Migraines are not your average headache. Many who experience them describe debilitating pain, which can last for over 48 hours for some people. While research has been unable to determine an exact cause or solution for migraines, this month’s newsletter will tackle some of the prevention and management strategies that may be effective for you.
Triggers & Timing
The key to migraine management is to stop it in its early stages. If you miss your initial “sensitivity” window, you may be setting yourself up for a longer migraine and require more medication or recovery time than otherwise necessary. Knowing what often triggers your migraines, or initial signs of it coming on can help you catch your window in time and start your treatment regimen. Triggers for migraine can vary significantly from person to person, but common ones include:
- Stress, changes to sleep
- Hormonal fluctuations
- Overexertion or missing meals
- Strong sensory experiences, like loud noise, strong odors, or bright lights
- Heavily salted or fermented foods, like aged cheese, alcoholic drinks, or cured meats
For some people, the beginnings of a migraine manifest in the form of an “aura”. This can include one or more of these forms:
- Visual aura – visual changes like flashing lights, foggy vision, blind spots
- Sensorimotor aura – sensory changes like numbness, weakness, tingling
- Dysphasic aura – language or verbal changes like slurred speech, mumbling
However, only 25-30% of people who get migraines experience an aura before its onset. For the majority, migraines come on without warning, making it difficult to differentiate between the beginning of a migraine or a regular headache.
Management with Medication
For many people, the first line of defense is over-the-counter painkillers, like ibuprofen or acetaminophen. However, if your migraines are severely debilitating, occur greater than four times a month, and/or require heavy doses of OTC painkillers to treat, you should talk to your doctor about prescription medication management options. Overuse of OTC painkillers can lead to organ damage and even cause rebound headaches. Current prescription medication options for migraine management include:
- Drugs that stop migraine: sumatriptan, rimegepant, metoclopramide, and others
- Drugs that prevent migraine: propranolol, duloxetine, verapamil, and others
Management with Nutrition
Nutritional management of migraines can often work alongside your medications to bring about a swifter response. Some common nutrition interventions include:
- Taking caffeine alongside painkillers to speed up action
- Having snacks on hand to reduce hunger-induced migraines
- Taking magnesium or riboflavin supplements
While research has been conducted on these interventions, the findings are not conclusive. Considering hormones, medications, and many other aspects can influence migraines, remember that nutritional changes are likely not going to be the perfect solution.
Alternative Management Strategies
Alternatives or additional options to help with preventing and reducing migraine symptoms vary widely. Many people with severe migraines have an odd or obscure remedy they swear by, but here are some commonly cited options:
- Yoga or general stretching
- Acupuncture, or pressure point massages
- Aromatherapy with peppermint oil
- Foot soak & massage
Finally, keeping a migraine journal can help you familiarize yourself with what often triggers and solves your migraines, which can assist you in finding the right recovery regimen for you. A helpful journal might include:
- Date and time of onset
- Overall duration of migraine
- Location of pain (i.e. base of skull, left temple)
- Possible triggers for that instance
- Pain management treatments used for that instance
Again, these alternative options are anecdotal, meaning there is currently no research indicating that they are proven to work. Therefore, take each option with a grain of salt.
Overall, migraines and their management strategies are extremely specific to each individual. Techniques for prevention and pain reduction are often not universal, and can sometimes be based on feeling rather than research, so finding the right regimen for yourself is important. Keeping a migraine journal can help you determine what works best for you. Most importantly, migraine management requires you to give yourself grace and take time for self-care. Pushing through one is only going to make it harder for you to recover! As always, seek professional medical advice before you start any treatments, techniques, or medications.
Author: Hafsah Khan, Dietetic Intern
References
Cleveland Clinic. “Migraine Aura.” Cleveland Clinic, 25 Nov. 2021, my.clevelandclinic.org/health/diseases/22131-migraine-aura.
Ha H, Gonzalez A. Migraine Headache Prophylaxis. Am Fam Physician. 2019 Jan 1;99(1):17-24. PMID: 30600979.
Shah, Divya R, et al. “Correction To: Migraine Aura without Headache.” Current Pain and Headache Reports, vol. 22, no. 12, 20 Oct. 2018, https://doi.org/10.1007/s11916-018-0738-9. Accessed 29 July 2025.
Sun-Edelstein, Christina, and Alexander Mauskop. “Foods and Supplements in the Management of Migraine Headaches.” The Clinical Journal of Pain, vol. 25, no. 5, 2009, pp. 446–52, www.ncbi.nlm.nih.gov/pubmed/19454881, https://doi.org/10.1097/AJP.0b013e31819a6f65.