There is no shortage of headache relief medicines on the market. And painkillers have their place. Take acetaminophen, aspirin or ibuprofen according to package directions at the first sign of a headache. You can often nip it in the bud.
But then again, if headache relief were that simple, you wouldn't be asking this question. Or perhaps you're interested in a nondrug approach. If you have a headache right now, the tips that follow will help you feel better fast. Some will work for tension headaches, others may help your migraines and some just might help you prevent your next headache, whichever kind it is. :) Women doctors agree that it's a good idea to experiment: Headache remedies work differently for different headaches, for different women, at different times.
Thumbs up, pain down. Place your thumbs right in the center of each temple. Massage firmly using a circular motion for a minute or two, or until you feel relief. If I catch it early enough, I find that I can sometimes stop a headache.
Take a hot bath or shower. This may further help your muscles relax.
Visualize away your headache. Imagine that your headache pain is caused by a rope that's knotted and wrapped tightly around your head. Then concentrate hard on seeing it unknot, inch by inch. Watch as it slowly loosens and falls away from your head.
Try necking with a heating pad. When you have a stiff neck, you can get a headache, because the stiff muscles hurt and cause pain that can be felt in your head. Remedy? Apply a heating pad to the back of your neck to soothe the stiffness.
Ice a migraine. For easing migraines, ice usually works better than heat, most likely because of its action as a vasoconstrictor--it shrinks blood vessels pressing on nerve endings. A resealable plastic bag full of ice, wrapped in a kitchen towel, works.
Feverfew for you? For occasional headaches take the herb feverfew. Research on feverfew suggests that it can be effective as a headache remedy; I've used it with success. I recommend taking two feverfew capsules (available at health food stores) three times a day until your headache is gone. Studies indicate that feverfew has anti-inflammatory properties, which is why it might be particularly effective for migraine headaches.
Lie down in a dark room. If you have migraines lying down in a darkened room and napping for an hour or so can usually make the headache history.
Have a snack. You can get headaches from just being hungry, because your blood sugar drops.
Always be aware of when you last ate. Try eating smaller meals, spread more frequently throughout the day.
Take a coffee break. If you feel a migraine coming on, go someplace quiet and have a strong cup of coffee. Take aspirin or ibuprofen according to package instructions. Like ice, caffeine acts as a vasoconstrictor, which seems to help migraines.
Or, do the caffeine wean. The surprising thing about caffeine is that either too much or lack of it can trigger pain. Too much caffeine can lead to headaches, because of an increase in tension or a decrease in sleep (or both). Consuming less than the usual amount of caffeine can lead to very painful withdrawal headaches. Frequently, weekday coffee or cola drinkers may drink less on weekends, and they get fierce withdrawal headaches. If you get headaches, give up caffeinated drinks slowly and gradually--by four to six ounces a day--perhaps by diluting regular brew with decaf until you're finally caffeine-free. You should also substitute eight cups a day of noncaffeinated liquids, such as water, juices, skim milk or herbal teas.
Keep a headache diary. Both tension and migraine headaches can have triggers. Your monthly cycle can affect headaches, too. I suggest that you log the time of day and month, the foods, activities, moods--anything that could possibly trigger a headache. After a couple of weeks, read your diary. See if anything obvious is causing your headaches and avoid the source if you possibly can.
It's a very individual thing. For many, chocolate can be a migraine trigger--though it doesn't trigger my migraines--but red wine will immediately send me right around the bend.
Avoid migraine triggers. Avoid the most common offenders: that is, foods that have been aged, fermented, pickled or marinated. Other reputed problem foods are those containing monosodium glutamate, or MSG (such as canned soups), nitrates or nitrites (such as lunchmeats).
And some added help:
Once a migraine takes hold, it's a bugger to relieve.
Restock your magnesium. I read about an Italian study that indicates that people with migraines are likely to have lower blood levels of magnesium than non-migraine-sufferers, and suggests that magnesium supplements for people with migraines warrant further study. Good food sources of magnesium include green leafy vegetables, legumes, seafood, nuts and whole grains.
Regulate sleep patterns. People who work irregular shifts have trouble with their migraines. Circadian rhythms seem to play a part in migraines. Try to get to sleep and wake up at the same times each day and don't sleep late on weekends. Also, avoid napping during the day, as this may change your circadian rhythms.
