Category: #migraine

The Best Way to Treat Migraines

March 30, 2022

The best way to treat migraines is to find the combination of therapy that works best for you. Whether that is a cocktail of prescription meds and OTC meds or an infusion cocktail or meds and exercise along with stretching, etc.

If there was one best way, you would be pain free and I would be rich.

You are different than someone else. Your triggers are different. Your needs are different. Go ahead, get mad and frustrated. It is maddening and very frustrating. Now, it is time to get to work. Railing against the pain will only make it worse.

Lessen Migraine Pain

What if you could lessen the pain considerably AND decrease the number of attacks? I am up for that, are you? We are going to be realistic. Nobody likes reality when they are in intense pain, and the goal will be to decrease that intensity. You get to choose. You can keep on going as you have been or you can make changes that will help you over time.

Will you choose to be disciplined in your treatment plan to reach your goal? It is simple, but it will not be easy. It will take some trial and error. What are your three goals? You get to pick what is important to you and your needs. Make them personal. Make them things you want to accomplish for yourself. These are the things that will keep you focused when you are not seeing much, if any, improvement at the beginning. It will be a long haul. You have probably been dealing with the attacks and intense pain for many years, so what is 6 more months?

Be Open to the Possiblity that you Can Lessen the Pain

Being open to the possibility that you can lessen the pain. Being open to the possibility that your attack days will decrease considerably. Why is your belief and thought process so important in this area? If you don’t really believe that you can actually be better and feel better, you will not stick with the plan. Barriers and failures will occur. Realize that, and get back on track. You messed up. You didn’t do what you had planned. Admit to yourself that you messed up. No excuses and no beating yourself up. Get back on track and move forward.

As we move forward, always check with your healthcare provider before trying OTC meds, supplements and adjunctive therapies.

About 40% of folks do not respond to prescription triptans. So, for them it is like taking water … they get no relief, but they sure do get that increased heart rate.

It is usually 3 or 4 things together that make the difference. You job is to find those 3 or 4 things that work for you. Here is where it can be difficult as you have to do those things for 3 months before deciding if it is helping you or not. Remember, it is a process. A wanted process that will help you to get better and feel better.

Keep a Headache Journal

If you have never done so, start a daily journal or diary. A spiral bound notebook is fine. You want to address the following:

    • Date

    • Morning – food and drink

    • Mid-morning – food and drink

    • Lunch – food and drink

    • Mid-afternoon – food and drink

    • Dinner – food and drink

    • Evening – food and drink

    • (noting the times will be helpful)

    • Overall mood – address morning, mid-day and evening and any significant stressors

    • Exercise – what, when and how long?

    • Headache today – Y or N

    • If, Yes –      what time began?
        • Notable weather (barometric pressure increase/decrease)

    • Medications taken – how much and when?

    • Relief – Y or N (maybe not gone, but much improved)

    • Symptoms prior to headache

    • Symptoms during headache

    • Time headache is gone

    • List your known triggers that may have precipitated this attack

    • Describe your body sensations – muscle tightness, teary eyes, numbness, tingling, nausea, etc.

Headache Treatments and how much they did or did not help

          Ex. Ice pack, Heat, Meds, Stretching, Trigger point release, etc.

Anything else that is particular to you.

We are looking for patterns. Not all migraines have patterns, but for those that do, we can work towards modifying or eliminating triggers. Triggers don’t cause migraine, but they set off the processes that cause the migraine.

It is best to fill this out on an ongoing basis. There are probably apps that will help you do this if you don’t want to do the writing. This is your research. This is your unique information. This is what can best help you to get better. For those of you that need help in finding your pattern and plans of action, contact me to see if we are a good fit to work together. and place Migraine in the subject line.

I do recommend that a person with migraine see a neurologist that specializes in treating migraine. You have to work with your health care provider. It is a team approach.

Things that you can try (home remedies) to see if they help:

    • Gel Ice pack – use for 20 minutes on your neck, shoulders or back area
        • Some folks like to place it on their eyes

    • Far Infrared heat – Migun mini wrap or mat (there are other manufacturers)
        • You can use far infrared heat for hours. It is to relax tight muscles.

    • Watch out for Medication Overuse Headaches – they are most common in folks that use OTC pain relief products multiple times per day (3 or 4 doses) and multiple days in a row (3 or 4). This is also known as a rebound headache.

    • Deep breathing exercises – Slow, deep breath in through your nose for a count of 4   and breathe out through pursed lips for a count of 6. Make that belly rise. Do this five times. You may be a little light headed. You can do this exercise 3-4 times a day.

