Managing Your Migraines
Migraines cannot be cured, but our headache specialists at Mount Sinai recommend patients follow these important tips to help manage these episodes and minimize their impact.
Keep a Headache Diary
It is important to understand how often migraine headaches actually occur and how long they last. In the diary, you want to note what seemed to trigger the attack, what medications were used to manage the attack, and how severe the attacks were. A good severity scale to use is 0-3: 0 is no headache, 1 is mild (meaning that it was bothersome but did not interfere with your activities), 2 is more severe that interfered with normal activities but did not require you to be in bed, and 3 indicates that the migraine required bed rest. Diaries are available as apps for many cellphones, but you can also keep track using a 30-day calendar. It is helpful to note when episodes start and stop, if relevant.
Note and Try to Avoid or Minimize Triggers
Triggers of migraine vary widely from person to person and from attack to attack. Common ones include certain foods, missing meals, using excessive caffeine then withdrawing between attacks. Other possible causes include dehydration, lack of sleep or oversleeping, bright lights and loud noises, weather changes, and hormonal changes. Alcohol is often a powerful trigger, and, if you are prone to headaches, you should avoid consuming alcohol as a way to prevent worse symptoms. Learn more about headache triggers
Carry Your Medications
When you are on medications to try and stop an attack, they are more likely to be effective if administered early in the migraine. Nothing works all of the time, but the longer you wait to treat, the more likely it is to fail. The exception is if you are taking these medications too often and are at risk for developing headaches that are caused by medication overuse. The details of medication use should be included in your headache diary, so it can be evaluated during visits with your doctor. Remember that over-the-counter medications and herbal medications are still medicines and need to be reported in your headache diary. Medications taken for other conditions need to be noted as well, as they can interfere with the migraine medications and sometimes worsen attacks. Learn more about headache treatments
If you are on preventive medications, take them on a regular basis
If you are on preventive agents, make sure that you take them regularly. These medications may work to reduce the number of migraines and make attacks more likely to respond to treatment, but this is unpredictable. These medicines generally take several weeks to become effective, and many become more effective over subsequent months. Short trials are not helpful.
Remember: Migraine Brains Don’t Like Change
Those susceptible to migraines have brains that do poorly with changes in the environment. That is why alterations in sleep timing and duration, missing meals, and fluctuations in hormone levels, stress levels, caffeine intake – and even shifts in the weather can easily trigger attacks. Read more about headache triggers and tips
Don’t Forget Regular Exercise
As with all pain syndromes, regular exercise can be helpful of managing migraine headaches. During an attack, most prefer to rest, but, in between attacks, non-strenuous, but regular exercise is helpful in reducing migraines. Regular exercise is also is associated with weight loss, and being overweight can increase migraine frequency and severity.