Migraine can be an extremely debilitating condition, but there are many ways to help keep it under control. We take a look at the latest strategies
Written by Madeleine Bailey on February 21, 2019
Reviewed by Dr Rob Hicks on March 3, 2019
Far more than a headache, migraine is a complex neurological condition that can affect your whole body. It’s also more common than you might think, affecting around one in seven worldwide.1 Discover the best ways to help prevent and manage migraine attacks.
How are migraines different from other headaches?
The pain you get with a migraine is usually far more severe than an ordinary headache, and often felt on one side of the head.
The headache – and accompanying symptoms – can cause migraineurs (people who get migraine) to lie down in a dark room for hours, even days, as attacks can last between four and 72 hours.2
Some migraineurs experience a couple of attacks a week, while others may only get them occasionally. Migraines are considered chronic if you get headaches on more than 15 days a month, with a minimum of eight of these days involving migraine, for at least three months.3
What are the symptoms of migraine?
Apart from intense headache pain, migraines are associated with nausea and/or vomiting, and sensitivity to light, sound or smells.4
There are two main types of migraine – without aura, affecting 70-90% of migraineurs, and with aura, thought to affect 10-30%.5
A migraine with aura gives you additional neurological symptoms that normally start from a few minutes to up to an hour before an attack.6 These symptoms can include visual disturbances, for example:7
- flashing lights or stars
- tunnel vision
- blind spots
- coloured spots
You can also experience other neurological symptoms, including:8
- pins and needles
- weakness on one side of the body
- speech difficulties
- partial paralysis (although this is rare)
If you experience an aura without a headache, this is known as a ‘silent migraine’.9
Who gets migraines?
You’re more likely to experience migraine if:10
- you’re female – it affects three times as many women as men
- you’re aged between 35 and 45, though it can happen at any age, often starting at puberty
- it runs in your family
What causes migraine?
It’s thought some chemicals in the brain increase in activity in certain areas, triggering migraine symptoms. But it’s not known exactly which brain chemicals are involved, nor why migraineurs are sensitive to these changes.11
However, there are some common migraine triggers, including:12
- changes to routines, such as missing meals
- emotions, including anxiety, excitement, and stress
- a change in sleep patterns
- hormonal changes, such as periods or the menopause
- environmental factors, including high altitude, high humidity or flickering lights
- some foods, such as certain cheeses and specific additives
- feeling hungry or thirsty
How to treat a migraine
There are many different ways to tackle a migraine attack:13
- over-the-counter painkillers such as paracetamol and ibuprofen, or sumatriptan, a migraine drug
- prescription triptans
- anti-nausea medication
- transcranial magnetic stimulation – a treatment that delivers magnetic pulses to your head, available on the NHS
What works for one migraineur may not work for another, so speak to your GP for advice on treatment.14
Five ways to prevent migraine attacks
1. Keep a migraine diary – this can help you spot avoidable triggers. Include food, eating and sleeping patterns, activities, the weather, menstrual cycle (if relevant) and emotions.15
2. Ask your GP about preventative medication – Botox injections are recommended under NICE guidance when three preventive drugs haven’t worked.16
3. Stick to a regular routine – make sure you get enough sleep, avoid getting dehydrated or too hungry, find time for some rest and relaxation every day, and try not push yourself with work or exercise.
4. Try acupuncture – NICE states that 10 sessions over five to eight weeks may be beneficial.17 It’s thought that the needles stimulate the body to produce its own pain-reducing chemicals.
5. Consider supplements – a US study found that taking 150mg of co-enzyme Q10 a day for three months helped reduce the number of days with migraine headache by 50% for some people,18 while 400mg of vitamin B2 (riboflavin) has been shown to have the same effect, also after three months.19
If you have migraines on more than five days per month or your migraines are severe, see your GP. Seek urgent medical attention if you or someone else experiences a headache with weakness or paralysis in one or both arms, slurred speech, stiff neck, confusion, rash, or seizures.20
Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.
1. Steiner TJ, Stovner LJ, Birbeck GL. Migraine: the seventh disabler
2. Migraine Trust. More than “just a headache”
3. Schwedt TJ. Chronic migraine
4. Migraine Trust. Migraine without aura
5. As above
6. Migraine Trust. Migraine with aura
7. As above
8. As Source 6
9. Annette McDermott. Healthline. Silent migraine: symptoms, treatments and more
10. Migraine Trust. Facts and figures
11. Dr Jacqueline Payne. Patient UK. Migraine
12. The Migraine Trust. Common triggers
13. NHS. Migraine – treatment
14. As above
15. NHS. Migraine – prevention
16. NICE. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
17. As Source 14
18. Rozen TD, et al. Open label trial of coenzyme Q10 as a migraine preventive
19. Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial
20. NHS. Migraine – overview