There are three broad approaches to treating chronic migraine: lifestyle and trigger management, acute treatments (i.e. those taken during attacks or exacerbations of chronic pain), and preventive treatments (medication or other interventions designed to reduce the tendency to have attacks).
While many patients find that lifestyle adjustments such as regularising meals and sleep can reduce the frequency of their attacks, some form of medication or other treatment is almost invariably necessary in patients with migraine.
When patients have chronic severe headaches, it can be difficult to recogniae specific triggers. Paradoxically it is often the case that as chronic headaches start to improve with treatment, triggers become more obvious. Regularity of regimen regarding meals, hydration, sleep and stress is always helpful in reducing the tendency to migraines; recognizing that this is helpful is straightforward butmaking the requisite changes in a modern busy life may be more difficult.
Many patients with chronic migraine will have other problems that exacerbate their tendency to headaches: these include depression, anxiety, other pain syndromes such as fibromyalgia, localized pain in head and neck structures, and conditions that create ‘metabolic’ strain such as sleep apnoea or postural orthostatic tachycardia syndrome.
Proper management of these is necessary to maximize the effect of any other migraine treatments. It is particularly important to recognize and manage medication overuse (including caffeine overuse) as failure to do so will render most attempts at preventive treatment ineffective.
One of the simplest but most important things to do in the management of migraines is to manage your migraine triggers. While it seems an obvious thing to do, it may not always be easy. Some things are obvious: eat regular meals, maintain good hydration, get enough sleep. Things that are not as easy to accomplish, although we “know we should” are keeping a regular schedule and a regular bedtime, exercising regularly, and maintaining a moderate caffeine intake.
There are many things that count as lifestyle triggers, but if you follow a generally healthy lifestyle, it covers most of them. Getting enough sleep is important, although many people try to skimp on sleep, most adults need 7 to 8 hours of sleep a night. One must follow a regular bedtime. Drinking enough water dehydration causes headaches, eating regular meals, exercising regularly play an important role.
Sleep disorders deserve special attention. There have been two studies which have identified sleep disorders as a risk factor for the development of chronic daily headache and improving sleep can help with the control of migraine. If getting on a good sleep schedule does not help, and you are still having trouble sleeping, discuss this with your doctor.
A sleep study may be helpful in making a proper diagnosis, as the problem may be more complex than simple insomnia. Maintaining a healthy weight can also be important in controlling headaches. There have been several studies that have identified obesity as a risk factor for the development of chronic daily headache, as well as several studies linking obesity to the increased frequency and severity of migraine.
If you can maintain a regular schedule, you will be one step ahead of the game in keeping your headaches at bay. Managing lifestyle triggers can go a long way toward reducing migraine headache frequency and severity and decreasing the amount of medication you might need.
Patients suffering from migraine should consume foods, which are rich in complex carbohydrates, omega-3 fatty acids and magnesium. Low fat foods should be eaten. Vegetables like dark green leafy vegetables, fresh fruits, whole grains and cereals, lean chicken and fish meats, beans, sea food, sardines, trout, turkey and duck meat, fish oil and olive oil are recommended as they help with migraine.
Other food supplements such as Vitamin C and Vitamin B complex, calcium, fish oil supplements can be prescribed by the doctor. Foods which trigger migraines are known as migraine food triggers and these include foods containing monosodium glutamate and other food items such as tea, coffee, red wine, chocolate, cheese, peanuts, processed meats all are migraine food triggers.
Some individuals may develop craving for food, such as high carb foods, before the onset of migraine. This is known as migraine food craving and should not be confused with a trigger.