of migraines; research indicates the antidepressants duloxetine and venlafaxine help prevent migraines.
- Beta-Blockers: Help relax blood vessels sometimes associated with migraine attacks; metoprolol and propranolol are among the most common beta-blockers prescribed to treat migraines.
- Calcium-Channel Blockers: Slow the narrowing of the blood vessels that sometimes causes migraine pain; calcium-channel blockers used to treat migraines include diltiazem and verapamil.
- Calcitonin Gene-Related Peptide (CGRP) Inhibitors: Block the effects of CGRP, a molecule that has been linked to migraine pain. To date, the U.S. Food and Drug Administration (FDA) has approved CGRP inhibitors erenumab and fremanezumab as preventative migraine medications.
Preventative migraine medications help reduce migraine frequency, duration and intensity, and they often require a prescription. If a person experiences chronic migraines, a preventative medication may be used to treat his or her migraine symptoms.
Abortive migraine medications may be taken during the early stages of a migraine to prevent a migraine attack from getting out of hand. If a person feels physical migraine symptoms that he or she believes may result in a full-blown migraine, this individual can use an abortive medication to address the migraine attack.
Oftentimes, abortive migraine medications are taken via skin patch, nasal spray or self-injection. Some abortive migraine medications are also available in pill form.
Triptans are among the most common abortive migraine medications. They help block migraine pain and may be taken within about two hours of a migraine’s onset.
Common triptans used to treat migraine pain include:
Triptans impact the nerves and blood vessels, and they are not recommended for individuals dealing with high blood pressure or heart disease. Additionally, triptans are not recommended for a migraine patient who previously experienced a stroke or is currently pregnant.
Rescue migraine medications can be taken at any point during a migraine attack to reduce migraine symptoms. They are often available over the counter and include:
The overall effectiveness of rescue migraine medications varies based on the individual and the severity of his or her migraine pain. In certain instances, rescue migraine medications cause nausea, dizziness, drowsiness and other side effects as well.
There is no guarantee that preventative, abortive or rescue medications will help a migraine sufferer achieve his or her desired results. Ultimately, it is important to consult with a primary care doctor to determine if medication is a viable option to treat migraine pain. Or, if migraine symptoms continue for an extended period of time, an individual may require a consultation with a neurologist. At this time, a neurologist may provide a chronic migraine diagnosis, as well as prescribe a migraine medication or alternative migraine treatments.
Alternative Migraine Remedies: Do They Really Work?
There is no shortage of alternative remedies used to treat migraines. These remedies include:
Acupressure involves the use of pressure to different parts of the body to relieve muscle tension and pain. One study of 40 people dealing with migraines without aura revealed acupressure helped relieve nausea and vomiting associated with their migraine attacks.
Magnesium supplementation helps migraine sufferers address migraine attacks that occur due to a lack of magnesium in the body. Magnesium has been shown to help regulate nerve and muscle function and enhance heart health, as well as treat nausea, vomiting and other migraine symptoms.
3. Dietary Changes
Certain foods and beverages sometimes trigger migraine attacks. These foods and beverages include:
- Caffeinated beverages
- Processed foods
- Red wine
With dietary changes, a migraine sufferer can limit his or her intake of foods and beverages that cause migraine symptoms. Also, doctors sometimes recommend migraine sufferers keep a journal so they can track foods and beverages that may trigger migraine attacks.
4. Essential Oils
Lavender and other essential oils often help people alleviate stress, anxiety and headaches. In one study of migraine patients, researchers found the inhalation of lavender oil helped reduce the severity of participants’ migraines.
Ginger is a natural remedy used to treat nausea and vomiting. A study of 100 migraine patients showed participants who took ginger to alleviate migraine pain achieved similar results to participants who consumed sumatriptan, a drug commonly prescribed to address migraine attacks.
Yoga helps enhance blood flow and limit muscle tension. A 2014 study revealed migraine patients who participated in yoga sessions achieved greater migraine pain relief than patients who relied exclusively on traditional migraine treatments.
7. Cold or Warm Compress
Using a cold or warm compress on the head sometimes helps reduce migraine pain. Choosing between a cold or warm compress depends on the individual; in certain instances, a cold compress works better than a hot compress, or vice-versa.
8. Herbal Supplements
Herbal supplements like butterbur and feverfew have been shown to help reduce migraine frequency and pain, but there may be risks associated with these supplements. As such, migraine sufferers should consult with a doctor before using herbal supplements.
