Managing migraines at home

A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. Many people feel a throbbing pain on one side of their head.

Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, including visual changes, that are a warning sign that a bad headache is coming.

Migraine headaches can be triggered by certain foods. The most common are:

  • Any processed, fermented, pickled, or marinated foods, as well as foods that contain MSG
  • Baked goods, chocolate, nuts, and dairy products
  • Fruits (such as avocado, banana, and citrus fruit)
  • Meats containing nitrates (such as bacon, hot dogs, salami, and cured meats)
  • Red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans

Alcohol, stress, certain odors or perfumes, loud noises or bright lights, and smoking may also trigger a migraine.

When You Get a Migraine

Try to treat your symptoms right away. The headache may be less severe. When migraine symptoms begin:

  • Drink water to avoid dehydration, especially if you have vomited
  • Rest in a quiet, darkened room
  • Place a cool cloth on your head

Over-the-counter pain medications such as acetaminophen, ibuprofen, or aspirin are often helpful, when your migraine is mild.

Your health care provider may have prescribed medicines that are used to stop a migraine. These drugs come in different forms. They may come as a nasal spray, rectal suppository, or injection instead of pills. Other medications can treat your pain, nausea, and vomiting.

Follow your health care provider’s directions about how to take all of your medicines. Patients who take pain medication more than 3 days a week on a regular basis can develop rebound headaches -- headaches that keep coming back.

Preventing Migraine Headaches

A headache diary can help you identify your headache triggers. When you get a headache, write down the day and time the pain began, what you ate and drank over the past 24 hours, how much you slept, and when and what was going on in your life right before the pain started. Also include information about how long the headache lasted, and what made it stop.

Some lifestyle changes that may help include:

  • Avoid triggers that seem to bring on a migraine headache.
  • Get regular sleep and exercise.
  • Slowly decrease the amount of caffeine you drink every day.
  • Learn and practice stress management. Some people find relaxation exercises and meditation helpful.

If you have frequent migraines, your doctor may prescribe medicine to reduce the number of your attacks. You need to take this medicine every day for it to be effective. Your doctor may have you try more than one drug before deciding which works best for you.

When to Call the Doctor

Call 911 if:

  • You are experiencing "the worst headache of your life."
  • You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a headache before.
  • The headache starts very suddenly.

Schedule an appointment or call your doctor if:

  • Your headache patterns or pain change.
  • Treatments that once worked are no longer helpful.
  • You have side effects from medication.
  • You are pregnant or could become pregnant -- some medications should not be taken during pregnancy.
  • You need to take pain medicines more than 3 days a week.
  • You are taking birth control pills and have migraine headaches.
  • You are having side effects from medications.
  • Your headaches are more severe when lying down.

References

Gilmore B, Michael M. Treatment of acute migraine headache. Am Fam Physician. 2011 Feb 1;83(3):271-80.

Loder E. Triptan therapy in migraine. N Engl J Med. 2010 Jul 1;363(1):63-70.

Silberstein SD, Young WB. Headache and facial pain. In: Goetz CG. Textbook of Clinical Neurology. 3rd ed. St. Louis, Mo: WB Saunders; 2007:chap 53.

Wilson JF. In the clinic: migraine. Ann Intern Med. 2007;147(9):ITC11-1-ITC11-16.

Update Date: 12/21/2011

Updated by: Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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