Looking for the best treatment for your migraines may take time, as you may need to try different types or combinations of medicines before you find the most effective ones. In this article we will look into various treatments available that may treat your migraines or at least manage its symptoms.
Pain relievers
People who suffer from migraines usually go for the usual over-the-counter pain relievers, such as paracetamol, aspirin and ibuprofen. These pain relievers can help to at least reduce migraine symptoms. Pain relievers tend to be most effective if they are taken at the onset of a migraine attack, as this gives them time to absorb into your bloodstream and ease your symptoms.
It’s not advisable to wait until the headache worsens before taking pain relievers, as it’s often too late for the medicine to work. Soluble pain relievers are a good alternative because they’re absorbed quickly by your body. If you cannot swallow pain relievers because of nausea or vomiting, suppositories may be a better option.
Caution should be advised when using pain relievers. Before taking over-the-counter pain relievers, always read the instructions on the packaging and follow the dosage recommendations.
Aspirin is not advisable to be used by children under the age of 16 unless it’s under the guidance of a healthcare professional. Aspirin and ibuprofen are also not recommended for adults who have a history of stomach problems, such as stomach ulcers, liver problems or kidney problems.
Taking any form of painkiller frequently can make migraines worse. This is sometimes called a “medication overuse headache” or “painkiller headache”. Speak to a doctor if you find yourself needing to use pain relievers repeatedly or that over-the-counter pain relievers are not effective. Your doctor may prescribe stronger pain relievers or recommend using pain relievers along with triptans.
If they suspect the frequent use of pain relievers may be contributing to your headaches, they may recommend that you stop using them.
Triptans
If ordinary pain relievers are not helping to relieve your migraine symptoms, you should make an appointment to see a doctor. They may recommend taking pain relievers in addition to a type of prescription medicine called a triptan, and possibly anti-sickness medicine.
Triptan medicines are a specific painkiller for migraine headaches. They cause the blood vessels around the brain to contract, which reverses the widening of blood vessels that’s believed to be part of the migraine process.
Triptans come in various forms such as tablets, injections and nasal sprays. Common side effects of triptans include:
- Warm sensations
- Tightness
- Tingling
- Flushing
- Feelings of heaviness in the face, limbs or chest
- Some people also experience feeling sick, a dry mouth and drowsiness
These side effects are usually mild and subside on their own. As with other pain relievers, taking too many triptans can lead to a medication overuse headache.
Your doctor will usually recommend having a follow-up appointment once you have finished your first course of treatment with triptans. This is so you can discuss their effectiveness and whether you had any side effects.
If the medicine was helpful, treatment will usually be continued. If they were not effective or caused unpleasant side effects, your doctor may try prescribing a different type of triptan, as how people respond to this medicine can be highly variable.
Antiemetics
Anti-sickness medicines, also known as antiemetics, can successfully treat migraines in some people including those who do not experience feeling or being sick. Anti-sickness medicines are prescribed by a doctor and can be taken alongside pain relievers and triptans.
As with pain relievers, antiemetics work better if taken immediately once the migraine symptoms begin. They usually come in the form of a tablet, but are also available as a suppository. Side effects of antiemetics include drowsiness and diarrhoea.
Surgery
For migraine patients who don’t respond well to other treatments, surgery may be a migraine treatment that restores their quality of life. The goal of migraine surgery is headache and migraine reduction. Migraine surgery may reduce the irritation and compression of trigger nerves, either by correcting the tissue surrounding the nerves or by blocking the pain signals. After surgery, patients may still get headaches, but they could experience a decrease in headache frequency, duration and pain severity.
It is important to note that there are no guaranteed results for migraine surgery, and results may vary. According to a study published in Plastic and Reconstructive Surgery, 88 percent of the patients surveyed five years after their migraine surgery reported at least 50 percent reduction in the frequency, severity and duration of their headaches. The University of Wisconsin–Madison reports studies showing success rates greater than 70 percent, with about a third of those patients reporting their headaches eliminated completely. A UT Southwestern physician claims an amazing 60 percent of his patients report being pain free after surgery, and almost 90 percent report at least a 50 percent reduction in pain.
Consult first with surgeons before undergoing the procedure. They will talk to you about your migraines and your medical history. They will need to examine you to determine if nerve compression could be causing your headaches, or if there are other indications that you have which may respond to surgical treatment.
Acupuncture
If medicines are unsuitable or do not help to prevent migraines, you can try acupuncture. Some doctor clinics offer acupuncture, but most do not, so you may have to pay for it privately. Evidence suggests a course of acupuncture of up to 10 sessions over a 5- to 8-week period may be beneficial.
Seeing a specialist
If the treatments above are not effectively controlling your migraines, your doctor may refer you to a migraine clinic for further investigation and treatment by a specialist. In addition to the medicines mentioned above, a specialist may recommend other treatments, such as transcranial magnetic stimulation.
Transcranial magnetic stimulation
In January 2014, the National Institute for Health and Care Excellence (NICE) approved the use of a treatment called transcranial magnetic stimulation (TMS) for the treatment and prevention of migraines.
TMS involves holding a small electrical device to your head that delivers magnetic pulses through your skin. It’s not clear exactly how TMS works in treating migraines, but studies have shown that using it at the start of a migraine can reduce its severity. It can also be used in combination with the medicines mentioned above without interfering with them.
But TMS is not a cure for migraines and does not work for everyone. The evidence for its effectiveness is not strong and is limited to people who have migraine with aura. There’s also little evidence about the potential long-term effects of the treatment, although studies into the treatment have so far only reported minor and temporary side effects. These include:
- Slight dizziness
- Drowsiness and tiredness
- A muscle tremor that can make it difficult to stand
- Irritability
NICE recommends that TMS should only be provided by headache specialists in specialist centres because of the uncertainty about the potential long-term side effects. The specialist will keep a record of your experiences using the treatment.
Got a question, or anything I can help with? My name is Steve Stretton, and I’m the owner and manager at Gelpacks.com. You can drop me a line here. Good luck!