Give aspirin a chance. An aspirin a day may keep migraines away. The problem with some of the prescription drugs used to try and prevent migraines (like beta and calcium channel blockers, antidepressants and mood-regulating drugs) is that they are like hitting a little problem with an awfully big hammer. Taking a regular 325-milligram aspirin tablet every other day, regularly, cut repeat migraine attacks by 20 percent. It might not work for everyone, but it's definitely worth trying, because if it works, it's an easy, inexpensive and relatively safe solution.
Hope this helps you. :)
2006-08-21 13:25:53
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answer #4
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answered by Anonymous
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http://en.wikipedia.org/wiki/Migrane
Treatment
Conventional treatment focuses on three areas: trigger avoidance, symptomatic control, and preventive drugs. Patients who experience migraines often find that the recommended treatments are not 100% effective at preventing migraines.
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Trigger avoidance
Patients can attempt to identify and avoid factors that promote or precipitate migraine episodes. Moderation in alcohol and caffeine intake, consistency in sleep habits, and regular meals may be helpful. Beyond an often pronounced placebo effect, general dietary restriction has not been demonstrated to be an effective approach to treating migraine.[1]
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Symptomatic control to abort attacks
Migraine sufferers usually develop their own coping mechanisms for intractable pain. A cold or hot shower directed at the head, a wet washcloth, less often a warm bath, or resting in a dark and silent room may be as helpful as medication for many patients, but both should be used when needed. A simple treatment that has been effective for some, is to place spoonfuls of ice cream on the soft palate at the back of the mouth. Hold them there with your tongue until they melt. This directs cooling to the hypothalamus, which is suspected to be involved with the migraine feedback cycle, and for some it can stop even a severe headache very quickly.
For patients who have been diagnosed with recurring migraines, doctors recommend taking painkillers to treat the attack as soon as possible. Many patients avoid taking their medications when an attack is beginning, hoping that "it will go away". However in many cases once an attack is underway, it can become intensely painful, last for a long time (sometimes even for several days), and become somewhat resistant to medical treatment. In contrast, treating the attack at the onset can often abort it before it becomes serious, and can reduce the frequency of subsequent attacks in the near-term.
The first line of treatment is over-the-counter abortive medication. Doctors start patients off with simple analgesics, such as paracetamol (known as acetaminophen in the U.S.), aspirin and caffeine. They may provide some relief, although they are not effective for most sufferers. Some patients find relief from taking Benadryl or anti-nausea agents.
Narcotic pain killers (for example, codeine, morphine or other opiates) provide variable relief, but their side effects, the possibility of causing rebound headaches or analgesic overuse headache, and the risk of addiction contraindicates their general use.
If over-the-counter medications do not work, the next step for many doctors is to prescribe fioricet or fiorinal, which is a combination of butalbital (a barbiturate), acetaminophen (in fioricet) or acetylsalicylic acid (more commonly known as aspirin and present in fiorinal), and caffeine. While the risk of addiction is low, butalbital can be habit-forming if used daily, and it can also lead to rebound headaches.
Amidrine (a cocktail of a pain reliever, a sedative, and a vasoconstrictor) is sometimes prescribed for migraine headaches.
Anti-emetics by suppository or injection may be needed in cases where vomiting dominates the symptoms. The earlier these drugs are taken in the attack, the better their effect.
Until the introduction of sumatriptan (Imitrex®/Imigran®) around 1985, ergot derivatives (see ergoline) were the primary oral drugs available to abort a migraine once it is underway. However, ergotamine tablets (usually with caffeine), though sometimes effective, have fallen out of favour. Absorption is erratic unless taken by suppository or injection. Dihydroergotamine (DHE), which must be injected or inhaled, can also be effective. These drugs can be used either as a preventive or abortive therapy.
Sumatriptan and related selective serotonin receptor agonists are now the therapy of choice for severe migraine attacks that cannot be controlled by other means. They are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70-80% of patients. Some patients have a recurrent migraine later in the day, and only one such recurrence in a day can be treated with a second dose of a triptan. They have few side effects if used in correct dosage and frequency. There have been some rare instances of cardiac arrest in patients using triptans. Some members of this family of drugs are:
Sumatriptan (Imitrex®, Imigran®)
Zolmitriptan (Zomig®)
Naratriptan (Amerge®, Naramig®)
Rizatriptan (Maxalt®)
Eletriptan (Relpax®)
Frovatriptan (Frova®)
Almotriptan (Almogran®)
Evidence is accumulating that these drugs are effective because they act on serotonin receptors in nerve endings as well as the blood vessels. This leads to a decrease in the release of several peptides, including CGRP and Substance P.
