I suffer from migraines. They started in my late 20’s, but were rare at the time. In the last few years they’ve gotten worse. At my peak I was experiencing an average of 4 migraine days a week. Now I get them a few days every month, but I’m not out of the woods yet. Every person, and every migraine is different, but I figured I’d share my experiences, what I’ve tried, what worked, what didn’t in the hopes that others may find some relief as well, at the very least in knowing they aren’t alone and there is hope!
What does it feel like?
The first sign of my migraine starts with extreme fatigue, which continues through the entire migraine episode. Then I get sore, achy muscles in my neck (more than usual). Then it hits a day or 2 later. I’ll get a sharp, stabbing pain on one side, rooted at the top of my neck right at the base of my skull (the occipital nerve area). Which side changes every migraine, but always only one side at a time. This pain is excruciating, to where I feel like I’m having a stroke at times. This lasts for a few days, accompanied by the fatigue. As the sharp pain subsides, I’m left feeling hung over, like the end of a sickness, with fatigue, and feeling foggy. Finally I’ll have relief for a few days, with only the fear of the next one lingering. In my 20’s the migraines were also accompanied by auras and nausea. The auras are the worst, so I’m glad I don’t have those now! They are when you have visual disturbances. Mine were black dots. The only relief is to go into a dark room and close your eyes. I also get tension headaches that feel like my entire head is under extreme pressure and throbbing. These have mostly disappeared with the treatments I’ll mention below.
Emotionally you get in a vicious cycle of hope and despair. There are so many different possible triggers and solutions. It feels like most don’t work, so you go through moments of just accepting that you live with pain. I’m lucky I have medications that help me deal with the pain somewhat, so I can function and go to work at least. I have friends that struggle with even that. And as a mom, I felt guilty when I was at my worst because I’d often have to say no and just go lie down instead of playing with my daughter. I live in fear of migraines enough that I avoid all possible triggers. It impacts your life a lot when you are avoiding going outside, walking, certain foods, etc. You find yourself saying no and feeling like you are missing out. And then there are the moments you have something planned, so you hope the migraine comes sooner so you can just get it over with before your plans come up. Chronic pain has emotional impacts as well as physical. Don’t give up, keep hope, get help!
Determining the causes and triggers for your migraines will help a lot in figuring out the best treatment. However, it’s a needle in a haystack. For awhile I’d try solutions that didn’t work because there were too many other triggers for me to see any benefit from one change. Now that I’ve found a few solutions that help take care of those triggers, it makes it easier to see other causes more clearly. Some of my possible causes are:
- astigmatism of my eyes
- sleep position and pillow
- not enough sleep (and I require a lot)
- exercise, even very light
- clenching and grinding my teeth
- desk ergonomics
- chronic sinusitis
- migraine medication overuse
Where to go for help
I’ve gone to a few different kind of doctors for help.
My regular doctor has actually given me a few medications to both treat and prevent. They work pretty well, but I’d like to avoid just taking medications all the time.
I tried a chiropractor who did an XRay and found arthritis, and my soft tissue and muscles are a mess. He admitted that chiropractic care isn’t generally a valid solution for migraines, but they also offer massages that have helped me deal quite a bit.
I saw a dentist to work on my teeth grinding.
I saw an eye doctor to test my eyes.
I also saw a neurologist. This is typically the doctor you should see to help you with migraines. They recommended physical therapy in their office, so I saw them as well. I’m now pending an MRI for further diagnosis.
I am also pending an appointment with an Ear, Nose, and Throat (ENT) doctor to look at the possibility of chronic sinusitis.
Treatments that didn’t work
I’ve read a lot that taking magnesium pills can help prevent migraines. I took magnesium for a few months, but never once saw a difference.
In general, I’m a huge believer of physical therapy. I’ve done it a few times for other injuries with huge success. It’s time consuming, but worth it. I was happy when my neurologist recommended physical therapy to treat and prevent migraines. I went once a week, and did additional exercises daily at home. My physical therapists were located right at the neurologists office and specialized in treatments for headaches, etc. They did some physical tests and said that most people have issues due to lack of flexibility. Physical therapy is very effective in that case. However, I have extreme flexibility. It’s unknown if that would cause my migraines, but we gave physical therapy a try anyway. I went to them for a few months and we did stretches, strength training, massage, heat, and even acupuncture with electro-stimulation. There was no progress, so eventually the physical therapists recommended I stop, go back to my neurologist and try a different treatment plan.
Tizanidine is a muscle relaxer. My neurologist prescribed this in the hopes it would relax my neck muscles. This was done during the same time as physical therapy so that the medication would help increase the effectiveness of the therapy. The side effects of feeling drowsy and drugged out were not fun. And after a few months I didn’t see any improvement, so I stopped.
Treatments that are working
I always thought I had good vision. I never noticed any inability to see things near or far. However, my family has a history of poor eyesight, and I stare at a computer screen all day, so it was inevitable. Once the migraines were unbearable, I took matters into my own hands and scheduled an appointment with an optometrist. They diagnosed me with astigmatism and gave me a prescription. I was told I would only need to wear the glasses while using a computer screen, or night driving. However, I’ve found a profound difference in wearing them all the time. It really helps!