    • Acupuncture

    • Massage (weekly or every other week)

SEEDS for migraine control – these are things that you can control to help ease migraines

S – Sleep – be consistent with your sleep schedule, even on your off days. Go to bed and get up at the same time. You may want to consider a sleep study test, especially if you have morning headaches or insomnia. You may or may not have sleep apnea, but there are other sleep disorders that may be impacting you.

Maybe you will benefit from a neck contour pillow? Roll up a towel and place it in the bottom of your pillow. Yes, scrunch your pillow up above the roll. You want to relax your neck muscles.

E – Exercise – Yep, off ass and on feet. Walk or run three or four days a week. Work up to 30 – 40 minutes. Start out with 5 minutes and walk three times a day. Consistency is the key here. You can actually do your breathing exercises while walking/running. Add weight training 2-3 times per week. Yoga, Tai chi or stretching three times a week. Start slow and build up. Find what you enjoy doing. If you think it is a chore, you won’t be consistent. You don’t have to love it, but you do have to like it enough to keep doing it. Maybe, you will like the benefits after it is over.

E – Eat – Foods and hydration are important. Regular meals and consistent hydration are important for overall good health. Eat for nutrition. Drink about half of your body weight in ounces of water every day. I know, most all liquids count, but do your water, too. If you weigh 160 lbs. then drink about 80 ounces of water throughout the day. A bottle of water is16.9 ounces. That comes out to 4.7 bottles of water per day. So, do 4 bottles of water per day and your other liquids. I would suggest a higher protein and a little lower carb diet plan. A heart healthy plan, an anti-inflammatory plan, the Mediterranean diet plan. Find one that works for you. It is a lifestyle change. Change takes time, discipline and planning.

D – Diary – Take the time to invest in yourself. Look at what is going on in your life with work, family and friends. What does your body feel like? How is your emotional state? How is your spiritual state? Make notes about your day, your health, your eating, your hydration and your exercise. We are looking for patterns, if they exist.

S – Stress – It can be good stress or bad stress, but it is all stress. Do something that you enjoy doing. Turn off the computer and your phone at 8:00 pm. Take a break, read, watch tv, talk, etc. Mindfulness meditation is a great tool to help decrease your stress. Journaling for 15 minutes a day to let everything on your mind get out. Practicing gratitude every day will decrease your stress. Write down three things you are grateful for each day. No, they cannot be the same three things each day.

Non-prescription supplements:

You do need to talk with your healthcare provider before stating these.

Riboflavin (B2) – 400mg per day

Magnesium – 400 mg per day (up to a maximum of 600mg per day)

Co-Enzyme- Q10 – 150 mg per day

These are the only three that have shown some promise in migraine therapy treatment. We still do not have any hard proof.

OTC Pain relievers:

Brand or Product name                      Active ingredients per tab/cap

Aleve®                                              naproxen sodium 220 mg

Advil®                                              ibuprofen 200mg

Bayer®                                             aspirin (ASA) 325 mg enteric coated

Anacin®                                            aspirin 400 mg and caffeine 32 mg

Excedrin® Migraine                          aspirin 250 mg, acetaminophen 250 mg,

                                                          caffeine 65 mg     

Excedrin® Tension headache             acetaminophen 500 mg, caffeine 65 mg

Tylenol® Regular strength                 acetaminophen 325 mg

Tylenol® Extra strength                     acetaminophen 500mg

Tylenol® 8 HR Arthritis Pain             acetaminophen 650 mg

Motrin® IB                                       ibuprofen 200 mg

Sudafed®                                          pseudoephedrine 30 mg (have to sign for at


Maybe you have found that taking two generic Excedrin® migraine, one 30 mg tab of pseudoephedrine and a prescription muscle relaxer works for you. Maybe you need a triptan or prescription preventives or a cocktail infusion. Maybe your migraine meds leave you out of sorts for two or three days later. Let’s find the best non-medication ways that will help you. Only take the medications that you need, they are not without risks.

There are many prescription medications to try. Hang-on, you may need to try quite a few to see what works for you. For those of you that have been unable to find a medication that works for you, give the non-medication adjuvant therapies a try. Scientists keep working on ways to prevent or lessen migraine.


What I wish you knew about migraines

It isn’t just a severe headache. Info for those that don’t know.

March 23, 2022

Migraines not only affect the person that has them, it also affects their loved ones. Everyone’s emotional health and well-being are affected. Irritation, negative feelings and sometimes anger shows up. That is normal. The problems arise when we don’t deal with the irritation, negative feelings and anger appropriately.

