How Migraines Are Treated

What are your options for symptom relief?

Migraines can cause a variety of symptoms, including head and neck pain, severe exhaustion, visual effects, trouble concentrating, and numbness of the hands or fingers. Treatment of a migraine episode often relieves the pain, but you may continue to experience many of the other migraine symptoms even after the pain subsides.

Luckily, there is a wide spectrum of effective treatment approaches available for migraine - including treatments to address migraines that have already started as well as treatments to help prevent future migraines.

While not comprehensive, below you'll find a list of different lifestyle changes, medications, procedures and home remedies that can help treat your migraines. Be sure to speak with your doctor about your symptoms and medical history to determine which migraine treatment strategy is best for you:

Treatment of migraines

Verywell / Brianna Gilmartin

Home Remedies and Lifestyle

When you have a migraine headache, home remedies can prevent it from getting worse, reduce the symptoms, and even completely alleviate it. A variety of options are effective and worth trying. 

Use Cold Packs

When you have head pain, neck pain, shoulder pain, or facial pain with your migraine, placing a cold pack on the sensitive area can alleviate the pain and may eliminate the symptoms altogether.

Cold therapy has an anti-inflammatory effect that constricts blood vessels and soothes nerves so that the brain senses less pain. As a general rule, you shouldn't apply cold packs for more than 30 minutes at a time.

Stress Less

Stress is one of the most common triggers for migraines. Simple stress management practices like mindfulness meditation, exercise, and journaling can help minimize stress and prevent migraines. Stress management is important for overall mental health and may also reduce chronic pain in the body.

Get Enough Sleep

Another common migraine trigger is insufficient sleep. Catching 7-9 hours of sleep every night can help prevent migraines. You may find it helpful to set a consistent sleep schedule, as changes in sleep patterns can trigger or worsen migraines. Sleep disorders are closely associated with migraines as well, so your doctor may order a sleep study to rule them out.

Consume Caffeine

The link between caffeine and migraines can be complicated. If you don’t regularly drink caffeinated beverages, just one serving can reduce your migraine symptoms or may even completely stop your migraine. That said, some people experience severe migraines after consuming caffeine, so this solution isn’t for everyone.

Keep in mind that caffeine withdrawal can also induce a migraine, so it's best to wean yourself off of caffeine rather than cutting it out abruptly. Being aware of your caffeine intake is crucial for migraine prevention.

Get Fresh Air

Sometimes, getting outside can help alleviate a migraine, especially if you are enclosed in a space without good air circulation or exposed to strong, bothersome odors. Excessively cold weather or humidity can trigger or exacerbate migraines, however. If you feel that your migraines could be weather-related, it may be helpful to keep track of the weather in a migraine journal.

Enjoy Yourself

Migraines are true neurological events, and sometimes they are unavoidable. Finding a calming and enjoyable activity to do can distract you from the symptoms, especially if you are dealing with a mild to moderate migraine.

Over-the-Counter (OTC) Therapies 

Some non-prescription medications can help lessen the symptoms of a migraine or help aid in prevention. These tend to be more effective when taken right at the start of a migraine or even before it starts (if you notice a prodrome before your migraine):

  • Non-steroidal anti-inflammatories (NSAIDs): Medications such as aspirin, ibuprofen, and naproxen are all pain relievers and anti-inflammatories that can help take the edge off migraine symptoms, eliminate a migraine completely, or aid in the prevention of a migraine altogether. Be sure to use as directed, as these medications can cause stomach upset and may increase your risk of bleeding, especially when taken frequently or at high doses. 
  • Acetaminophen: Acetaminophen is a pain reliever that is not an NSAID and is not associated with the stomach upset and bleeding effects that can occur with NSAIDs.
  • Excedrin Migraine: This medication contains a combination of acetaminophen, aspirin, and caffeine. Keep in mind that aspirin is an NSAID, so you should ask your doctor before taking any other NSAID with Excedrin Migraine.

Be sure to discuss your migraine treatment with your doctor, as many of the medications can produce side effects. Aim to take the lowest dose of over-the-counter medications that can relieve your migraine episodes. This strategy can help prevent rebound migraines and averts the need to constantly increase your medication dose.

Prescriptions

Prescription medications can be used during a migraine attack. A number of medications are specifically indicated for the treatment of migraine episodes, and some treatments that are indicated for other conditions are often used for the treatment of migraine episodes as well. 

If you have recurrent migraines, your doctor might give you a prescription for one of the several different medications commonly prescribed for treating migraines.

Migraine Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Triptans

There are many different triptans, and this category of medicines is approved for the treatment of acute migraine. Triptans include Imitrex (sumatriptan), Relpax (eletriptan), Zomig (zolmitriptan), Amerge (naratriptan), Maxalt (rizatriptan), Axert (almotriptan), and Frova (frovatriptan).

These medications are serotonin agonists, which means that they work directly on serotonin receptors to stop migraines. They also induce vasoconstriction (narrowing of the blood vessels), which may be related to their therapeutic effect.

Triptans are powerful medications and can increase the risk of heart attack and stroke, so they are not recommended for use if you have risk factors for these conditions.