These drugs are available only by prescription (US, Canada and UK) although Sumatriptan is to be available in the UK over the counter from mid-June, 2006. [2] It is also expected to become eligible for generic status in the United States in 2007. Many migraine sufferers do not use them only because they have not sought treatment from a physician.
Regarding comparative effectiveness of these drugs used to abort migraine attacks, a 2004 placebo-controlled trial (Cephalalgia. 2004 Nov;24(11):947–54) reveals that acetylsalicylic acid, sumatriptan and ibuprofen are equally effective.
Triptan therapy has been shown to result in a reduction in lost productivity. Sumatriptan has been shown to result in an average of 0.5 fewer missed workdays during the first three months of therapy and 0.7 fewer missed workdays within the first six months, as well as a reduction in the number of days spent working while symptomatic. The average reduction in lost productivity has been estimated at $1,249, at a cost of $25 per day of disability avoided. The annual net savings in reduced health care costs and lost productivity, over the increased cost of triptan therapy, has been estimated at between $114 and $540 per patient; thus the use of these pharmaceuticals represents a cost savings as well as an improvement in the patients' quality of life.
Intravenous chlorpromazine has proven very effective in treating status migrainosus - intractable and unremitting migraine.
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Preventive drugs
Patients who have more than two headache days per week are usually recommended to use preventives and avoid overuse of acute pain medications.
Preventive medication has to be taken on a daily basis, usually for a few weeks, before the effectiveness can be determined. It is used only if attacks occur more often than every two weeks. Supervision by a neurologist is advisable. A large number of medications with varying modes of action can be used. Selection of a suitable medication for any particular patient is a matter of trial and error, since the effectiveness of individual medications varies widely from one patient to the next.
The most effective prescription medications include several classes of medications including beta blockers such as propranolol and atenolol, antidepressants such as amitriptyline, and anticonvulsants such as valproic acid and topiramate.
Sansert has been returned to the US market after being temporarily withdrawn by Novartis. Although highly effective, it has rare but serious side effects, including retroperitoneal fibrosis.
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Alternative approaches
Because the conventional approaches to migraine prevention are not 100% effective and can have unpleasant side effects, many seek alternative treatments.
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Physical therapy
Many physicians believe that exercise for 15-20 minutes per day is helpful for reducing the frequency of migraines. [3] (PDF)
Massage therapy and physical therapy are often very effective forms of treatment to reduce the frequency and intensity of migraines. However, it is important to be treated by a well-trained therapist who understands the pathophysiology of migraines. Deep massage can 'trigger' a migraine attack in a person who is not used to such treatments. It is advisable to start sessions as short in duration and then work up to longer treatments.
Chiropractic adjustments to the upper cervical spine are very effective in treating migraine headaches. There is research to support these claims. One study found that the upper cervical adjustment was just as effective as drug therapy for chronic cases. It is also noted that routine spinal adjustments help prevent the frequency, duration, and intensity of the headaches.[citation needed]
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Prism eyeglasses
At least two British studies have shown a relationship between the use of eyeglasses containing prisms and a reduction in migraine headaches.
Turville, A. E. (1934) Refraction and migraine. Br. J. Physiol. Opt. 8, 62–89, contains a good review of the literature and theories existing in 1934, and includes the vascular theory of migraine that is popular today. In that study, Turville suggests that many patients were provided with complete relief from migraine symptoms with proper eyeglass prescriptions that included prescribed prism.
Wilmut, E. B. (1956) Migraine. Br. J. Physiol. Opt. 13, 93–97, replicated Turville's work. Both studies are subject to criticism because of sample bias, sample size, and the lack of a control group.
Neither study is available online, but another study which found that precision tinted lenses may be an effective migraine treatment and which references the Turville and Wilmut studies can be found here. [4] (PDF)
Turville's and Wilmut's conclusions have largely been ignored since 1956 and it is widely believed that vision problems are not migraine triggers. However, a casual search of the usenet archives maintained by Google Groups shows many anecdotal reports demonstrating a relationship between migraines and eyeglasses. [5]
Most optometrists avoid prescribing prism because, when incorrectly prescribed, it can cause headaches. Prism has been proven effective at relieving motion sickness, which itself has many symptoms that are similar to the aura that accompanies migraine.[6]
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Herbal and nutritional supplements
50 mg or 75 mg/day of butterbur (Petasites hybridus) rhizome extract was shown in a controlled trial to provide 50% or more reduction in the number of migraines to 68% of participants in the 75 mg dose group, 56% in the 50 mg dose group and 49% in the placebo group after four months. Native butterbur contains some carcinogenic compounds, but a purified version, Petodolax®, does not.[7]
Cannabis was a standard treatment for migraines from the mid-19th century until it was outlawed in the early 20th century in the USA. It has been reported to help people through an attack by relieving the nausea and dulling the head pain. There is some indication that semi-regular use may reduce the frequency of attacks. Further studies are being conducted.
