January 23, 2017

Managing Migraine Misery

“Doctor, my headache is so bad. I think it’s a migraine!”

Many people ask me if they might have migraine headaches  — or is it “just” a tension headache?  The amount of pain doesn’t determine the type of headache, but rather what is causing it.  A tension headache is outside the skull and generally covers the whole head “like a tight band.”

A migraine, on the other hand, is “pressure” inside the head.  It is often one-sided, but can change sides from time-to-time.  Associated symptoms might be strange sensations, or vision disturbances such as flashing lights, or darkening such as “tunnel-vision.”  Very often the pain will get worse with bright lights or loud noises.  As a result, people who get migraines seek a dark, quiet place to suffer.  Many people also get nausea and/or vomiting.

Should You Medicate A Migraine?

In the medical world we speak of “control” and “triggers” in regards to migraines.  I rarely use long-term medications to prevent migraines because they have many side-effects and aren’t very effective.  Medications used for the pain include all of the “NSAID” (acetaminophen, ibuprofen, and so forth) drugs, opiate (vicodin, darvocet), and other pain medication, as well as migraine-specific drugs.  This last group includes the “triptans” which constrict blood vessels and will often abort a migraine.  Those who suffer with migraines often have to move around to different drugs as one quits working, to find another that will work – but only for a time.

Fight Back With Food

Prevention starts with avoiding “triggers” such as:

  • Chocolate
  • Coffee
  • Wine
  • Cheese
  • Or other specific food

In fact, about 80% of migraine headaches are related to diet and can be prevented.  The way we start is to keep a diet and headache diary.  List the foods you eat all day and headaches in another column.  We often find a pattern to associate the headache with the trigger.  The amount of time you do this depends on how often you get them.  Daily headaches don’t require much time, but monthly headaches are more difficult to track.


Nightshade foods are classified as potatoes, tomatoes, sweet and hot peppers, eggplant, tomatillos, pimentos, paprika, cayenne and Tabasco sauce. A particular group of substances in these foods, called alkaloids, can impact nerve-muscle function.

For these we do the elimination diet.  By eliminating one food (most often we start with the “usual suspects” of milk, wheat, and the “nightshades”) at a time to see what effect it has.  This is often fruitful.

Vitamin Relief Outnumbers Prescription Success

For those who aren’t able to find a food trigger, there are now several natural formulas for preventing migraines that don’t require a prescription. Plus, they statistically work better than the prescription medications.  These formulas include:

  • Magnesium
  • B-vitamins
  • Feverfew extract
  • Butterbur extract

There are several brands and can be found at most vitamin and herb stores.  Since they are preventative, they don’t relieve the pain once you already have a headache.  They are taken daily and most find a decrease in headaches within the first month.  Many of my patients come back for more, telling me they no longer have migraines — at all!

Healing Migraine Methods

Acupuncture is often miraculous for both prevention and treatment.  Chiropractic manipulation helps many.  For those with emotional triggers I recommend a book by John Sarno, MD called The Mindbody Prescription: Healing the Body, Healing the Pain. Since each person may have a different cause of headaches, there are many different treatments.  It’s important to find what works best for you.

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Those who come into my office with a migraine get a shot of magnesium with B-vitamins in the vein that aborts the headache in seconds. It is natural, and has no side-effects, except 30 seconds of feeling hot.  We used to do this in the ER when I was training, but since the “triptans” became available the doctors no longer think of this simple, safe, and effective B-vitamin shot treatment.

Don’t Make a Migraine Mistake

As a doctor who has worked with many people who suffer with migraines, the best advice I can give is the words of Winston Churchill: “Never give up!”  My experience is that those who continue to search for answers find them.  It’s a common mistake to stay with a treatment that doesn’t work because that’s all your doctor had to offer.  Move on!  Get help!  If you aren’t getting the help you need, find some one who can help you.  We have so many options today; there is no reason for you to suffer.




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