Fioricet and Fiorinal

Fioricet is a combination of acetaminophen, caffeine, and butalbital, while Fiorinal is a combination of aspirin, caffeine, and butalbital, which can also be combined with codeine (a narcotic). Butalbital is a barbiturate, which means that it acts as a depressant and can make you sleepy. It is also addictive and can cause side effects such as shaking, confusion, and tremors. 

The American Academy of Neurology strongly recommends against using butalbital for migraines, except as a last resort. While Fioricet and Fiorinal have been used for migraines in the past, they should no longer be used because the risks outweigh the potential (modest) benefit.

Ergots

Dihydroergotamine and ergotamine (Cafergot) are potent vasoconstrictors that are effective in alleviating migraine symptoms. They can cause serious side effects, however, and are not recommended if you have blood vessel disease, kidney disease, or heart disease.

Steroids

Oral steroids have been used to both prevent migraines and reduce symptoms of acute migraines. Many people experience relief of pain and other migraine symptoms with this treatment. Speak with your doctor to find out if this is a viable treatment for your migraines.

Opioids

Opioids, also referred to as narcotics, have been used in some instances for the treatment of migraines. However, the American Academy of Neurology says opioids should be used only in exceptional circumstances. Opioid medications, which include codeine, fentanyl, and hydrocodone, are not the most effective option for treating migraine symptoms, and they are highly addictive. 

Reglan (Metoclopramide)

An antiemetic used for the treatment of nausea and gastroesophageal reflux, Reglan can be used for migraine relief. Because most migraine treatments are not safe during pregnancy, Reglan is often the preferred migraine therapy during pregnancy.

However, the medication is associated with a distressing side effect called focal dystonia, which causes a strong involuntary muscle contraction often described as “lockjaw."

Periactin (Cyproheptadine)

An antihistamine medication generally used for allergies, Periactin is often used to treat migraines in children. A common side effect of Periactin is drowsiness, so you should not drive or operate machinery until you know how Periactin affects you.

Reyvow (Lasmiditan)

Like the triptans, lasmiditan is a serotonin receptor agonist. It works a little differently, however, by altering electrical activity in the brain, not by inducing vasoconstriction. Reyvow is a brand of lasmiditan that was approved for use by the FDA in 2019.

CGRP Antagonists

CGRP (calcitonin gene-related peptide) is a protein in the brain and nervous system that increases during a migraine attack, causing vasodilation, light sensitivity, and pain. CGRP antagonists relieve symptoms by suppressing CGRP. FDA-approved medications that target CGRP for acute pain relief include Nurtec ODT (rimegepant), and Ubrelvy (ubrogepant).

Notably, the FDA also recently approved Nurtec ODT for migraine prevention - making this medication the first and only treatment available to both treat migraines in the moment and help prevent future migraines.

Surgeries and Specialist-Driven Procedures 

Surgical procedures and injections are generally considered preventive approaches to migraine therapy and are not typically used for the treatment of an acute attack. However, there are some techniques that can help in the treatment of acute migraine attacks that do not respond to oral medications.

Injections

In some cases, injection of an anesthetic, a muscle relaxant, or steroids can be used when a migraine is not responding to any other therapy, with inconsistent success rates. Intravenous infusions of ketamine or propofol, both powerful anesthetics sometimes used for surgical anesthesia, have been used for acute migraine treatment. For chronic migraine, injections of botulinum toxin can be used as preventive therapy.

Spring TMS

A non-invasive device approved for migraine treatment, this magnetic stimulator is placed at the back of the head to deliver a magnetic pulse, which can stop a migraine attack. (TMS stands for transcranial magnetic stimulation.) This is considered a safe treatment without risks or side effects.

Complementary and Alternative Medicines (CAM)

CAM approaches to migraine treatment can be very effective for some people. However, not everyone experiences relief with these options. They are considered safe, and if you experience migraines, it may be worth trying CAM treatments to see if they can work for you. 

Ginger

In terms of oral supplements, ginger is the only one that has been consistently proven effective in alleviating the symptoms of acute migraine. It can be consumed raw, as gum or candy, or in hot or cold tea.

Tiger Balm

As a topical treatment, Tiger Balm is more effective than placebos and equally as effective as medication in reducing tension headaches. It has also been used in migraine treatment with some success.

Lavender Oil

Lavender oil is the only aromatherapy that has been proven effective in the treatment of episodes of migraine. It is a safe option—inhalation of lavender oil can reduce the severity of a migraine and may eliminate the symptoms as well.

Frequently Asked Questions

How should you relieve migraine pain when pregnant?

Your doctor may recommend home remedies first since some migraine medications aren't safe during pregnancy. This can include using cold packs, finding ways to reduce stress, and getting enough sleep. If you do need medication to treat a migraine, some are considered likely to be safe, including acetaminophen, metoclopramide, diphenhydramine, and cyproheptadine, but check with your doctor first.

Can your diet affect migraine pain?

Some people report that certain foods, such as alcohol and chocolate, can trigger their migraines. If you think that your migraines happen when you eat a certain food, try limiting the food for four weeks and keep a diary of your symptoms during that time. Eating a balanced diet with whole foods is also an important part of staying healthy and reducing the risk of migraines.

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