Preventing a Migraine Attack

Believe that if you are a migraine sufferer, you sure have endured a lot of pain and discomfort during an attack, if so, you may want to know its causes, and migraine treatment tips that may provide you with the relief.

What is migraine?

A migraine is an intense, throbbing or pulsating pain, usually on one side of the head and often behind one eye or temple. It is caused by the enlargement of the temporal artery, i.e. the artery that lies on the outside of the skull and under the skin of our forehead. When this artery enlarges, it stretches the nerves around it which causes certain chemicals to be released. These chemicals are the cause of the pain.

The pain may accompanied by nausea, vomiting, numbness, difficulty in speech, loss of appetite, fatigue and extreme sensitivity to light, sound and smell. For some people, a migraine attack is preceded (or known as warning symptoms) by an aura, visual distortions such as blurred or tunnel vision and seeing stars or zigzagging lights, or an altered sense of taste and smell. A migraine attack can last anywhere from a few hours to several days and may be so debilitating that it prevents our normal activities. However, a migraine poses no significant threat to a person's overall health.

We may want to know that migraines afflict about 10% of world population, striking women far more often than men and may run in families. Episodes can vary in frequency from several times in one week to once every few years. While the intensity and frequency of migraines often subside with age, auras may continue unabated while in older people, they are sometimes mistaken for symptoms of a stroke.

What is the difference between migraine and headache?

Migraine is a disease while a headache is only a symptom. Migraine pain is caused by the expansion of blood vessels, while headache pain is caused by the narrowing of blood vessels. During a migraine attack, inflammation of our tissue surrounding the brain can worsen the pain.

What causes migraines?

The severity and frequency of a migraine attack is different for each person. You may want to know that a migraine can be triggered by controllable and uncontrollable factors. The latter include weather patterns, stress and menstrual cycles while the former include bright lights, caffeine and alcohol. What follows are some common migraine triggers:

• Allergic reactions
• Bright lights, loud noises and certain odour or perfume
• Physical or emotional stress
• Changes in sleep patterns
• Smoking or exposure to smoke
• Skipping meals
• Alcohol or caffeine
• Menstrual cycle fluctuations, birth control pills
• Food containing tyramine (red wine, aged cheese, smoked fish and some beans), artificial substances like aspartame and monosodium glutamate (MSG) or nitrates (bacon and hot dogs)

Although the uncontrollable factor such as heredity is believed to play a role, the exact underlying cause of migraines remain unknown. Medical scientists currently think migraines are the result of spasms in the arteries that supply blood to the brain and scalp. Once the affected blood vessels constrict, it caused the other arteries in the brain to rapidly dilate, thus triggering the release of chemicals that cause intense pain and inflammation. Also medical research indicates that a low level of the brain chemical called serotonin may play a role in this process.

What are the alternative medicine ways to prevent or minimise a migraine attack?

To prevent a migraine, identify and avoid the specific trigger for you. If you suffer from frequent migraines, it may help to keep a food diary to identify any food that may be a trigger. Since there is no specific cure for migraines, the goal is to prevent symptoms by avoiding triggers.

Some people find relief from their migraines through acupuncture. Getting enough sleep each night and regular exercise may help as well. Be careful with your diet and avoid artificial sweeteners and substances.

Here are some tips that may help to manage your migraine effectively and to minimise pain:

• Keep a diary for a few weeks, noting when you have migraines and any possible contributory factors. Foods such as red wine, chocolate, and cheese are common triggers. You may want to know that taking too much caffeine or cutting back suddenly on your regular intake can cause migraine too.
  
  
• Stick to a schedule - Wake up at the same time every day, including Saturdays and Sundays. By sleeping in, you are upsetting your body's internal clock which sets up a chain of reaction that can trigger a migraine. In short, try to keep to a regular sleep pattern as too little or too much sleep can trigger a migraine.
  
  
• Massage your temples - If you have throbbing pain in your temples, apply some pressure and massage the area with your fingertips to relieve the pain. What you should do is to use a circular motion, massage your temples, and then repeat in the hollows at the sides of your eyes, behind your ears, and over your neck. It is good to know that self-massage with rosemary oil can be effective to relieve a migraine.
  
  
• Eat regularly and drink 6-8 glasses of water a day. Sip water throughout the day, especially if you have been vomiting.
  
  
• Take a rest - Migraine pain can be easily aggravated by physical activities, even something as mild as taking a walk. When you are having a migraine, lie down and take a rest. If possible, lie down in a dark, quiet room with pillows to support your head and try to sleep. You may want to know that by holding an ice pack against your forehead can bring temporary relief as the cold numbs the pain and also helps contract dilated blood vessels.
  
  
• Mind your magnesium level - Some people are more prone to migraine attacks when they have magnesium deficiency. Try taking 200 mg of magnesium every day for two months to see if it helps. Take note that people with heart or kidney problems should avoid magnesium supplements.
  