Look, the person that has migraines does not want to have them. They are sometimes debilitating and their quality-of-life sucks. Remember, it is not just a severe headache, it is a brain disorder. I have been on both sides of this issue. I have only had three debilitating migraines in my life. I also have had many migraines that were annoyances and I have had some that you cannot think clearly for hours. When you can’t think clearly, it takes about four times as long to work on a project than it normally does. Sometimes, you can push through and sometimes you can’t. Sometimes, medications work and sometimes they don’t.


I know what most of my triggers are and I can do a pre-emptive strike with over-the-counter and prescription meds when I feel the familiar pain beginning.  I call it, the cocktail. I usually only have to take the cocktail once and the pain decreases to where I can function almost normally. The great thing about the cocktail, I use less medication overall. My migraines are acute. If they were chronic, then I would have to take preventative measures all of the time. Preventative measures include prescription medications, supplements, massage, running, walking, stretching, etc. As you can see, there are many things that may help with preventative measures. You have to find the group of things that will work for you. We will talk more about treatments and prevention next time.

I am thankful that I do not have chronic migraines. For those that do, I can empathize with you. I can also empathize with your family. It is hard on the family when you have plans and then a debilitating migraine flares-up. The plans go out the window or the one that is having the migraine flare-up is left at home. It sucks.

If someone is having a severe migraine, they probably should not be left alone. They should be watched. Why? Because they usually cannot get liquids or crackers safely on their own. A person that is having a severe migraine may be having neurological deficit problems and they could even have a stroke. If a person gets to status migrainosus (severe pain, lasting 3 days or more) they can have a stroke. They usually need to be in the hospital at this stage with a neurologist monitoring their condition.

As you can see, migraine is not just a bad headache. It takes the whole family working together to help get a handle on calming down migraine. Learning and understanding what a migraine disorder is and the ways in which each of you can help makes it much less stressful on all involved.

Eating nutritionally better, regular exercise, staying hydrated, learning more effective ways to deal with stress will help all involved. Help lighten the load at home for the one that has migraines. Be supportive. Ask how you can help them. Don’t be an ass. This is hard when you have been dealing with migraines for a while. During an attack is not the time to go through all the preventive measures “they should be doing.” Learning their own preventive measures takes time.

For those that have migraine flare-ups. Are you actively doing anything to try and find ways to decrease your attacks? Are you open to trying two or three things for 3 months to see if they help? Some of you have hurt for so long, that you don’t feel like you have the energy to find things that help. Maybe, you need help in getting plans of action that are unique to you and your needs.

**Shameless plug – I help with these types of plans. – Shameless plug over.**

If you have given up, I hope that you reconsider. Will you be open to the possibility that you can be helped? That you can get better and feel better? Yes, it will take time and effort on your part. You deserve to have fun and a good quality of life. If you are looking for an end to all the flare-ups and pain, that is not realistic, at this point in time. A decrease in migraine days and a decrease in the severity of pain is possible.

I encourage you to share this with others. Especially those that do not understand what happens during a migraine attack. My goal for this article is to help others better understand what a person that has migraines goes through.

Headache Types – Migraine, Non-migraine and Mixed

There are many types of headaches, about 150 different types. First, we have to figure out if the headache is a primary headache or a secondary headache. A primary headache has no known underlying cause. A secondary headache is the result of another condition. The other conditions are things like, inflammation, bacterial or viral infections, a trauma to the head or neck, sinusitis, etc.

Examples of the most common primary headaches:

    • Cluster headache

    • Migraine (with and without aura)

    • Tension headache (medically known as tension-type headache)

    • Trigeminal autonomic cephalalgia (TAC), including cluster headache and paroxysmal hemicrania

    • Silent migraine

    • Basilar migraine

    • Abdominal

    • Ocular

    • Vestibular

    • Status Migrainosus – ongoing pain lasting for more than 3 days

Examples of the most common secondary headaches related to another medical condition:

    • Disease of blood vessels in the brain

    • Head injury

    • High blood pressure (hypertension)

    • Infection

    • Medication overuse

    • Sinus congestion

    • Trauma

    • Tumor

    • Hangover

    • Menstrual

    • Exertional

There is a mixed type of headache, a migraine and a tension type headache that happen at the same time. Some call it a mixed tension migraine.

A migraine can occur in four different phases. Not everyone will experience every phase.

Premonitory phase – also known as the prodrome phase

Non-painful symptoms that may occur a few hours of a few days Before the headache arrives.

