By Puja Aggarwal, Managing Director, as told to Kara Mayer Robinson
As a board-certified neurologist who treats migraines — and someone who gets migraines regularly — I feel your pain.
About 2-3 times a month I get a complete migraine in the back of my head. It also has photophobia, or light sensitivity, and driving forces in my vision. If I get migraines, it can last for 6-8 hours.
Between my own migraines and those I treat in my practice in Orlando, FL, I became proficient in managing them.
But just because certain things help me does not mean it will help you. Different people have different types of migraines, and this affects what works and what does not.
Know your triggers first
Everyone’s triggers are different. This is the key to identifying and avoiding your personal triggers.
Mine include stress, lack of sleep, dehydration, meals left over and a glass of red wine. (Yes, this is just one that is needed.)
Yours may be different. Common triggers include:
- Some smells
- Certain types of light
- Eat too much
- Food Additives
- Loud noises
- Your menstrual cycle
Once you know your triggers, you can do your best to stay away from them. It can reduce how often you get migraines, how severe they are, or even ward off before you start.
How to drive triggers
To stay on my migraines, I always try to stay hydrated, exercise regularly and avoid skipping meals.
Dehydration can cause migraines. It can also cause migraines to last longer. Try to drink at least 64 grams of water a day to keep water.
If you are hungry, try to eat three solid meals a day.
Lack of sleep can also cause migraines and make them last longer. I tell my migraine patients that they should sleep at least 7 hours a night.
I also take 400 milligrams (mg) of magnesium every day. Magnesium oxide is best for migraines and can reduce how frequent and severe it is. It helps me, but it does not help everyone. If you have frequent or severe migraines, magnesium may not work for you.
Editor’s note: Consult your doctor before taking supplements to make sure they are a good choice for you.
If a migraine strikes
Once a migraine occurs, one of the first things I do is drink fluids and eat something.
I also take medication. I usually take 400 mg of ibuprofen, which helps reduce my pain. You can also try over-the-counter medications like Excedrin Migraine or Tylenol.
But be careful. If you take too much medication for your migraines, it can actually get worse.
Too much acetaminophen, ibuprofen, naproxen or other pain medications can lead to overuse of medication. It feels like a chronic, daily headache or migraine. This can happen if you take one of these medications 2-3 days a week for several weeks.
Again, keep in mind that certain treatments work for some people, but not for others. There are many options, so talk to your doctor to find out what works best for you.
Your doctor may suggest certain medications that can stop severe migraines if you take them at the onset of a migraine. These include:
- Almotriptan malate (Axert)
- Eletriptan hydrobromide (Relpax)
- Frovatriptan (Frova)
- lasmiditan (Reyvow)
- Naratriptan (Amerge)
- Rizatriptan benzoate (Maxalt)
- Sumatriptan succinate (Imitrex)
- Zolmitriptan (Zomig)
They may also prescribe medication to prevent migraines, such as:
- Galcanezumab (emgality)
- Rimegepant (Nurtec)
- Sodium valproate (Depakote)
- Topiramate (Topamax)
- Ubrogepant (Ubrelvy)
Other things to try
If you have frequent migraines, Botox shots can help. Botox is a drug that blocks neurotransmitters that carry pain signals from your brain.
Botox helps some people relieve migraines, but not others.
I did not try it because my migraines do not occur often. It is best for people with chronic migraines, or 15 headaches a month.
You can also try alternative treatments like these:
- Yoga and meditation can help reduce stress and migraines.
- A scalp or facial massage can help relieve pain.
- Acupuncture can help reduce the number of migraines you get or alleviate them if you get them.
Sensitivity to light
When a migraine makes it uncomfortable for me to be at the light, it usually takes about 20-30 minutes. I can sit in a room with the lights off, and it turns on.
I’m happy – it’s fast for me. But it differs from person to person.
If you have photosensitivity when you get migraines, try to stay in a cool, dark room. Maybe you should wear an eye mask as well.
One last thing: Talk to your doctor about the type, severity and frequency of your migraines. They can tailor your treatment to your personal needs.