Since childhood, Seattle attorney Sarah Lawer has been plagued by migraines brought on by exercise and heat. But as she grew up, her migraine triggers evolved.
“All my life, I’ve just tried to power through headaches,” Lawer says. “But you get them and eventually you can’t ignore them.”
Like most migraineurs, she was willing to try almost anything to make the pain go away. Over the years, she experimented with a host of prescriptions and non-traditional therapies, including massage, acupuncture and biofeedback, each resulting in varying degrees of success.
Ultimately, it was ridding her diet of gluten that helped Lawer manage her migraine pain. According to the National Headache Foundation (NHF), the diet that she has followed is unusual and used primarily for celiac disease. Its effects could be due to many other factors, such as: age; spontaneous remission, which often occurs; a change in lifestyle; or the elimination of many of the multiple triggers associated with migraine. Most clinicians believe that in about 30 percent of migraine sufferers, diet can be a factor. Migraine patients are particularly susceptible to changes in lifestyle, such as missing a meal, oversleeping, fatigue and dieting. The food and beverage items that are most often cited as triggers to a migraine attack include chocolate, cheese, fermented or pickled foods, caffeine, and alcoholic beverages—in particular, red wine.
For most migraine and headache sufferers, managing head pain is a simple matter of taking prescription or over-the-counter medications. For some unfortunate individuals, drugs just don’t work.
This uncertainty leads many people to try complementary or alternative therapies, a range of techniques that can be used in tandem with traditional medications. Some of these approaches have proven effective in clinical trials, while others have largely anecdotal support.
“If a person believes in it, there’s a chance it might work,” says Kathleen Farmer, PsyD, a psychologist with the Headache Care Center in Springfield, Mo.
Here are seven common complementary therapies—many of them relatively inexpensive—that could be your key to migraine and headache relief.
1. Lifestyle Adjustments
When Alexander Mauskop, MD, a neurologist and director of the New York Headache Center, sees patients, he always provides a handwritten list of suggested lifestyle changes and complementary therapies that usually includes exercise, meditation and certain supplements.
“The most proven thing we start with is regular aerobic exercise,” he says.
He recommends 20 to 30 minutes of exercise five days a week. Good sleep habits are also important, and there are many dietary interventions that can help.
2. Vitamins and Supplements
Although vitamins and supplements have little scientific support as a migraine or headache treatment, many have proven effective for patients. In Dr. Mauskop’s research, as many as half of all migraineurs have a magnesium deficiency, which can exacerbate the attacks. For these patients, taking daily supplements often improves matters. For many headache sufferers, he also recommends feverfew, butterbur and coenzyme Q10, better known as CoQ10.
Farmer cautions that the quality of a supplement is important, and patients generally get what they pay for. The inexpensive formulations available at chain stores can be less potent and less effective. She suggests researching supplements and brands online or visiting a reputable health food store.
3. Acupuncture
Given acupuncture’s lack of side effects and high success rate, Dr. Mauskop is quick to recommend it to his patients. From his experience, he estimates the therapy works for about 50 to 60 percent of migraineurs, though it usually takes four or five sessions to see any benefit.
The disadvantages? It’s time consuming and somewhat costly. Patients must come in for weekly sessions, usually for 10 to 12 weeks. Because insurance generally doesn’t cover acupuncture, this can get expensive fast. Although costs vary from provider to provider, each session typically runs about $100, Dr. Mauskop says.
According to the NHF, other physicians and patients who have used acupuncture extensively have reported equivocal results, and the outcomes have not been sustained.
4. Aromatherapy
Scientific studies suggest that lavender and peppermint scents can help manage migraines and headaches. A 2010 study by Shiraz University of Medical Sciences in Iran found that peppermint relieved nausea and vomiting associated with migraines. Other studies have shown that the smell of peppermint can reduce the perception of pain.
Rather than using aromatherapy to relieve a migraine, Dr. Mauskop recommends enlisting positive scents to avoid the bad smells that can trigger an attack. One option is a product called Migrastick, a small, inexpensive roller filled with lavender and peppermint essential oils. Dr. Mauskop tells patients who get stuck on a bus or train next to a heavy perfume wearer to take the product out, put it under their nose and inhale.
5. Cognitive Behavioral Therapy and Biofeedback
This model of therapy helps patients identify thoughts or mental triggers, such as self-doubt or relationship troubles, that excite the nervous system. Once these stressors are identified, the therapist and patient work together to develop methods of staying relaxed.
“When I see people who have trouble with migraines, I find there’s something else going on with them that they don’t know how to handle,” Farmer says. “They don’t want to admit it or maybe they’re not even aware of it.”
This tactic is especially effective when paired with biofeedback, a system that tracks patients’ responses to stress and teaches them how to lower their nervous system’s excitability.
Most psychologists are trained in cognitive behavioral therapy, Farmer says, but when you call a psychologist’s office, you should ask about experience working with migraine and headache patients. And if you don’t click with one therapist, try someone else.
“Not every psychologist is right for everyone,” Farmer says.
According to the NHF, biofeedback is an excellent adjunctive therapy. Many studies demonstrate that a course of biofeedback will reduce the severity and frequency of acute headache attacks.
6. Massage
When New York City dermatologist Debra Jaliman’s migraines became a daily occurrence about six years ago, she made it her mission to research every available option. She tried acupuncture, compresses, thrice-daily doses of butterbur and thousands of dollars in other treatments. But the therapy that finally worked for her was massage.
“I get it twice a week, and it really does help me,” Jaliman says. Before her sessions begin, she makes sure her masseuse is aware of her migraine trigger points.
“[Massage helps] undo the fight-or-flight response that a lot of migraineurs experience,” Farmer says. “Many migraineurs do feel victimized by their migraine. They are in survival mode, which makes all of the muscles tense.”
Other lower-cost relaxation techniques, such as meditation, yoga and tai chi, can also help ward off migraines. Farmer says some people even find relief from a relaxing facial.
7. Creativity
In addition to being fun and making your life more enjoyable, activities such as dancing, singing, painting, or crafting can help relax the body and raise your migraine threshold.
“When you do something creative, you go to a more relaxed state,” Farmer says. “Anything that takes you out of the pain zone [is beneficial].”
She encourages patients to identify creative pursuits they enjoy and spend a little time every day doing them.
Common Migraine-Fighting Vitamins and Supplements:
- Butterbur: An herb with anti-inflammatory effects that grows primarily in Europe and Asia and has been proven in some research to reduce migraine and headache frequency.
- Coenzyme Q10: A substance produced in the human body and necessary for the basic functioning of cells. CoQ10 levels can decrease with age.
- Feverfew: This plant is a member of the sunflower family. Studies show that taking capsules of dried feverfew leaves can decrease the frequency of migraines.
- Magnesium: The fourth most abundant mineral in the body. According to the National Institutes of Health, magnesium is necessary for more than 300 biochemical reactions.
- Riboflavin: This essential vitamin, part of the vitamin B complex, helps the body perform chemical reactions and break down carbohydrates, proteins and fats.
