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Whether you know someone who gets migraines or have experienced them yourself, you likely know that these excruciatingly painful headaches can be debilitating.
The good news is that we have a better understanding of migraines than ever before, according to Angel Moreno, a nurse practitioner at the UCLA Goldberg Migraine Program who specializes in non-pharmacologic migraine remedies.
“Migraine, for a long time, was a very invisible disease,” Moreno said.
Headache disorders like migraines and cluster headaches affect almost 3 billion people around the world each year. They’re one of the most common neurological conditions, with up to 50% of women and 20% of men experiencing migraines in their lifetime. While there are prescription medications that can help treat and prevent headaches and migraines, many people want to explore non-pharmacological remedies or lifestyle changes that will help too.
For those seeking alternatives, we asked experts for tips, over-the-counter products, and home remedies that can be used for migraines and headaches.
What causes headaches?
There are two types of headache disorders, primary and secondary, said Dr. Juliana VanderPluym, a United Council for Neurologic Subspecialties–certified headache specialist and neurologist at the Mayo Clinic.
Primary headache disorders occur when there’s an issue at the cellular or electrical level, or the nervous system is generating the headache unprompted. In other words, the headache itself is the problem. Migraines are an example of a primary headache disorder.
Secondary headache disorders are cases where some other condition is potentially damaging or irritating the nerves, such as a neck injury or a sinus infection. People with secondary headache disorders would likely seek treatment for their main concern, which hopefully would resolve the headaches.
While it was once thought that lifestyle or behavioral factors trigger migraines, VanderPluym said that studies show the hypothalamus, the brain region that regulates appetite, temperature, and other body functions, can become activated early on, before people even have head pain.
“Some doctors speculate that maybe what we think are food triggers like craving chocolate or wine or cheese or salty meats or things like that, maybe those foods that we think are triggers aren’t actually triggers,” she said. “Maybe it’s the hypothalamus that makes us crave those things. Then we eat them and we get the migraine, but we were going to get the migraine anyways because the hypothalamus became active.”
Placing too much emphasis on potential triggers makes people feel personally responsible for their symptoms when they may not be doing anything at all to cause them. While it’s a good idea to pay attention to sleep issues or stress management that may increase the risk of a migraine, people don’t need to be overly concerned about everything they’re putting into their body, VanderPluym said.
Since there’s no one-size-fits-all approach when it comes to treating people with headache disorders, it’s important to work with a physician on treatment plans and preventative measures to find the right balance between the general guidelines and individual needs.
How to get rid of a headache
Once VanderPluym identifies whether a patient has a primary or secondary headache disorder, she breaks down her treatment into three categories — lifestyle recommendations, rescue treatments, and preventative treatments.
“Migraine is a condition that doesn’t really like big changes, so we want to make sure that people have sort of consistency in their lifestyle habits and that they’re also following healthy lifestyle habits,” she said.
Moreno recommends a healthy diet for his headache patients. He suggests eating small, protein-rich meals scattered throughout the day to get a consistent amount of energy to the brain.
“We get into problems when people eat a lot of sugar, a lot of processed carbohydrates,” Moreno said. Those types of foods may create a peak of energy followed by a crash, whereas a diet rich in vegetables and animal proteins can help sustain an appropriate amount of energy being delivered to the central nervous system, he said.
Both experts said headache-prone people could consider taking a magnesium supplement and vitamin B2, also known as riboflavin. Moreno also likes to incorporate coenzyme Q10, another type of supplement.
“The data tells us that if you combine those three supplements for about two months, you start to see a reduction in the severity of migraine and potentially the frequency of migraine,” he said. “The way that these supplements work, they are essentially cofactors in helping the body in extracting energy from the food that we eat and the air that we breathe. It’s all about supporting metabolism.”
The next category would be what VanderPluym calls rescue or acute treatment, which is medication people take for relief when they’re starting to have migraine symptoms. Rescue treatments can be prescription medications (like triptan drugs for migraines) or over-the-counter pain medicines like acetaminophen or ibuprofen.
She said to be careful with this category of pain medicines because some products like Excedrin, which contains caffeine, can result in rebound headaches if they are overused.
It’s possible for rebound headaches to occur if you get into a cycle of using these medicines and get another headache when the drug wears off, so you take the medication once again. If you find yourself taking medicine for headaches two or more days out of the week, you should see a doctor to discuss preventative measures so you can avoid this cycle.
For those experiencing nausea with their migraines, Moreno said treating the nausea can help. There are some medicines that may relieve this symptom, but one non-pharmacologic treatment he recommends is ginger extract. He also emphasized the importance of staying properly hydrated, which doesn’t always mean just drinking water.
“You need the right electrolyte balance to actually get the water into cells,” he said. He’s a big proponent of electrolyte replacement products without tons of added sugar to reach optimal hydration levels.
Not everyone who gets headaches or migraines necessarily needs the third category — preventive treatments. VanderPluym said it depends on how often you get migraines or their severity. If they are very frequent or severe, initiating a preventative plan will ideally reduce the symptoms.
Those preventative measures could involve trying Moreno’s supplement trio, or turning to behavioral interventions like cognitive behavioral therapy or biofeedback training.
“If you want to completely avoid taking anything, those have very strong evidence but do require work and finding a psychologist who’s trained and can provide instructions,” VanderPluym said.
Whether you have migraines, cluster headaches, or tension headaches that you’re looking to treat or even avoid without relying too much on prescription medications, these are some products that may help.