Supplementation of coenzyme Q10 has been found to have a beneficial effect on the condition of some sufferers of migraines. In a well-controlled trial, Young and Silberstein found that 61.3% of patients treated with 100 mg/day had a greater than 50% reduction in number of days with migraine, making it more effective than most prescription prophylactics. Fewer than 1% reported any side effects. [8]
The plant feverfew (Tanacetum parthenium) is a traditional herbal remedy believed to reduce the frequency of migraine attacks. Clinical trials have been carried out, and appear to confirm that the effect is genuine (though it does not completely prevent attacks).
Kudzu root (Pueraria lobata) has been demonstrated to help with menstrual migraine headaches and cluster headaches. While the studies on menstrual migraine assumed that kudzu acted by imitating estrogen, it has since been shown that kudzu has significant effects on the serotonin receptors. Kudzu Monograph at Med-Owl.
Magnesium citrate has reduced the frequency of migraine in an experiment in which the magnesium citrate group received 600mg per day oral of trimagnesium dicitrate. In weeks 9-12, the frequency of attacks was reduced by 41.6% in the magnesium citrate group and by 15.8% in the placebo group.[9]
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Non-drug medical treatments
Botox has been used by some sufferers in an attempt to reduce the frequency and/or severity of migraine attacks (Botox for Migraines).
Spinal cord stimulators are an implanted medical device sometimes used for those that suffer severe migraines several days each month[5].
Transacranial Magnetic Stimulation (TMS): At the 49th Annual meeting of the American Headache Society in June 2006, scientists from Ohio State University Medical Center presented medical research on 47 candidates which demonstrated that TMS–a medically non-invasive technology for treating depression, obsessive compulsive disorder and tinnitus among other ailments–helped to prevent and even reduce the severity of migraines among its patients. It essentially disrupts the aura phase of migraines before patients develop full-blown migraines.[10] In about 74% of the migraine headaches, TMS was found to eliminate or reduce nausea and sensitivity to noise and light.[11] Their research suggests that there is a strong neurological component to migraines. A larger study will be conducted soon to better assess TMS's complete effectiveness.[6]
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Other alternatives
Some migraine sufferers find relief through acupuncture which is usually used to help prevent headaches from developing. Sometimes acupuncture is used to relieve the pain of an active migraine headache. In one controlled trial of acupuncture with a sham control in migraine, the acupuncture was not more effective than the sham acupuncture but was more effective than delayed acupuncture.
There is a point between the thumbs and index finger that is shown to help subside headaches if the headache or migraine isn't too severe. Apply pressure with your opposite index finger and thumb close to where the thumb connects to the index. A slight pain is often the signal that it is the correct point.
Incense and smells are shown to help. The smell and incense of apples and lavender have been proven to help with migraines and headaches more so than most other scents.
Biofeedback has been used successfully by some to control migraine symptoms through training and practice.
Sleep is often a good solution if a migraine is not so severe as to prevent it, as when a person awakes the symptoms will have most like subsided.
Diet, visualization, and self-hypnosis are also alternative treatments and prevention approaches.
Bruxism, clenching or grinding of teeth, especially at night, is a trigger for many migraineurs. A device called a nociceptive trigeminal inhibitor (NTI) takes advantage of a reflex limiting the force of clenching. It can be fitted by dentists and clips over the front teeth at night, preventing contact between the back teeth. It has a success rate similar to butterbur and co-enzyme Q10. Massage therapy of the jaw area can also reduce such pain.
In many cases where a migraine follows a particular cycle, attempting to interrupt the cycle may prolong the symptoms. Letting a headache "run its course" by not using painkillers can sometimes decrease the length of an episode. This is especially true of cases where vomiting is common, as often times the headache will subside immediately after vomiting. Curbing the pain may delay vomiting, and prolong the headache.
2006-08-19 02:53:18
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answer #8
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answered by Anonymous
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