  
• It was reported that consuming fish with a high content of omega-3 fatty acids, such as tuna and salmon, may aid in migraine prevention.
  
  
• Prepare for travel - A migraine attack is sometimes triggered by a change in altitude. If you are planning to go on a flight or to a high altitude place, it is advisable to take a high altitude pill to reduce the severity of the attack. Wear sunglasses if you are out in bright daylight.
  
  
• If possible try to exercise regularly, as it can help to reduce the frequency and severity of migraine headaches. 
  
  
• Stay calm and stress-free - Uncontrolled stress and anxiety can also trigger a migraine attack; allow yourself some time to indulge in a relaxing activity every day. 

Other alternative medicine approaches such as acupuncture, yoga, aromatherapy, craniosacral therapy, meditating, biofeedback and other relaxation techniques have all been shown to benefit migraine sufferers. While these alternative medicine approaches will not cure migraines, but is recommended as some of them work by promoting relaxation, and aid sleep and digestion.

What are the natural remedies and food supplements useful for migraine sufferers?

Feverfew (Tanacetum parthenium) is a garden herb that is available as supplements in the form of capsules, tablets, leaf powder, or tea. Some people find that it reduces the frequency of migraine attacks. Try taking for a few weeks to see if they help. Side effects: usually none, but rarely with mouth inflammation or ulcers. However, rebound headaches, anxiety, and palpitations may occur if taken for long periods and then stopped suddenly. Precautions: Not suitable for pregnant women (may cause miscarriage) or those breastfeeding. You should avoid taking blood-thinning drugs such as warfarin or antidepressants if you are taking feverfew.

Magnesium and calcium - should be taken long term by anyone who gets migraines as they help to maintain healthy blood vessels. It is good to know that magnesium supplementation is specifically effective in individuals with low tissue or low ionized levels of magnesium, which is something quite common in patients with migraine.

B vitamin such as riboflavin and folic acid - may provide some significant relief for people who average four migraine attacks per month as it helps in ending or preventing migraine headache.

Fish oil - can help individuals with migraines by suppressing inflammation to reduce the frequency, duration, and severity of headaches.

Butterbur (Petasites hybridus) - is commonly use in Europe for treatment of migraine due to its antispasmodic effects on smoothing muscle and vascular walls, as well as have the anti-inflammatory effects by inhibiting leukotriene synthesis. Patients should look for butterbur extracts that do not contain pyrrolizidine alkaloids, which are carcinogenic and can cause liver and kidney damage.

Melatonin - a hormone best known as a sleep agent for people with insomnia, looks promising for cluster headaches and might be considered when other options fail. Some preliminary research has suggested that taking a dose of 3 mg every evening might reduce the frequency, the duration and intensity of episodic migraine.

Caffeine - although excessive caffeine or caffeine withdrawal can cause headaches in some people, a combination of caffeine and analgesics can help decrease pain related to tension and migraine headaches because caffeine enhances the analgesic activity of non-steroidal anti-inflammatory drugs (NSAIDs).

How about prescription and non prescription drugs treatment and prevention for migraine sufferers?

I would say that if your migraines are mild or infrequent, you may be able to get sufficient relief from an over-the-counter pain reliever such as aspirin, acetaminophen, paracetamol, or ibuprofen, that is provided you take the pain reliever during the first 30 minutes of an attack or taken as soon as migraine symptoms or aura begin to develop. A combination of paracetamol and codeine which provides stronger painkilling effects than the single aspirin, acetaminophen, paracetamol, or ibuprofen alone, are usually available in non-prescription headache formulations to help relieve the pain of severe migraine in some people. CAUTION: Don't give aspirin to anyone under 16 years, unless on doctor’s advice, as there is a risk of rare but potentially fatal, a condition called Reye’s syndrome. Don’t take remedies containing painkillers with other painkillers due to risk of overdose.

For those who get frequent migraines (two or more disabling attacks per month), prescription medications may be the only way to prevent or reduce symptoms. Prescription drugs used for this purpose include beta-blockers (such as Inderol and Toprol, which relax blood vessels), antidepressants (such as Amitriptyline), and special antimigraine drugs, i.e. Anticonvulsants such as Depakote and Topamax, which were recently approved by the FDA for preventing migraines. You may want to know that there are some drugs  available for halting migraine symptoms once they begin, these include so-called triptan medications, such as sumatriptan.

It is also important to know that your doctor may give painkillers and an anti-nausea drug in one tablet for general pain relief and for controlling nausea that usually resulting from migraine itself or as a side effect of other migraine drugs. Alternatively, take prochlorperazine tablets, which are dissolved on the gum to relieve nausea and vomiting.

Arrange to see your doctor if:

• Your migraines are not getting better with those natural and alternative medicines/self help or prescribed drugs and treatments as mentioned above;
• You are having frequent or severe attacks.