Migraines: Steps to head off the pain

Medicine is a proven way to both treat and prevent migraines. But medicine is only part of the story. It’s also important to take good care of yourself and understand how to cope with migraine pain when it strikes.

The same lifestyle choices that promote overall good health also can reduce the number of migraines you have and lessen the migraine pain.

Combining medicine with behavioral measures and lifestyle can often be the most effective way to handle migraines.

Find a calm environment

At the first sign of a migraine, take a break and step away from whatever you’re doing if possible.

• Turn off the lights. Light and sound can make migraine pain worse. Relax in a dark, quiet room. Sleep if you can.
• Try temperature therapy. Apply hot or cold compresses to your head or neck. Ice packs have a numbing effect, which may dull the pain. Hot packs and heating pads can relax tense muscles. Warm showers or baths may have a similar effect.

• Sip a caffeinated drink. In small amounts, caffeine alone can relieve migraine pain in the early stages. Caffeine also may enhance the pain-reducing effects of acetaminophen (Tylenol, others) and aspirin.

  Be careful, however. Drinking too much caffeine too often can lead to withdrawal headaches later on. And having caffeine too late in the day may interfere with sleep, which can affect migraines.

Sleep well

Migraines may keep you from falling asleep or wake you up at night. Likewise, migraines are often triggered by a poor night’s sleep.

Here are some tips to encourage sound sleep.

• Establish regular sleep hours. Wake up and go to bed at the same time every day — even on weekends. If you nap during the day, keep it short. Naps longer than 20 to 30 minutes may interfere with nighttime sleep.

• Unwind at the end of the day. Anything that helps you relax can promote better sleep: Listen to soothing music, soak in a warm bath or read a favorite book.

  But watch what you eat and drink before bedtime. Intense exercise, heavy meals, caffeine, nicotine and alcohol can interfere with sleep.

• Lessen distractions. Save your bedroom for sleep and intimacy. Don’t watch television or take work materials to bed. Close your bedroom door. Use a fan to muffle distracting noises.
• Don’t try so hard to sleep. The harder you try to sleep, the more awake you’ll feel. If you can’t fall asleep, read or do another quiet activity until you become drowsy.
• Check your medicine. Medicine that contains caffeine or another stimulant — including some medicine to treat migraines — may interfere with sleep.

Eat wisely

Your eating habits can influence your migraines. Consider the basics:

• Be consistent. Eat at about the same time every day.
• Don’t skip meals. Fasting increases the risk of migraines.
• Keep a food journal. Keeping track of the foods you eat and when you have migraines can help you find potential food triggers.
• Avoid foods that trigger migraines. If you suspect that a certain food is triggering migraines, remove it from your diet to see what happens. These foods may include aged cheese, chocolate, caffeine and alcohol.

Exercise regularly

During physical activity, your body releases certain chemicals that block pain signals to your brain. These chemicals also help reduce anxiety and depression — two conditions that can make migraines worse.

Obesity also increases the risk of chronic headaches. Maintaining a healthy weight through exercise and diet can provide additional benefits in managing migraines.

If your health care provider agrees, choose any exercise you enjoy. Walking, swimming and cycling are often good choices. Just remember to ease into exercise gradually, as very vigorous exercise may trigger migraines.

Manage stress

Stress and migraines often go hand in hand. You can’t avoid daily stress, but you can keep it under control to help manage your migraines:

• Simplify your life. Don’t look for ways to squeeze more activities or chores into the day. Instead, find a way to leave some things out.
• Manage your time wisely. Update your to-do list every day — both at work and at home. Delegate what you can, and divide large projects into manageable chunks.
• Take a break. If you feel overwhelmed, a few slow stretches or a quick walk may renew your energy for the task at hand.
• Adjust your attitude. Stay positive. If you find yourself thinking, “This can’t be done,” switch gears. Think instead, “This will be tough. But I can make it work.”
• Enjoy yourself. Find time to do something you enjoy for at least 15 minutes every day. It could be playing a game, having coffee with a friend or pursuing a hobby. Doing something you enjoy is a natural way to combat stress.
• Relax. Deep breathing from your diaphragm can help you relax. Focus on inhaling and exhaling slowly and deeply for at least 10 minutes every day. It may help to relax your muscles, one group at a time. When you’re done, sit quietly for a minute or two.

Keep a migraine diary

A diary may help you determine what triggers your migraines. Note when your migraines started, what you were doing at the time, how long they lasted and what, if anything, provided relief.

Until recently, avoiding migraine triggers was considered the best advice. But new research suggests this may actually increase sensitivity to potential triggers.

A more useful approach may be to gradually expose yourself to triggers, and learn to cope with these headache triggers by using behavioral management techniques. These may include identifying and challenging negative thoughts, relaxation training, and stress reduction. More research is needed to understand if and how this approach is more effective in managing migraines.

Strive for balance

Living with migraines is a daily challenge. But making healthy lifestyle choices can help. Ask your friends and loved ones for support.

If you’re feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain.