Manage your migraine in the long term with these tips, including finding a supportive care team and trying alternative treatments that work with your medication plan.
So you’ve received a diagnosis of migraine and have been following the immediate treatment plan your doctor prescribed—now what? Like many people who have been living with migraine for a while, you may be searching for additional and better ways to manage your symptoms.
We spoke with Dr. Ira Turner, a headache specialist and member of the American Migraine Foundation Editorial Board, about what people can do to better equip themselves to manage their migraine for the long term. Whether you feel like you’ve tried everything or you’ve just received a diagnosis, remember: You are not alone—and there is hope.
During our conversation, Dr. Turner shared seven effective ways to manage migraine. Be sure to check out the links in the sections below for additional resources.
1. Find a Headache Specialist
While your primary care physician (PCP) is a great place to start, it’s important to connect with a doctor who focuses on migraine, such as a migraine or headache specialist.
“One of the important things is finding a doctor or a nurse practitioner who’s willing to listen to you,” says Dr. Turner. “If you find you’re not getting a satisfactory interaction with your caregiver, maybe you need to make a change or look for somebody who’s interested in taking care of migraine.”
Dr. Turner points out that some PCPs are certified in headache medicine and that a headache specialist does not necessarily have to be a neurologist. Nurse practitioners and physician assistants are often very skilled at taking care of people with migraine and can also be an important part of your care team.
Need help finding a headache specialist near you? Use our Find a Doctor tool.
2. Keep a Clear, Detailed Symptom Journal
A symptom journal or headache diary is a very helpful tool for people with migraine, especially as you prepare for a visit to a headache doctor. This is a document where you note your headache days, symptoms and potential triggers, as well as all medications and treatments you’ve tried in the past. Be sure to include the dosage of any prior treatments as well as how long you tried them.
While your symptom journal should be detailed, it doesn’t have to be time-consuming or complicated to update. “I like to keep it simple. I have people keep a calendar and make an entry on the days you get a headache,” says Dr. Turner. “Put as much [detail] as you can on that calendar, but don’t get to the point where you’re writing a book.”
In order for the journal to be useful, your doctor should be able to review it quickly and understand it clearly. Find more tips on keeping a headache journal here.
3. Know That Identifying Migraine Triggers Is Complicated
Identifying migraine triggers can be important and helpful, but the process might not be straightforward or consistent. “Many patients say, ‘I just want to find my trigger’—but it’s rarely just one trigger,” says Dr. Turner. “It’s usually combinations of triggers. Some of them, like weather changes, we have no control over. Some of them, like changes in stress levels, we have only minimal control over.”
Migraine is a complex disease that impacts everyone differently. Keeping a symptom journal can help you identify and manage specific triggers, but there are two common issues: “Not everybody has reproducible consistent triggers,” says Dr. Turner, “and triggers—or what people think are triggers—are not always actually triggers.”
He explains that certain things may seem like triggers but are actually symptoms of the prodrome (or pre-headache) stage of an attack. Common examples include sudden sensitivity to light or cravings for specific foods. It’s important to work with your doctor to more accurately determine what may or may not be causing your migraine attacks.
4. Learn About Complementary and Integrative Treatments
Everyone living with migraine needs an acute attack medication. This could be a prescription medication proven to be effective for migraine or a neuromodulating device. Opioids and combination medications containing butalbital should be generally avoided. In patients with frequent migraine or with significant disability, preventative therapy is usually required.
When it comes to long-term pain management, many individuals also start to look for ways complementary and integrative treatments can supplement a medication plan.
These types of treatments may include:
- Lifestyle changes
- Cognitive behavioral therapy
- Nutraceuticals and supplements
- Yoga and meditation
- Mindfulness exercises
- Breathing and relaxation techniques
These therapies can help reduce stress and relieve symptoms, but Dr. Turner cautions that for some people, it can be difficult to find providers or cover the cost.
“I think it’s beneficial—the problem is access,” he says. “The unfortunate thing is, insurance [often doesn’t] cover a lot of this… and it’s getting harder and harder to get access for behavioral healthcare.”
For those who have trouble accessing certain treatments or getting them covered by insurance, Dr. Turner points to some alternatives. “Fortunately, [people may be able to get some online care] at little or no cost,” he says. “For example, our colleague Dawn Buse, who’s a psychologist, is excellent and has a website that patients can go on at no cost—I often direct patients to her.”
The American Migraine Foundation also offers helpful resources on complementary and integrative treatments.
5. Develop a Strong Support Network
No matter where you are in your migraine journey, it is crucial to have a strong support system in place when managing migraine long-term. Having people in your life who understand what you’re going through means you won’t have to suffer in silence. They can also help you look into resources and treatment options, encourage you to reach out to your doctor when you need to, and help you stay engaged with your community.
“It’s really important to have a family member [to provide support] if at all possible, preferably a spouse, because they’re the ones who put up with each other all the time,” Dr. Turner says. “But it could be almost anybody in the family or even just a very close friend.”
Connecting with other people who have migraine is another great way to build your support system. Our Move Against Migraine group is run by doctors and migraine experts, and provides support and solutions for people with migraine and their loved ones.
6. Learn How to Make Work and School Accommodations
Migraine is a debilitating disease, and you never know when it’s going to strike, even if you have a strong management plan in place. For that reason, it’s helpful to know how to request the necessary accommodations at work (or at school for your child) when you need them.
In the workplace, you can start with educating your employer and co-workers about migraine. You can also suggest reasonable workplace accommodations to help you avoid triggers like harsh lighting and strong smells, as well as policies like regular breaks and meal times that can help prevent attacks.
If you’re not able to work due to migraine, you may look into getting disability benefits while you continue to try different treatment options.
“Trying to get disability for headache disorders is often a very, very difficult process. That’s why keeping detailed records is so important,” says Dr. Turner. “I always recommend, if you’re missing work, if you’re missing family activities—document it. If you find that you can’t drive a car because of the sensitivity to light or just can’t concentrate when you’re driving—document all these things. Again, diaries are very, very helpful in that regard.”
7. Keep Learning About Migraine and New Treatments
For many people, a migraine management plan involves multiple treatments that work together or are used at different times or in different situations—and that plan can change over time.
Ongoing education is a key part of managing migraine long term. Staying up-to-date on the latest treatments and migraine education helps you ask your doctor the right questions when fine-tuning your management plan. A better understanding of your unique migraine symptoms can also relieve excess stress and worry.
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Dr. Turner also advises people to stay hopeful about future treatments and research. “We learn more over time,” he says. “That’s the way medicine and science is—it’s not set in stone. Things will evolve over time, we’ll have a better understanding of these things, and we’ll have better treatments.”
Migraine is challenging to manage and it can take time to find the right treatment plan for you, but there is hope. Start with our “What to Do After a Migraine Diagnosis” guide and some of Dr. Turner’s tips above. By tapping into different treatment options, resources, and areas of support, you can work with your doctor to find the best way to manage your migraine.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.