How to Manage your Migraines
How to better manage the cause and triggers of migraines?
Whereas there is no cure for migraines, they can become more manageable by gaining an in depth understanding of their frequency, severity and prevalent characteristics. When consulting migraine patients on how to prevent migraines, a general practitioner or a neurologist will usually ask some of these questions:
- How often do they occur and what is the duration?
- How severe are the migraines?
- Where did the headache start?
- What were the symptoms?
- What could have triggered them? ( This is perhaps the most important question)
- What medication was used to relieve the pain?
- Were any alternative or natural remedies used for pain relief?
Remembering these details, especially a long list of potential triggers can be a tedious task. Maintaining a migraine diary or record of migraine attacks can help a patient note down important details and report back to their doctors. A comprehensive record of migraine attacks can help a migraine sufferer better communicate their condition to their doctor. Different methods of tracking migraines include a traditional paper diary, migraine tracking apps and tracking on a spreadsheet.
Analyzed data from the recorded migraine events can help in identifying prevalent trends and patterns for a migraine patient’s condition. Such an analysis can also highlight any anomalies within a patient’s migraine events which may signal the presence of something more serious such as a brain aneurysm or a blood clot in the brain.
6 Steps To Identify and Eliminate Migraine Triggers
Identifying and understanding migraine triggers can help in reducing migraines. However, many times, two or more triggers work together to bring about a migraine. Hence having a systemic approach towards identifying, testing and eliminating triggers can be helpful in reducing migraines.
The first step towards reducing migraines is to understand what sets them off and recording every possible trigger can be incredibly helpful.Neurologists and general practitioners both suggest that their patients record their migraine events to get a better understanding of what could be triggering them.
Although the paper diary was quite frequently used in the past, it has become less popular as it can get difficult to maintain. As it relies heavily on the memory of the migraine sufferer who may record a migraine event after it has ended, the paper diary can also result in inaccurate records. Migraines can happen at any time and carrying a paper diary when a person is out and about can be quite inconvenient. There is also a risk of misplacing it a paper diary which could mean losing months of migraine records.
Many migraine sufferers record their events in a spreadsheet on their computers. Whereas this is a safer method than a paper diary to store migraine records, it may not be the most convenient. Like a paper diary, a person may not always have access to their computer when a migraine happens and recording after a migraine has ended can result inaccurate records.
Since smartphones are so common now and most people do not go anywhere without them, migraine apps are perhaps the most convenient way to record migraine details. Tracking with a migraine app also ensures that your records are safe, easily accessible and all in one place. The best part about migraine apps is that they analyse data and provide trends and patterns which provide more insight to a person’s migraines.
Step Two: Trends and Patterns
When migraines are being recorded regularly, especially with a migraine app, it will be easier to see the trends over time. The reports will highlight which triggers are more prevalent and in what circumstances they occur.
Step Three: Categorize Triggers
Once a list of triggers is identified, categorizing these triggers and tackling them accordingly can be a good first step towards elimination. You can find the categories of triggers here.
Step Four: Eliminate Triggers One by One
Eliminating potential triggers one by one can confirm if a particular trigger is setting off migraines. Hence if stress is the trigger in question, a migraine sufferer must analyse if a migraine almost always occurs as a result of feeling stressed. If it is a one-off occurrence, stress may not be the culprit and can be counted as a non-trigger. Similarly, for example, if a person suspects alcohol to be a trigger and a migraine occurs almost four out of times after alcohol consumption, then it is most likely a trigger.
Food items that are suspected to be triggers must be eliminated by determining how often a migraine occurs after consuming them. However since many times several food items are consumed together, it can become hard to identify which food is actually a trigger and which is not. It is thus important to isolate the elimination of suspected triggers- for example, if avocados are a suspected trigger and MSG is a suspected trigger, avoid them one by one to see if migraines attacks are reduced. If a migraine occurs almost always at the time or a little while after a particular food item is consumed, it is most likely that it is a culprit.
Tracking daily activities and linking them to migraine attacks can help reduce their occurrence. Although it is not always easy to avoid behavioural triggers, especially those like stress and anxiety, tracking can help a migraine sufferer understand the reason behind these triggers and systemically change their work schedule, lifestyle or daily routine to reduce migraines.
For example, if a person almost always experiences migraines at work, and their main trigger is stress, it is safe to conclude that they need to take some decisions related their work life which will reduce their migraines. Similarly, if someone regularly skips meals and that triggers their migraines, they must make an extra effort to eat at the right time to avoid a migraine. Often simply making small lifestyle changes based on the results can considerably improve a migraine sufferer’s quality of life.
Many people with stress and anxiety may find treatments such as biofeedback, cognitive behavioural therapy and counselling to be helpful in relieving migraine occurrences. Read more about these therapies here.
If a person experiences migraines almost every time during storms, rain, and extreme heat or in a space with bright lights and noise, they are most likely triggers for them. Environmental triggers are usually not in a migraine sufferer’s control especially those related to weather and barometric pressure changes. Nevertheless, it is important to avoid exposure to these triggers as much as possible and take precautions in order to avoid the aggravation of migraine symptoms.
For triggers like loud noise or bright lights, it may be best to avoid places where they are present. IF they occur in places which are unavoidable like work, it may be best to leave the room or find a dark space to take some rest. Although weather related triggers are harder to avoid, it may help to check weather forecasts for potential changes in weather, take the day off from work or cancel plans to go home and rest.
Step Five: Assess the Effect
It is important to keep measuring the effect of elimination and to regularly record the results. If elimination of a particular trigger did not reduce migraine attacks, it is most likely not a trigger and vice versa. Often two triggers may act together to bring about a migraine and this may be a discovery made during the process of elimination.
Step Six: Keep Up with the Plan
It is common to have some unconfirmed suspect triggers on the list. Identifying triggers, especially food triggers, can take a while and is not an overnight process. The key to success is to measure the effects of the elimination process. If the migraines are not reducing, the trigger list may need to reassessed and tested again.