Dr. Anna Pace discusses additional treatment for patients beyond their typical regimen.
When it comes to migraine treatment, doctor-prescribed medicines or over-the-counter drugs can be the first things to come to mind. But migraine treatment has a wide scope. It sometimes includes what are known as complementary or integrative treatments. These additional supplements or strategies can be used in addition to a person’s usual migraine treatment.
“Complementary and integrative treatments for migraine are a common topic I discuss with my patients daily,” says Dr. Anna Pace of the Icahn School of Medicine at Mount Sinai Hospital. “But this is also a topic I have a personal interest in—I’ve had migraine my entire life. I have found some of these treatment options to actually be very helpful in reducing my headache frequency.”
But what are these treatments, and how do they help? There is not as much science supporting them, but complementary and integrative treatments have anecdotal evidence of relief in some patients. Let’s take a look at some complementary and integrative treatments and their potential effect on migraine.
Why Do People Seek Out Integrative and Complementary Migraine Treatments?
There are a number of reasons people turn to complementary and integrative migraine treatment, according to Dr. Pace.
“One of the more common reasons people seek out complementary and integrative treatments is because they may be on a lot of different medications,” she says. “They may not be achieving optimal headache control on these treatments or they’re having too many side effects. Or, they’re just on too many medications.”
But there are other, more-specific reasons people might look into complementary and integrative migraine treatment. Some people want to reduce the amount of stress that migraine has on their lives. They may be looking to improve their attendance at work since migraine can, at times, keep people away from their job. Other people may just prefer a non-pharmacological treatment approach.
Types of Integrative and Complementary Migraine Treatments
Nutraceuticals for Treating Migraine
There is evidence from clinical trials that oral magnesium oxide may be an effective preventive strategy for people with migraine. Some theories about how it works include the idea that magnesium can help to prevent waves of cortical spreading depression and aura. Magnesium, in theory, also reduces the release of inflammatory or activating chemicals that can cause migraine. Intravenous magnesium sulfate can also be helpful in the acute setting.
Other potentially useful nutraceuticals include vitamin E, which may help with menstrual migraine. There is limited data on this, but it may reduce nausea, photophobia and phonophobia during menstruation. There is also evidence that riboflavin, or B2, may be an effective preventive medication in some people with migraine.
While nutraceuticals may not seem dangerous, Dr. Pace advises all patients to use caution. Some of these treatments can react with other drugs or conditions if used in the wrong way. For example, magnesium may cause diarrhea, and it is possible to overdose on Vitamin E.
“Just because it is natural doesn’t necessarily mean it is safe,” she says. “Vitamins are not approved or regulated by the FDA, so it is important to discuss these options with your doctor before starting to determine if they are appropriate and okay to use.”
Yoga/Tai Chi for Treating Migraine
The kind of mind/body therapy that yoga can provide may help create relief from migraine. Keeping up with yoga consistently can reduce headache frequency, intensity and duration, so it’s important to practice regularly if you plan to use it as a complementary migraine treatment. However, certain types of yoga such as “hot yoga” may be uncomfortable for people with migraine. Others, such as “restorative yoga,” may be tolerable even for a patient with chronic migraine.
Tai Chi can also have a similar benefit for patients with migraine. Specifically, it can help improve balance, which can be very useful for those with vestibular symptoms or vestibular migraine.
Mindfulness/Meditation for Treating Migraine
Many people believe that stress is a major trigger for their migraine. This is where mindfulness and meditation can come into play, as they have been known to help reduce migraine severity, duration and acute pain medication use. It may also help to relieve stress and anxiety while improving feelings of well being.
“Life these days often involves multitasking,” Dr. Pace says. “You walk down the street with headphones in, listening to music, maybe checking your email on your phone and thinking about everything you have to do when you get home. Mindfulness is about slowing down and being aware of the moment. It’s not about clearing your mind. It’s more about acknowledging all of your thoughts and focusing on the moment.”
Biofeedback for Treating Migraine
Biofeedback involves becoming more aware of the changes that occur in the body and learning
how to exert control over generally involuntary functions. Biofeedback allows you to see your vitals in real-time and learn how to stabilize them on your own. Dr. Pace says there is great evidence that biofeedback can reduce the frequency, intensity, and duration of migraine and tension-type headache.
“When you’re stressed, you may notice elevated heart rates, tightened muscles, and sweating,” she says. “During biofeedback, you can see these changes on a monitor, then a therapist teaches you exercises to help manage these changes.”
Acupuncture for Treating Migraine
A traditional Chinese medicine, acupuncture is reported to increase the release of serotonin, dopamine and other chemicals that may help to treat chronic pain, and can be helpful in preventing episodic migraine. There are, however, conflicting results on studies in acupuncture as a treatment for migraine.
Talk to Your Doctor About Treatment Changes
The most important thing to remember, no matter what treatment changes you plan on making, is to talk to your doctor. This is especially true given that complementary and integrative migraine treatments do not have the scientifically proven track record that many medications do. Your healthcare provider can help you make informed decisions and avoid treatments that could be harmful or ineffective.
Migraine Treatment Results May Vary By Patient
“Not everyone is going to benefit from all of these different options,” Dr. Pace says. “Not all of these options are right for you. I think the most important thing you can do is to get an idea of what else is available. Then, talk to your doctor one-on-one about some that interest you to make sure that they’re safe.”
The American Migraine Foundation aims to support patients at all stages of their migraine journey. Visit our website to find a healthcare provider near you or to learn more about migraine treatments and developments in migraine research in our doctor-verified resource library.