Insufficient rest is a leading cause of migraines. Conversely, migraine sufferers who create comfortable, distraction-free sleep environments may be better equipped than ever before to get adequate rest. They should also strive to get between seven to nine hours of sleep per night to lower the risk of migraine attacks.
Dehydration increases the risk of a migraine attack. If a migraine sufferer consumes a sufficient amount of water daily, he or she can avoid dehydration. In fact, a good rule of thumb for migraine sufferers is to consume at least eight, 8-oz. glasses of water every day.
Alternative migraine remedies should only be used after consulting with a doctor. Following a medical consultation, one or more of the aforementioned alternative migraine remedies may be used to help a migraine sufferer relieve his or her migraine pain.
How Is Botox Used to Treat Migraines?
Botox, a neurotoxin that comes from Clostridium botulinum bacteria, is a popular non-surgical cosmetic treatment used to address visible signs of aging in the face. It also helps chronic migraine sufferers treat their migraine symptoms.
Botox paralyzes muscles that cause abnormal muscle contraction – something that may result in migraine pain. During a Botox for migraine treatment, Botox is injected into different areas of a patient’s skin.
Botox may be injected into one or more of the following migraine anatomical trigger points:
- Forehead: Botox is injected into the area between the eyebrows and above the forehead.
- Temples: Botox is injected directly into a patient’s temple.
- Neck: Botox is injected into different portions of the back of the neck.
Botox provides temporary migraine pain relief, and chronic migraine patients may receive Botox treatments every two to four months. Various tests are also performed to determine if a chronic migraine patient is a good candidate for Botox injections.
Is Migraine Surgery Necessary?
Migraine surgery is a permanent solution for migraine pain. It is minimally invasive, and in most cases, helps stop migraines.
Migraine surgery is a complex procedure, and it treats migraine trigger points in the face, scalp or neck. Prior to surgery, a chronic migraine patient undergoes various tests to determine his or her eligibility; these evaluations may include a doppler test and nerve block injections. Migraine surgery is only performed if it is determined to be a safe, effective option for a chronic migraine patient.
Migraine surgery is usually performed as an outpatient procedure, and patients can return home the same day as treatment. It is often completed under general anesthesia and takes anywhere from one to five hours to finish.
Each migraine surgery plan is customized to a chronic migraine patient, and it may be used to address one or more anatomical migraine trigger points. Most patients who undergo Botox treatments are viable candidates for migraine surgery, too.
Scarring is typically minimally following migraine surgery. In the first few days after migraine surgery, a patient may need to care for his or her stitches. Surgical drains may be required as well.
The average recovery period following migraine surgery lasts about one to two weeks. At this point, a patient experiences bruising or swelling that disappears on its own. Antibiotics may be provided to a patient for use during the initial week after surgery. In some cases, a patient may also be prescribed pain medication.
The full results of migraine surgery may become visible within about two to four weeks of treatment. Thus far, more than 90% of migraine surgery patients have reported a significant reduction in the duration, frequency or intensity of migraines. Meanwhile, nearly 50% are migraine-free within a few months following surgery.
Which Migraine Treatment Is Right for You?
Every migraine is different, and the best treatment for migraines varies from person to person. To figure out the best way to treat a migraine, it is essential to consult with a primary care doctor.
Initially, a primary care doctor will review a patient’s medical history and perform an evaluation. He or she may then prescribe migraine medications to treat this individual’s migraine symptoms.
If a person experiences headaches on more than 15 days per month, this individual may be dealing with chronic migraine pain. To obtain a chronic migraine diagnosis, an individual should consult with a neurologist. Like a primary care doctor, a neurologist will examine a patient and may recommend migraine medications.
Of course, a chronic migraine patient who constantly experiences migraines – despite the fact that he or she is currently using different migraine medications – may require additional help. In this scenario, Dr. Cabin can provide immediate assistance.
Dr. Cabin is a board-certified head and neck surgeon with dual-subspecialty training in facial plastic and reconstructive surgery. Dr. Cabin’s unique expertise allows him to develop custom treatments for chronic migraine patients. That way, Dr. Cabin ensures each of his chronic migraine patients can permanently address their migraine symptoms.
Migraine treatments – and the results they provide – vary. Regardless of how long a person has been dealing with migraines or the severity of his or her migraine pain, it is crucial to do everything possible to address this individual’s migraine symptoms.
There is no need to let migraine pain linger. At the first sign of migraine pain, an individual should seek out his or her primary care doctor. If migraine pain persists, this individual should then meet with a neurologist. And if migraine pain still lingers at this time, setting up a migraine treatment consultation with Dr. Cabin is ideal.