    • Unexplained mood changes

    • Food cravings

    • Neck stiffness

    • Increased yawning

    • Diarrhea or Constipation

    • Increased sensitivity to light, sound, or smells

Aura phase – sensory disturbances that may occur before or during an attack

Visual auras may occur in one or both eyes

    • flashing lights

    • zig-zagging lines

    • blurred vision

    • blind spots that expand over time

Sensory auras cause numbness or tingling that starts in the arm and radiates to the face.

Motor auras cause problems in the person’s ability to think clearly and communicate verbally.

    • slurred or jumbled speech

    • difficulty understanding what others say

    • difficulty writing words or sentences

    • having trouble thinking clearly

Headache phase – pain ranges from mild to sever (not everyone will have a headache, but they may have all of the other symptoms such as nausea, vomiting, off balance, etc.

Postdrome phase – happens after the headache subsides and lasting a few hours to a few days

    • exhaustion

    • confusion

    • generally feeling like crap


Migraine Triggers:

    • lack of sleep or jet lag

    • hunger or dehydration

    • foods

    • additives

    • alcohol

    • caffeine

    • medication overuse

    • smells

    • lights and sounds

    • weather

    • female hormones

    • physical activity
    • stress

Unusual signs and symptoms of migraine:

    • Body chills

    • Phantom smells

    • Brain fog

    • Insomnia

    • Stuffy or Runny nose

    • Watery eyes

    • Your skin or hair hurts – Allodynia – pain from things that do not normally hurt

    • Hiccups

    • Ringing in your ears

    • Double vision

    • Trouble hearing or understanding what others are saying

    • Sparks of light in vision

The Complete Headache Chart

Type Symptoms Precipitating Factors Treatment Prevention
  Hangover Headaches   Migraine‐like symptoms of throbbing pain and nausea not localized to one side. Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue. Liquids (including broth). Consumption of fructose (honey, tomato juice are good sources) to help burn alcohol.   Drink alcohol only in moderation.
  Caffeine‐ Withdrawal Headaches Throbbing headache caused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.     Caffeine.   In extreme cases, treat by terminating caffeine consumption.     Avoiding excess use of caffeine.
        Exertion Headaches Generalized head pain of short duration (minutes to 1 hour) during or following physical exertion (running, jumping, or sexual intercourse), or passive exertion (sneezing, coughing, moving one’s bowels, etc.).   10% caused by organic diseases (aneurysms, tumors, or bloodvessel malformation). 90% are related to migraine or cluster headaches. Cause must be accurately determined. Most commonly treated with aspirin, indomethacin, or propranolol. Extensive testing is necessary to determine the headache cause. Surgery to correct organic disease is occasionally indicated.       Alternative forms of exercise. Avoid jarring exercises.
    Post‐Traumatic Headaches Localized or generalized pain, can mimic migraine or tension‐type headache symptoms. Headaches usually occur on daily basis and are frequently resistant to treatment.   Pain can occur after relatively minor traumas. Cause of pain is often difficult to diagnose.     Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback.     Standard precautions against trauma.
    Hunger Headaches Pain strikes just before mealtime. Caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping or missing a meal.     Strenuous dieting or skipping meals.   Regular, nourishing meals containing adequate protein and complex carbohydrates.     Same as treatment.
  Temporomandibul ar Joint (TMJ) Headaches A muscle‐contraction type of pain, sometimes accompanied by a painful “clicking” sound on opening the jaw. Infrequent cause of headache.   Caused by malocclusion (poor bite), stress, and jaw clenching.   Relaxation, biofeedback, use of bite plate. In extreme cases, correction of malocclusion.     Same as treatment.
      Tic Douloureux Headaches Short, jab like pain in trigger areas found in the face around the mouth or jaw. Frequency and longevity of pain varies. Relatively rare disease of the neural impulses; more common in women after age 55.   Cause unknown. Pain from chewing, cold air, touching face. If under age 55, may result from neurological disease, such as MS.       Anticonvulsants and muscle relaxants. Neurosurgery.       None.
  Fever Headaches Generalized head pain that develops with fever. Caused by swelling of the blood vessels of the head.   Caused by infection.   Aspirin, acetaminophen, NSAIDs, antibiotics.   None.

