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What to do When a Migraine Strikes

Uh-oh. You feel that pounding between your temples and it can only mean one thing: an oncoming migraine. But what can you do besides sequester yourself to a dark, quiet room? We consulted the medical experts for their foolproof prevention and treatment plan.

Body+Soul, April/May 2006

If you've done all you can but still get a migraine, your best bet is conventional medications. "Plain aspirin or ibuprofen works well for some people," says Dr. Cheryl Bushnell. Others may need prescription pain relievers or a triptan drug like Imitrex, which are safe if used moderately. According to Bushnell, the key to successful treatment is to determine what helps your migraines, and then do what is needed early to prevent the headache from getting worse. Applying a cold cloth or cooling menthol pad (such as Migraine Ice) to your forehead may also help ease pain by constricting blood vessels.


1. Know Your Triggers
A migraine can strike due to any number of triggers: stress, fatigue, changes in the weather, bright lights, and strong odors, as well as certain foods. Keep a diary and see if you detect any patterns.


2. Change Your Diet
Foods and beverages contain chemicals that can trigger migraines in susceptible people. Common culprits include aged cheese, avocados, chocolate, fermented or pickled foods, monosodium glutamate (MSG), nuts, onions, processed meat, and red wine. If any of these become "problem" foods for you, simply limit your consumption of them. But remember: don't skip meals. Low blood sugar can set off a migraine.


3. Keep Caffeinated
On the flip side, some migraine sufferers find relief from caffeinated beverages. Although regular consumption of caffeine can trigger headaches, moderate amounts of it may relieve a migraine, possibly by constricting blood vessels in the head. "The first thing a lot of my patients do when they feel a migraine starting is grab a cup of coffee or a can of cola," says Bushnell. This remedy works best if you use caffeine only when you have a migraine.


4. Stay Active
Exercise in any extreme can cause a migraine: sudden, vigorous activity can trigger migraines in some people, while regular, moderate movement can reduce their frequency and severity.


5. Try Biofeedback or Acupuncture
Have you heard of either? Biofeedback is a relaxation technique that trains patients to control a bodily function, such as heart rate or blood pressure and therefore, change blood flow in the brain during migraine attacks. Meanwhile, acupuncture is a complementary medical practice that involves stimulating certain points on the body, often with a needle penetrating the skin, to alleviate pain.


6. Take Key Supplements
The herb feverfew has earned a reputation as an effective migraine treatment, but our doctors think it's overblown hype. Instead, Weil suggests trying one of these supplements: Butterbur, Magnesium, Vitamin B2. Just be sure that you commit to daily use over the course of several before you expect to see results.


In the end, however, your best bet may be to simply let a migraine run its course. "Do what's possible as far as treatment," says Dr. Andrew Weil. "But if all else fails, you may just need to lie down in a dark room and allow yourself to have the headache." For a more indepth explanation of the tips above, check our Migraine Prevention Plan.

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