When a migraine headache takes hold, resistance, as the evil rulers say, is futile—at least, for all but the most heroic among us. But before a headache springs full blown, you may be able to avoid or dial down the pain by taking evasive action. Not every tip listed here works for everyone, and change doesn't come overnight. But experimenting with these suggestions may help you avoid getting a headache, or better manage one if it does arrive.
No. 1: Keep a headache diary.
Writing down the details of your headaches—how long they last, how severe they are, what was happening before the pain started and how you sought relief—can help you and your doctor identify your headache "triggers." For example, certain foods may bring on headaches, as can stress, menstrual cycles, bright light, perfumes and even changes in the weather. Once you have an idea of what could be fueling your headaches, you can try to avoid at least some of the triggers. "If you don't write things down and look at it over the course of time, you may not see relationships when it comes to trigger factors," says Dr. Fred Freitag, associate director of the Chicago-based Diamond Headache Clinic and a board member of the National Headache Foundation. "It may not be just one thing by itself that affects you. It may be several factors."
No. 2: Watch what you eat.
Food often gets the blame for triggering migraine headaches. In fact, so many foods have been implicated, says Dr. Lisa Mannix, a neurologist with Headache Associates in Cincinnati, that axing them all would mean giving up a healthy diet. Besides, she adds, only 20 percent to 30 percent of people can consistently identify the foods that trigger their headaches. Still, it won't hurt to experiment by dropping a couple of the most frequent troublemakers to see if it makes a difference. Start with what Mannix calls "the big three": red wine; processed meats and other foods that contain sodium nitrite; and foods that contain the seasoning monosodium glutamate, or MSG.
No. 3: Get enough magnesium.
Magnesium relaxes blood vessels and reduces the likelihood that migraine-inducing electric signals in the brain will be generated, both of which can cut your chances of getting a headache. Supplements are OK, says Freitag, but try making changes in your diet first to see if you notice any improvement. For example, replace white-flour breads and pastas with whole-wheat versions. Other magnesium-rich foods include leafy green vegetables and nuts (although for some, nuts are a headache trigger).
No. 4: Eat regular meals.
Just as important as avoiding foods that may trigger headaches is making sure you eat a healthy diet and don't skip meals. As Freitag explains, your brain runs on two things: oxygen and sugar converted from the food you eat. Once that sugar is gone, you need to feed your brain. In fact, if you tend to wake up with morning headaches, Freitag suggests eating a piece of fruit just before you go to bed to see if that helps stave off the early morning pain.
No. 5: Be careful with caffeine, alcohol and tobacco.
For some sufferers, caffeine's a major culprit. “When it's ingested daily or nearly daily it tends to make migraines worse," says Freitag. Alcohol, especially red wine and dark liquors, can be headache triggers. So can tobacco and second-hand smoke, which you shouldn't be messing around with anyway, headaches or not.
No. 6: Stick to a sleep schedule.
Keeping regular hours—even on the weekends—may help you avoid pain. Mannix advises her patients to make a concentrated effort to go to bed and get up at the same time each and every day. "Remember," she says, "we're talking about your very sensitive nervous system. Any change—external or internal—can change how you feel."
No. 7: Exercise regularly.
The idea is to improve the production of endorphins, the brain's natural painkillers. To do that, Freitag advises a minimum of 20 minutes to a half-hour of concentrated aerobic exercise, such as walking at a brisk, 4-miles-per-hour pace at least three times a week. Mannix says go for more if you can: 30 to 60 minutes per session, five days a week.
No. 8: Manage stress.
You can try all kinds of techniques, from massage to yoga to biofeedback. The important thing, says Mannix, is to find something you can do fairly quickly and easily. "Dealing with stress successfully sometimes means just giving yourself some time," she says. Read a book, go for a walk, even go shopping if that works for you.
No. 9: Try acupressure.
Acupressure, a form of traditional Chinese medicine that's based on the same ideas as acupuncture, involves putting gentle pressure on different points of your body and is a technique you can do yourself. Finding out if it works for you, Freitag says, may take a bit of trial and error. "But you can do all these things together," he says. "When you feel a headache coming on, you can take some Ibuprofen and do your acupressure. They're not mutually exclusive."
No. 10: Apply a cold pack.
Cold, says Freitag, "has a bit of a local anesthetic effect." So, go ahead: Place a cold pack on your forehead. "You don't need a fancy ice pack," says Freitag. "All you need is a package of frozen peas wrapped in a towel."
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