      Arthritis Headaches Pain at the back of head or neck. Intensifies on movement. Caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck.     Cause of pain is unknown.     Anti‐inflammatory drugs, muscle relaxants.       None.
Eyestrain Headaches Usually frontal, bilateral pain, directly related to eyestrain. Rare cause of headache. Muscle imbalance. Uncorrected vision, astigmatism.   Correction of vision.   Same as treatment.
      Temporal Arteritis A boring, burning, or jabbing pain caused by inflammation of the temporal arteries. Pain, often around ear, on chewing. Weight loss, eyesight problems. Rarely affects people under 50.     Cause is unknown. May be due to immune disorder.     Steroids after diagnosis. Confirmed by biopsy.       None.
      Tumor Headache Pain progressively worsens, projectile vomiting, possible visual disturbances speech or personality changes; problems with equilibrium, gait, or coordination; seizures. Extremely rare condition.       Cause of tumor is usually unknown.     If discovered early, treat with surgery or newer radiological methods.       None.
      Tension‐Type Headaches     Dull, non‐throbbing pain, frequently bilateral, associated with tightness of scalp or neck. Degree of severity remains constant.       Emotional stress. Hidden depression. Rest, aspirin, acetaminophen, ibuprofen, naproxen sodium, combinations of analgesics with caffeine, ice packs, muscle relaxants. Antidepressants if appropriate, biofeedback, psychotherapy. If necessary, temporary use of stronger prescription analgesics.     Avoidance of stress. Use of biofeedback, relaxation techniques or antidepressant medication.
      Migraine without Aura     Severe, one‐sided throbbing pain, often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light. Certain foods, the Pill or menopausal hormones, excessive hunger, changes in altitude, weather, lights, excessive smoking, and emotional stress. Hereditary component. Ice packs; isometheptene mucate, combination products containing caffeine, ergotamine, DHE injectable and nasal spray, 5‐HT agonists; analgesics or medications, which constrict the blood vessels. For prolonged attacks steroids may be helpful. Biofeedback, betablockers (propranolol, timolol), anti‐convulsant (divalproex sodium). Calcium blockers and NSAIDs may prevent or treat migraine headaches.
      Migraine with Aura Similar to migraine without aura, except warning symptoms develop. May include visual disturbances, numbness in arm or leg. Warning symptoms subside within one‐half hour, followed by severe pain.       Same as migraine without aura.   At earliest onset of symptoms, treat using biofeedback, ergotamine, dihydroergotamine or a 5‐HT agonist. Once pain has begun, treatment is identical to migraine without aura.     Prevent with same techniques as migraine without aura.

          Cluster Headaches Excruciating pain in vicinity of eye. Tearing of eye, nose congestion, flushing of face. Pain frequently develops during sleep and may last for several hours. Attacks occur every day for weeks/month, then disappear for up to a year. 80% of cluster patients are male, most ages 20‐50.         Alcoholic beverages, excessive smoking.       Oxygen, ergotamine, sumatriptan or intranasal application of local anesthetic agent.       Use of steroids, ergotamine, calcium channel blockers and lithium.
      Menstrual Headaches     Migraine‐type pain that occurs shortly before, during, or immediately after menstruation or at mid‐cycle (at time of ovulation).       Variances in estrogen levels.         Same treatment as migraine. Small doses of vasoconstrictors and/or anti‐inflammatory drugs before and during menstrual period may prevent headaches. Hysterectomy does not cure menstrual headaches.
  Hypertension Headaches Generalized or “hairband” type pain, most severe in the morning. Diminishes throughout day. Severe hypertension: over 200 systolic and 110 diastolic.   Treat with appropriate blood pressure medication.   To prevent, keep blood pressure under control.
          Aneurysm Symptoms may mimic frequent migraine or cluster headaches, caused by balloon‐like weakness or bulge in blood‐vessel wall. May rupture (stroke) or allow blood to leak slowly resulting in a sudden, unbearable headache, double vision, rigid neck. Individual rapidly becomes unconscious.           Congenital tendency. Extreme hypertension.           If aneurysm is discovered early, treat with surgery.           To prevent, keep blood pressure under control.
            Sinus Headaches Gnawing pain over nasal area, often increasing in severity throughout day. Caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Sinus headaches are rare. Migraine and cluster headaches are often misdiagnosed as sinus in origin.       Infection, nasal polyps, anatomical deformities, such as a deviated septum, that block the sinus ducts.           Treat with antibiotics, decongestants, surgical drainage if necessary.             None.
  Allergy Headaches   Generalized headache. Nasal congestion, watery eyes. Seasonal allergens, such as pollen, molds. Allergies to food are not usually a factor. Antihistamine medication; topical, nasal cortisone related sprays or desensitization injections.   None.


Sometimes the dang chart does not completely transmit correctly, so you can use the link above.