What are the most common treatments options for migraine? This article covers the most popular, from pharmaceutical options to alternative treatments.
What is migraine?
Migraine is a condition associated with periods of moderate to severe head pain (in most cases), and also nausea, vomiting, and sensitivity to light and sound.
Answers to some of the most common questions about migraine are answered in this article Is my migraine actually a migraine?
Because of the debilitating nature of migraines for some people, having effective treatment and management options are extremely important.
And its our fundamental belief that chiropractic care, especially upper cervical chiropractic procedures, are an important part of this management.
Unfortunately, many primary care practitioners will automatically prescribe pain medications to their patients, sometimes without clear instructions and without establishing the desired outcome.(1)
This, together with inadequate evaluation of the patient’s condition, often lead to treatment failure.
When this happens, the patient may be referred to a neurological headache specialist without being informed of the potential for help with upper cervical chiropractic procedures.
This article covers the most common treatment options for migraine, including general chiropractic care.
What are the treatment options for migraines?
- Surgical intervention
- Chiropractic and manual therapy
- Oriental medicine and acupuncture
- Nutritional and lifestyle modifications
Drug therapies for migraine
Medications for migraine are categorized as either acute or preventative in nature.
- Acute treatments are taken on an as-needed basis to abort or reduce the severity of the current migraine attack.
- Preventive treatment or prophylaxis, on the other hand, is taken daily to prevent or reduce the likelihood of upcoming headache episodes.
Common medications prescribed for migraine (2) include:
- Selective serotonin agonists or triptans
- Ergot alkaloids
- Non-steroidal anti-inflammatory drugs
- Combination analgesic
- Opioid analgesic
- Tricyclic antidepressants
- Botulinum toxin (BOTOX)
Despite new advances in pharmacological management of migraine, many patients still do not respond positively.
Some patients do not tolerate drug treatments, whether acute or preventive, due to side effects or the contraindications that the drug may have based on their other health problems.
Surgical treatments for migraine
Surgery has limited efficacy for migraine due to the variety of surgical trigger sites targeted and procedures employed. Note that the American Headache Society (AHS) does not recommend surgical attempts of “deactivating” trigger sites for any form of migraine.(3)
Manual therapies for migraine
There are various manual approaches that have been found to provide migraine relief, including for patients who have failed to respond to traditional treatments.
Clinical massage therapy
Clinical massage therapy is performed by physiotherapists, occupational therapists, and massage therapists. Muscles that are stressed and tensed contribute to the occurrence of migraines. Massage promotes circulation and relaxes the muscles. Increasing blood flow in these areas can help provide pain relief.
Chiropractic care is defined as another type of complementary and alternative medicine (CAM) used for managing migraine and other chronic headaches. It involves manual adjustments of cervical spinal structures in the neck area to reduce the severity and frequency of migraine attacks. However, many migraine patients have found that not all chiropractic techniques are beneficial. It is important to find a chiropractor who understands migraine symptoms and employs gentle manipulation (chiropractic adjustments) of the neck.
Scientific studies of chiropractic care efficacy
- One case study examined the use of chiropractic adjustment on a 52-year old female patient with migraine of 40-year duration. At the end of the study, the patient reported reduced muscle tenderness, improvement in range of motion, and muscle relaxation. No migraine episodes have been reported at 6-month follow up. (4)
- A 6-month randomized controlled trial of chiropractic spinal manipulation in 127 volunteers showed that patients with migraine headaches attributed to stress responded well to chiropractic care. (5)
- A survey conducted on 1,896 chiropractors revealed that more than 53% of their caseload involve migraine cases. (6)
Lifestyle modifications for migraine
Lifestyle modifications may also reduce migraine frequency and improve your general well-being:
- eating regular, healthy, and balanced meals
- avoiding triggers
- proper hydration
- stress management
- exercise, yoga, and other physical activities
- getting adequate sleep
Other alternative therapies that may provide migraine relief include:
- acupuncture and/or chinese medicine (herbal)
- progressive muscle relaxation
1. Tepper SJ, Spears RC. Acute Treatment of Migraine. Neurologic Clinics. 2009;27(2):417-427. doi:10.1016/j.ncl.2008.11.008
2. Smitherman TA. Clinician’s Manual on Migraine. Cham: Springer International Publishing; 2016. doi:10.1007/978-3-319-02777-7
3. Loder E, Weizenbaum E, Frishberg B, Silberstein S. Choosing wisely in headache medicine: The American Headache Society’s list of five things physicians and patients should question. Headache. 2013;53:1651–9.
4. Chaibi A, Tuchin PJ. Chiropractic spinal manipulative treatment of migraine headache of 40-year duration using Gonstead method: a case study. J Chiropr Med. 2011;10(3):189-93.
5. Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics. 2000;23(2):91-95. doi:10.1016/S0161-4754(00)90073-3
6. Moore C, Adams J, Leaver A, Lauche R, Sibbritt D. The treatment of migraine patients within chiropractic: analysis of a nationally representative survey of 1869 chiropractors. BMC Complement Altern Med. 2017;17(1):519. Published 2017 Dec 4. doi:10.1186/s12906-017-2026-3