One of my triggers is the sun. When I go outside on a sunny day (pretty much every day in Arizona), I squint so much I get a migraine. I tripped over these TheraSpecs Classic Migraine Glasses for Light Sensitivity, Photophobia and Fluorescent Lights. I got the outdoor lenses that are polarized, and 100% UVA/UVB blocking. The main point of these glasses is that they block 80% of the blue-green wavelengths, called FL-41 lens technology that theoretically can trigger migraines. Honestly, I don’t usually buy into marketing like this, but I got desperate and figured it wouldn’t hurt to try. Immediately upon wearing them I saw a difference! They also offer them custom made with your prescription, and I now regret not doing that! They have a few different styles and sizes, so check out their collection here: TheraSpecs
One of my biggest issues is that my migraines would be so bad they would keep me from sleeping. And not getting enough sleep causes a migraine. So it’s easy to get in a vicious cycle. A few times a week the migraine would start in the middle of the night while I was sleeping and the pain would wake me up. Well, I’m a stomach sleeper. Not a good position for people with neck issues. So, I changed my sleep position. I thought it would be hard to train myself, but just being conscious of it helped a lot. I start out on my back or side. Inevitably during the night I would roll onto my stomach in my sleep, but luckily I would wake up and remember to turn over. Every once in awhile I wouldn’t care because I was half asleep, but I’d remind myself of the pain and that was enough to motivate me. Now I mostly sleep on my side and never have a migraine start at night. Every once in awhile I’ll end up on my stomach and the neck pain will wake me up. I’ll shift position and the pain goes away. For those that are heavier sleepers, I’ve read tricks like taping a marble to the front of your shirt. The discomfort will wake you up enough to roll over.
Related to sleep position, I found a better pillow that is actually made for my sleep position, and fits my size. This may take some trial and error on your part to find the right one. Give a new pillow a few nights to get used to it as well. I use the Bluewave Bedding Ultra Slim Gel Memory Foam Pillow for Stomach and Back Sleepers – Thin and Flat Therapeutic Design for Spinal Alignment, Better Breathing and Enhanced Sleeping and have had great success!
When I saw the chiropractor he recommended massage therapy. They offer medical massage at their office. It gets billed under the physical therapy code, and luckily my insurance covers it! However, these aren’t like a relaxation massage at a spa. It’s deep tissue, so it gets pretty intense. They also do Gua Sha, which involves scraping the skin with a special tool to increase circulation. It usually leaves really nasty looking bruises down my whole neck and back, although it doesn’t hurt. I go twice a month, and while it doesn’t prevent my migraines, it does seem to shorten the length. It also reduces the severity of my daily baseline headache by relaxing the muscles.
Continuous birth control pills
One of my migraine triggers is hormones. This is fairly common in women. I would always get a very predictable migraine the day before my period would start, and it would last for about 5 days. Some women get it at the end of their period. When I was pregnant I didn’t have a migraine at all, but after my child was born, I had a nasty one that lasted a few months. I’m on the birth control pill, but that alone wasn’t enough. My regular primary care doctor recommended I skip the blanks and be on the active pills continuously. One benefit is that it completely stopped the hormone triggered headaches within about 2 months. Another side benefit is that I no longer have a period, at all, and it’s perfectly safe! As always, consult your own doctor first…
Rizatriptan Benzoate (also known as Maxalt) is the medication I’ve taken the longest. You take it at the first sign of a migraine, and it helps decrease the symptoms and shorten the length. This has worked well for me. I use the orally disintegrating tablets which seem to work faster.
Over the counter medications
Advil (Ibuprofen), Tylenol (Acetaminophen), Aspirin, Aleve do not work on their own for a migraine. However, when taken in combination with the Rizatriptan Benzoate above, it increases the effectiveness, so I take them together for relief. Warning that taking Ibuprofen long term is not good for you, and can cause rebound headaches, so take only occasionally as needed, and consult a doctor.
So, caffeine does help reduce the symptoms as well. However, caffeine is a very common trigger, so I generally avoid it. There have been times I’d drink just a little during the worst of it, just so I could get through my day. But I’d recommend you find better treatments, and instead try to remove caffeine completely from your diet.
I’ve tried ice. I’ve tried heat. They both provide minimal comfort in the moment.
Biofreeze Pain Relief Gel is a sports cream that works the best, in my opinion. Another treatment that can provide temporary relief of your pain symptoms, especially if they are accompanied by sore muscles.
Nortriptyline is another medication, but one that is meant to prevent. It used to be prescribed for depression, but they now use it more commonly at a really low dose for migraines. This actually does seem to work pretty well. I didn’t have a migraine unless I triggered it. But it also seems that you build up a tolerance. I used to only take one pill and it worked great. After a few months it worked less effectively, so I increased to the full prescribed amount of 2 pills. This also seems to work, but I wonder if it will also eventually stop. Additionally, this was prescribed by my general practitioner doctor. My neurologist recommends that I not be on this longer term, so we are continuing to explore different medication options.
My dentist has diagnosed me with clenching and grinding my teeth. I’ve tried a few mouth guards with them. I’m apparently crazy at night since we were unable to find one that prevents the grinding completely. So now my mouth guard just protects my teeth and doesn’t stop it. However, most folks have better success at using a mouth guard to stop grinding. Ask your dentist if you grind!
The Neck Hammock Portable Cervical Traction Device for Neck Pain Relief and Physical Therapy looks a bit intimidating, but if you have migraines it also looks tempting. Especially if you get relief from physical therapy or massages. I tried this out and found it basically stretches your neck. Even when I’m not in a full migraine, it feels really good and does provide relief and comfort.
What’s next for me?
I’m currently waiting for the results from my brain MRI with the Neurologist. I also started taking Aimovig, which is a shot you give yourself monthly. If that works, I’d wean off the Nortriptyline. So far, it does seem to be working. I’ve also gotten advice to try Benadryl instead of Advil, so I may try that next time… I’ll keep you posted!
Also, check out this blog post from a friend who suffered from a severe migraine episode for 159 days and see how she managed to find relief: https://reneetumolo.com/2015/02/28/one-year-ago/
What works for you? Leave me comments!