5 Ways to Optimize Your Migraine Care

While it may sometimes seem like your migraines are overwhelming your life, there are ways that you can become more proactive in your migraine care. Taking a more active role will help you feel empowered and give you hope for a healthier future. Here are five strategies that can help you optimize your migraine care (under the guidance of your healthcare provider, of course).

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Engage in Healthy Habits

Start with the basics. Get yourself into a daily routine that promotes physical and mental wellness. Some healthy habits you can start implementing right away include:

  • Eat a healthy diet that's rich in fruits, vegetables, whole grains, and lean proteins.
  • Choose meal times that are consistent from day to day and not so spaced apart that you experience distressing hunger.
  • Stay hydrated. Consider flavored water, sparkling water, or unsweetened tea.
  • Maintain a regular sleep routine. Go to bed at the same time every night and wake up at the same time every morning (even on the weekends).
  • Engage in regular relaxation activities like yoga, mindful meditation, reading, or listening to music.
  • Exercise at least 150 minutes a week. Choose moderately intense exercises such as jogging, walking briskly, or playing tennis. It's OK to break this down into sessions, such as 30 minutes, five days a week.

See Your Primary Care Physician

It's important to see your primary care physician, in addition to your headache specialist or neurologist, if you have one. This way, any underlying medical conditions can be addressed. You may be surprised how much other aspects of your health can impact your migraine disorder.

Sleep

Discuss any sleep problems with your healthcare provider. Snoring, a morning headache, the urge to move your legs, or difficulty falling or staying asleep may indicate an underlying disorder such as sleep apnea, restless legs syndrome, depression, or anxiety.

Mood

It's also important to discuss any new physical or mood symptoms with your healthcare provider, even if you don't think they are important. For example, signs of depression include a loss of interest in activities and feeling sad, guilty, or hopeless most of the time. Research indicates that treating your depression may help your migraines (and vice versa).

Medications

Give your healthcare provider a list of medications you're taking, including over-the-counter medications, supplements, vitamins, or herbal preparations, as well as how much alcohol and caffeine you regularly use. This helps them zero in on any potential interactions.

Other Pain

Tell your healthcare provider about any other sources of pain in your body, for example, the muscles in my neck hurt or I have pain all over. These could indicate a second pain process occurring along with your migraines, like fibromyalgia or a myofascial trigger point.

Write It All Down

While the idea of maintaining a migraine diary may seem a bit tedious or even old-school, you may be surprised at how useful it is. It can help even if you've already been diagnosed with a headache disorder. Here's why keeping a log of your headaches can be so beneficial.

It Can Confirm a Diagnosis

A diary may be particularly useful to help your practitioner confirm your migraine diagnosis. Remember, it's always possible that you actually have a different type of headache or migraine disorder than you previously thought—or were previously diagnosed with.

You could have more than one headache or migraine disorder occurring simultaneously. A detailed diary can help your healthcare provider sort this all out.

It Can Target Triggers

Your diary may alert you to migraine triggers. Keeping track of all of these factors can help you see patterns you may not have spotted otherwise. Include as much information about your day as you can. Write down details about:

  • Foods
  • Beverages
  • Habits
  • Activities
  • Environmental exposures
  • Weather changes
  • Stressful life events

Any of these things could be contributing to your migraines.

It Can Be Therapeutic

The simple task of writing can be healing, a way to relax as you take the time to review your thoughts and care for your health. You can use your diary as a way to keep track of your emotional health as well.

Alternative Ways to Journal

If writing in a journal doesn't appeal to you, try typing notes on your phone, using a small tape recorder, starting a spreadsheet, or asking for the help of a friend or partner.

Learn the Right Way to Take Your Meds

If you're like many people with migraines, you may not be sure when to take pain-relieving medication for your migraines. This isn't surprising—especially for those who endure chronic migraines, it can be challenging to differentiate between a headache that has persisted for days and a new headache that erupts on the tail end of the previous chronic headache.

Another potential problem is that some people with migraines are at risk or are already suffering from medication overuse headaches. This means that you develop another type of headache disorder on top of your preexisting headache disorder, which can further confuse the picture.

