elnathan Blog: Effective Migraine Treatment

It says a lot about the desperation of migraine sufferers that researchers are studying how they describe their headaches on Twitter. (Perhaps not surprisingly, it turns out the words worst and massive are the most common adjectives used.) As the 36 million Americans who get these uberhead-aches know, it takes more than 140 characters to describe the true misery--and a host of strategies to keep the pain under control.
Most people who get migraines--defined as having at least two of these symptoms: pain on one side, lasting from four hours to three days, having a pulsating quality, and coming with nausea or sensitivity to light or sound--don't take advantage of all their options, studies show. Here is a checklist of the fixes, some very new, to keep in (your aching) mind.

1. Track Your Triggers
To pinpoint yours, keep a log of each headache, noting when it happened, what you were doing, and what you ate and drank for 24 hours before. Potential culprits: hormonal changes, cigarette smoke, bright light, caffeine, and food with nitrates, MSG, or a compound called tyramine, like aged cheese and lunch meats. Spotting a pattern and then sidestepping triggers can help keep the pain at bay.
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2. Treat Your Allergies
Experts aren't sure why a majority of migraine sufferers have runny noses or why migraines are two to three times more common in people with nasal allergies, but here's an educated guess: Inflammatory substances released during an allergy attack seem to activate the trigeminal nerve, a primary driver of migraine pain, making headaches more frequent and severe, says Dawn C. Buse, an associate professor of neurology at Albert Einstein College of Medicine. Relieving your allergies--with nasal steroids, antihistamines, or allergy shots--may improve any headache symptoms that accompany them.  
3. Get Electrified
Electric-pulse techniques: not as old-fashioned as they sound. They're actually among the most exciting developments in migraine treatment, says Stephen Silberstein, director of the Headache Center at Jefferson University.
The first-ever FDA-approved device, called Cefaly, features a headband that delivers a mild electrical current to stimulate the upper branch of the trigeminal nerve. Zapping it is meant to increase endorphins and block pain signals in the nervous system--and in a recent survey, Cefaly (which costs $300) seemed to do that successfully for slightly more than half of the 2,300 testers. (No word yet on use among headache-prone Trekkies, but the outlook is good.)
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4. Stash Painkillers
Prescription triptans like sumatriptan, a.k.a. Imitrex, and cheaper nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox) do help people ride out the misery. There's also Cambia, an NSAID that dissolves in water to make a cocktail that can relieve pain in 15 minutes. But don't overuse them: All can cause rebound headaches and raise the risk of chronic migraines. Ask your doctor about combining triptans with NSAIDs--that's been linked with a lower risk of chronic migraines.
5. Spit Out The Gum
Israeli researchers suspected that gum chewing might be why teenage patients often have chronic migraines, so they asked 30 young sufferers to quit their habit for a month. Symptoms improved for all but 4 of them--and for 19, pain disappeared altogether. The likely mechanism: Chewing stresses the jaw's temporomandibular joint, which in turn can trigger head pain.
These 5 other gross side effects of chewing gum will definitely have you rethinking your next wad.
6. Go Prophylactic
You're not a wuss for retreating under the covers when you get that ice-pick-to-the-temples feeling. Likewise if migraines force you into bed three or more times a month and you decide to take preemptive drugs. An assortment makes migraines shorter, less severe, and up to 80 percent less frequent.
Oddly, all were created to slay other illnesses but then were found (and FDA approved) to treat migraines, too. They include beta-blockers, antiseizure drugs, and even Botox (when injected into the head and neck). Antidepressants aren't FDA approved for migraines but are also regularly used off-label. While each of these drugs works in a different way, they share the ability to reduce excitability in the brain by relaxing blood vessels or lowering the nervous system's response to pain.
7. Break The Fast Every Day
Your morning oatmeal saves you from a blood sugar dip that can get your head a-throbbing. "When you fast, that activates the hypothalamus, the brain region that controls the drive to eat," says B. Lee Peterlin, director of Johns Hopkins Headache Research. And an activated hypothalamus is not what you want: It's been shown to be closely associated with migraine attacks.
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8. Watch For Bolts
You already know that weather can make your brain feel like it's in a pressure cooker. (More than half of people with migraines are sensitive to drops in variables like air pressure and temp.) Now a study that matched lightning activity with headache diaries kept by people in Ohio and Missouri has found that flashes alone may lead to migraines. Scientists can't explain the effect but theorize that lightning may emit electromagnetic waves, produce ozone in the atmosphere, or release fungal spores (lovely!) that cause trouble separate from other factors. Peterlin suggests preempting drastic weather shifts with meds: triptans for five days or NSAIDs for six.
9. Count Your Omegas
Go for 3s, not 6s: Fatty fish and plant sources such as chia seeds are rich in omega-3 fatty acids, which convert to compounds that block pain signaling in the nervous system. Meanwhile, omega-6 fatty acids in corn, safflower, and soy oils convert to pain-promoting compounds. We need both fatty acids, but our diets have too many 6s and too few 3s. People with chronic headaches who ate a high-3, low-6 diet for 3 months changed their brains' chemical makeup and had fewer and shorter headaches.