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Scientists haven’t yet found a cure for migraines, but they are getting better at understanding what causes them and the best ways to manage them. Good news for the UK’s 10 million sufferers, says Jane Druker. Here’s how...
1. Stick to routines
‘If you suffer regularly, your brain is sensitive to environmental changes, ranging from the external (loud noises and bright lights) to internal (hormonal changes). These are perceived as threatening,’ explains Dr Richard Day, whose research focuses on the role of the gut microbiome in migraines. ‘So be consistent, from your sleep schedule to mealtimes to when you exercise. It can help prevent the incidence of attacks.’
2. Know your triggers
Keep a diary over the course of several months and record exactly what you did or ate before a migraine starts. Common triggers include products that contain monosodium glutamate; meats containing sodium nitrates (such as bacon and salami), red wine, aged cheese, smoked fish and baked goods. Alcohol, caffeine, smoking and dehydration can also be risk factors. Dietitian Jane Clarke says: ‘Keeping blood sugars balanced can make the difference between a migraine and a pain-free day. If you crave something sweet – pears, dried apricots, plums, grapes, dates and kiwi fruit seem to be tolerated well. Combining the fruit with a hit of protein will help to slow down the absorption of sugar into your blood stream, meaning it’s less likely to trigger an attack.’ Skipping meals – especially breakfast – is also likely to spark a migraine, she says. Three balanced meals a day, plus a couple of healthy snacks, should help. ‘If you feel the pain coming on, nibble something bland, such as toast or some rice cakes, and drink some water; it can be just enough to lessen the severity.’
‘Exercise induces your body to produce natural painkilling chemicals known as endorphins,’ says Dr Sabine Donnai, GP and preventative medicine specialist. ‘Make sure to eat and drink beforehand, to avoid low blood sugar levels and dehydration, and stretch for 10 minutes before and afterwards to prevent muscle tension.’
4. Consider Botox
For chronic migraines, Botox can work by blocking the small nerves that carry pain from the head to the brain. The treatment is given as a series of injections and usually works for around three months.
5. Look out for new drugs
For migraines that are milder in severity, simple over-the-counter pain relief can help. ‘For severe attacks, the prescription drugs are triptans, which help reverse the changes in the brain that cause migraines,’ says GP and nutritionist Dr Sarah Brewer.
6. Try supplements
For migraines in midlife and beyond, Dr Brewer recommends nutritional supplements such as magnesium (for anxiety), B vitamins (for menopausal hormones) and coenzyme Q10 (for heart and blood pressure). ‘These have the potential to prevent migraines in some patients by regulating the balance of chemicals in the nervous system.’
7. Identify the warning signs
Not everyone who suffers from migraines will experience the prodromal phase – the warning signs before a migraine that can include excessive yawning, difficulty focusing, food cravings, and sensitivity to light, sound or smells. For those that do, it’s important to recognise the signs, says headache specialist Dr Ana Gago-Veiga. ‘The symptoms can occur a few hours or several days before a migraine reaches its peak. Identifying them so that you can take action to avoid the triggers that exacerbate your attacks, or start your medication promptly, is key.’