Don't be surprised if your healthcare provider asks you to stop taking your current migraine medications at the beginning of your treatment plan. Though this can be tough, it is meant to help your practitioner determine if medication overuse headache is playing a role in your head pain.

Differentiating between headaches and medication overuse headaches is why it's extremely important to seek out help from a healthcare provider.

Talk to your primary care physician or, if your migraines are severe or chronic, talk to a neurologist. A headache specialist can teach you how to distinguish between migraine "on" and "off" days so you can treat your migraine attacks when they first begin—or even before they begin.

Your healthcare provider can also teach you exactly how to take your fast-acting "rescue" medication, as there are a few tricks to it. For example, many people don't take the appropriate dose when their migraine attack starts. Others are unaware that their medication might need to be taken again at a specific time interval after the first dose.

Additionally, many people don't realize that there are a number of unique medication formulations. For instance, there are triptans that are available as a nasal spray or as an injection given underneath the skin. There are many options to try before you find the medications that work best for you.

Look Into Preventive Migraine Medication

The purpose of preventive migraine medication is to reduce the number, duration, and severity of migraine attacks, as well as to decrease your use of fast-acting migraine medications.

There are a number of reasons why your healthcare provider may prescribe a preventive medication for you, such as:

  • You experience four or more migraine attacks per month.
  • You have migraine attacks that negatively impact your quality of life or your ability to function.
  • You can't tolerate acute migraine medications because of side effects, or they're not an option for you due to another health condition. For example, if you have heart disease, you may not be able to take a nonsteroidal anti-inflammatory drug (NSAID) or a triptan.

There are a number of preventive migraine medications to choose from, each with its own unique side effects, mechanism of action, and dosing regimen. It may take some trial and error, as well as patience, before you find the best preventive medication for your needs.

Examples of preventive migraine therapies include:

  • Aimovig (erenumab): anti-CGRP monoclonal antibodies
  • Ajovy (fremanezumab): anti-CGRP monoclonal antibodies
  • Emgality (galcanezumab): anti-CGRP monoclonal antibodies
  • Topamax (topiramate): anticonvulsant
  • Depakote (divalproex/sodium): anticonvulsant
  • Inderal (propranolol): beta-blocker
  • Toprol (metoprolol): beta-blocker

Treating and Preventing Migraines

In May 2021, the FDA approved Nurtec ODT (rimegepant) to prevent migraines. Nurtec ODT was already approved to treat acute migraines—or migraines that have already started—making it the only medication approved to both treat and prevent migraines.

What to Expect

Preventive migraine medication is considered to be effective when it decreases the number of migraine attacks you get in a given month. This means that you shouldn't stop taking your preventive medication just because you continue to get migraines. Migraines are not "cured," they're managed.

If you're not happy with your migraine preventive medication because of its effectiveness, side effects, or other concerns, be sure to talk to your healthcare provider—don't stop taking it on your own. A different medication may be a better choice for you, such as the new generation of migraine medications called anti-CGRP monoclonal antibodies.

You should also know that taking a migraine preventive medication is not a life-long commitment. It can be a good way for you to gain control of your attacks until you can sort out potential triggers or the acute migraine therapies that work best for you.

A Word From Verywell

Be persistent in your effort to learn about your migraines. While there are a number of effective therapies available, it may take hard work and patience to get to the bottom of how to best care for your unique migraine situation.

Try exploring non-pharmaceutical options as well, like diet changes, cognitive behavioral therapy (CBT), pressure-regulating earplugs, meditation, light therapy, ice packs, Alpha-Stim or TENS units, and supplements (under the guidance of your physician).

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. American Migraine Foundation. Headache hygiene - What is it? Published April 12, 2016.

  3. Stanford Health Care. Headache diary.

  4. Ha H, Gonzalez A. Migraine headache prophylaxis. Am Fam Physician. 2019;99(1):17-24.

  5. Gürsoy AE, Ertaş M. Prophylactic treatment of migraine. Noro Psikiyatr Ars. 2013;50(Suppl 1):S30-S35. doi:10.4274/npa.y7199

  6. Nurtec ODT (rimegepant). Full prescribing information. Updated May 2021.

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