Category: pain

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.


Describing a migraine to a non-migraine person & Which Time is best, Standard or Daylight-Saving?

You get a “two fer” today.


A migraine is NOT just a bad headache. Did you know that there are people in the world that have never had any type of headache? I have met a few. I could not believe that there were people that had never had any type of headache. Well, I had to talk to them and explore further. Sure enough, they had never had any type of headache. One thing that I learned is that it is very difficult to explain a pain that they have never experienced, so that they can understand that pain.

Pain is subjective.. It depends on the type of pain and the person experiencing the pain. Why is it so hard to explain? I think one of the reasons is that we need a base reference. What are the different types of pain you have experienced? Tension headache, broken arm, broken leg, broken toe, kidney stone, childbirth, arthroscopic surgery, major surgery, heart attack, arthritis flare-up, etc.

Even if someone has the same kind of injury, the pain may still be different than yours. I know. It is crazy, isn’t it? What if we learn how to better state the pain we are experiencing and how to help others understand what a migraine is? They may never understand the pain you experience, but let’s try to help them understand what a migraine is and what a migraine is not.

Here is the definition of a migraine by the National Institute of Neurological Disorders and Stroke. “The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number of attacks (at least 5, lasting 4-72 hours if untreated), and additional symptoms including nausea and/or vomiting, or sensitivity to both light and sound. Migraine is three times more common in women than in men and affects more than 10 percent of people worldwide. Roughly one-third of affected individuals can predict the onset of a migraine because it is preceded by an “aura,” visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a number of different factors, including stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and dietary substances.  Migraine in some women may relate to changes in hormones and hormonal levels during their menstrual cycle.  For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine has a genetic cause.”

Look at that. Does that look like just a bad headache? No! It is a brain disorder. It can cause a stroke. It can be debilitating for hours, days and sometimes months.

Look at this information from the Cleveland Clinic. “A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision and many more.

What’s a migraine? What does a migraine feel like?

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.

What are the types of headaches? What type of headache is a migraine?

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.”

Learning to describe your pain more effectively.


    1. Nociceptive Pain: Typically, the result of tissue injury. Common types of nociceptive pain are arthritis pain, mechanical back pain, or post-surgical pain.

    1. Inflammatory Pain: An abnormal inflammation caused by an inappropriate response by the body’s immune system. Conditions in this category include gout and rheumatoid arthritis.

    1. Neuropathic Pain: Pain caused by nerve irritation. This includes conditions such as neuropathy, radicular pain, and trigeminal neuralgia.

    1. Functional Pain: Pain without obvious origin, but can cause pain. Examples of such conditions are fibromyalgia and irritable bowel syndrome.

Words used to describe pain.

    • pressure

    • aching

    • squeezing

    • cramping

    • burning

    • freezing

    • numbness

    • tingling

    • shooting

    • stabbing

    • electric shocks (jolts)

    • burning

    • sharp

    • dull

    • intense

    • aching

    • cramping

    • shooting

    • stabbing

    • gnawing

    • gripping

    • pressure

    • heavy

    • tender

    • prickly

    • stinging

    • pounding

    • pulsating

    • throbbing

    • sick (associated with nausea)

    • tightness

    • vise-like

    • jabbing

    • lightning bolts

    • constant

    • constant with jabs

Record your Migraine

Keep a record. Clues are very valuable.


Time (how long did it last)

Where is the pain located?

Are there triggers? List them.

How quickly does the headache develop? (Suddenly, over time, starts low and increases, etc.) Describe the start. You may have to think back before the pain started, what was going on?

Is there a family history of migraines or headaches?

What do you take? What works? What does not work?

Things that may happen Before a migraine

Can you recognize some of the lesser-known symptoms of a migraine? The things that may happen before the pain begins.

    • Intense throbbing or dull aching pain on one side of your head or both sides.

    • Pain that worsens with physical activity.

    • Nausea or vomiting.

    • Changes in how you see, including blurred vision or blind spots.

    • Being bothered by light, noise, or odors.

    • Feeling tired and/or confused.

    • Stopped-up nose.

    • Feeling cold or sweaty.

    • Stiff or tender neck.

    • Lightheadedness.

    • Tender scalp.

We should talk about the different types of migraines and medication overuse headaches next time.

Next is the time change debate.

Time Change Stuff

Everybody has an opinion. Especially the two weekends a year we change our clocks. Most of us are out of sorts for a week or two. The “reasons” that are used to change the time twice a year are plentiful and are usually exaggerated or down right wrong.

We aren’t gaining any daylight. The amount of daylight is still the same, our time of day has changed. I am a night owl, but I think that I would prefer the Standard Time to be the one we stay with. Settle down, you can have your say later and I hope that you do. It is much more interesting when we can have a discussion.

When I was younger, I would ask why do we do this? I was told it was to help the farmers and conserve energy. The very next questions was, you guessed it, “how?” So, we would have more time in the evening to do hay. Since most of my family had other jobs during the day and did the farming chores after work and on the weekends, that made sense to me. As for the energy conserving … well, that did not get a good explanation. We stayed out until dark-thirty so I guess we didn’t have to use as much electricity for air conditioning. I know now that there isn’t a good explanation. We no longer use coal to heat. We have much better light bulbs now. It is much better to set the thermostat and leave it alone.

Our body’s circadian rhythm is closer to Standard Time

What happens if the change to Daylight-Saving Time is made permanent? I guess we need to decide if that hour of daylight is better for us to use in the morning or the evening. Our circadian rhythm is closer to Standard Time. It seems as though it is better health wise for us to stay on Standard Time. Kids catching the bus would benefit more from Standard Time. When it is dark out, I don’t want to get up and I know that it is harder to get the kids up. It is hard to get them to bed when it is daylight outside and they have school the next day. Even if you can get them in bed, they don’t go to sleep. They are getting a double whammy. They lose out on sleep time and they are hard to get up in the morning while it is still dark outside.

Maybe the farmers want more light in the mornings. It is really hot outside after two or three.

Now I hear that Congress is getting ready to get in to the time change game. This may be interesting. It looks like our representatives are leaning towards Daylight-Saving Time. If it passes then Hawaii and Arizona will have to change their clocks. Whichever group has the best lobby will probably win.

I do like the idea of never having to change our clocks forward and back. I prefer us to be on Standard Time for health reasons and kids that have to get up early and catch a bus. For the parents that have to get them to bed, it will be easier on you to get them to bed when it is dark outside.

Yes, I do know that Daylight-Saving Time gives us more daylight in the evening to be active or “do stuff.” Is that one hour in the evening worth all the other issues we will have to deal with?

I don’t know 100% which is best, but I am leaning towards Standard Time. If Daylight-Saving Time is picked, then we will make the best of it, do some studies over 10 years and see. Just pick one!

And your thoughts?