Managing Chronic Migraines
Chronic migraines have a serious impact on an individual’s quality of life and overall his or her health. Firstly, the symptoms are often severe enough to interfere with daily activities as reported by a survey from National Headache Foundation: 90% of individuals suffering from migraines cannot function normally on the day of a migraine attack, many of them experience nausea, vomiting and sensitivity to light and noise in addition to the typical severe, throbbing headache; 30% require bed rest and a similar percentage will miss at least one day of work due to a migraine within three months.
We should also take into consideration the long-term complications of chronic migraines. For example, both migraines and severe headaches are a risk factor for stroke, affecting both genders especially before the age of 50. Chronic migraines (especially those with aura) may also increase the risk of developing certain heart diseases (such as high cholesterol and high blood pressure). Other conditions linked with migraines include anxiety (especially panic disorders) and depression.
How Are Chronic Migraines Managed?
Conventional medicine offer two forms of treatment for chronic migraines: the first one is focused on managing the acute attacks, the second one on preventing future attacks.
The most common drugs for migraine attacks include the over the counter pain killers (aspirin, acetaminophen, ibuprofen), triptans, ergots. Because the painkillers can cause rebound headache and are associated with various side effects they should not be used for more than 9 days per month.
The drugs that prevent migraine attacks are typically used if the migraines occur more frequently, or if the attacks are not well-controlled by the above mentioned drugs. In this category we have beta blockers (i.e. propanolol), anti-seizure drugs (divalproex, valproate) or tricyclic antidepressants (i.e. amitriptyline). Botox injections are also helpful for chronic migraines, and American Academy of Neurology also recommends a herbal remedy derived from butterbur for migraine prevention.
Non-Drug Options
Neurostimulation devices such as TMS (transcranial magnetic stimulation) is a device currently investigated for the treatment of chronic migraines as it showed to help prevent the attacks at the first warning signs that precede a migraine attack. A variety of neurostimulators are now available on the market- some are attached to the head, some are implantable, and they all work in a similar way; they modulate the function of nerves responsible for migraines by using electric and magnetic energy.
Alternative Medicine
Complementary and alternative medicine also offers natural and quite effective options for chronic migraine suffers. The American Headache Society approved the use of the herb butterbur as it helps to reduce the frequency and severity of migraine attacks. Micronutrients like riboflavin, magnesium and Coenzyme Q10 in proper dosage (in supplement form) are also helpful. Melatonin had been studied mostly for migraine prevention.
Biofeedback, meditation, chiropractic, osteopathic and massage therapy also provide benefits for managing chronic migraines.
There is no treatment that works all the time for everyone, but there are many options to choose from and they can also be combined. Just be aware that some herbs do interact with over the counter and prescription medication, and thus you should consult a doctor for any changes in your treatment plan.
