Migraine relief is complicated by several factors. For one thing, no one’s really sure of what the exact mechanism is behind migraines. The main theory has to do with increased excitability of the brain’s cerebral cortex and abnormal control of neurons in the brainstem, but this theory is still unproven. Scientists think a mix of environment and genes is to blame, with two thirds of migraine cases running in families and the existence of migraine triggers generally accepted. Hormones also seem to play a role, with boys more affected than girls before puberty and reverse proportions between the sexes in adults.
Even how migraine presents can be highly variable. The typical one-sided pulsating headache can last 2-72 hours and can have associated nausea, vomiting, and light or sound sensitivity. In up to one third of people, there’s also an aura: a passing sensory or motor disturbance that signals the headache will occur soon. An individual migraine sufferer can experience any combination of these symptoms, and atypical migraines also occur that do not follow the one-sided headache model.
The basic treatment for migraine is still simple pain relief like ibuprofen, paracetamol, or mefenamic acid. Any nausea should also be treated with an antiemetic, and any identifiable triggers should be avoided.
For regular migraine sufferers, prevention is key, and a range of factors can help here, including basic ones that help your health in general, like drinking plenty of water and exercising regularly. Meditation, omega 3s, B vitamins, and magnesium are also recommended. None of these are very helpful when migraine strikes, though, and those who want to keep it natural are best served by some surprisingly effective natural remedies.
Caffeine is one remedy that has proven effective for some, though it ironically serves as a trigger for other people. Excessive caffeine use can also trigger rebound headaches.
Feverfew is one of the herbal agents which, if taken daily, can reduce both the number of migraines and their intensity. Those who want to try it should look for supplements that can provide 100-150 mg per day of parthenolides, the active chemical.
Butterbur is an herb that’s probably the best natural remedy for migraine. The chemicals it contains are thought to relieve spasms and decrease inflammation, and it can be used for both migraine prevention and relief. Unfortunately it’s not readily available, and it needs to be sourced from a dependable laboratory since the unprocessed herb is toxic and needs to be purified properly to be rendered safe. Its long-term safety has also not been established. For those willing to try it, studies have found 75 mg twice daily effective for prevention and 100 mg every three hours (up to 300 mg/24 hrs) can relieve ongoing migraines.
Non-herbal options for migraine prevention include triptans, ergotamines, several seizure drugs, and members of the family of antihypertensive drugs known as beta blockers, and migraine sufferers for whom simple over-the-counter remedies don’t work should discuss these with their physicians.
For migraine sufferers whose headaches are particularly frequent and/or intense, and whose quality of life is poor despite drug therapy, surgical options are available. These range from surgically cauterizing some of the superficial blood vessels of the scalp to removing muscles in areas known as “trigger sites.” These are theorized to be points where sensory nerves are being stimulated by a surrounding muscle or specific contact points. The nerve irritation triggers a cascade of events that lead to inflammation of the meningeal layers surrounding the brain, which leads to migraines. Regardless of specifics, migraine surgery is reserved for cases where noninvasive treatments have failed.