Avoiding Migraines Altogether

Pinpointing triggers can help patients skip migraines

/ Author:  / Reviewed by: Joseph V. Madia, MD

Migraines can be debilitating once they set in, but you may be able to beat them at their own game. Pinpointing triggers and taking action as soon as you feel their effects can help you avoid migraines and reduce their severity.

Other techniques may help migraine sufferers by stopping the painful headaches in their tracks.

Pinpointing what triggers migraines can be key.

Dr. Paul Schulz, from the department of neurology at The University of Texas Health Science Center at Houston (UTHealth) Medical School and a member of the faculty of the Mischer Neuroscience Institute at Memorial Hermann-Texas Medical Center, said that about 20 percent of the population suffers from migraines, though some may skip seeing a physician and instead treat it at home.

"If you can identify the triggers, in most cases it is easier to stop it before it starts," Dr. Schulz said. "It can be environmental; it can be foods. The triggers can be different for different people."

The classic migraine is characterized by seeing white spots in front of the eyes followed by an array of symptoms including pain, blurred vision, lightheadedness and nausea. The lights may suddenly seem too bright and noises may feel amplified.

Dr. Schulz said the common migraine can be a bit tougher to diagnose because it may resemble a tension headache, where a patient feels like their head is in a vice. Despite their differences, they require the same treatment.

Find the trigger

One of the keys to skipping migraines altogether is figuring out what triggers them. This can be tough since it can vary by patient, and some patients may have more than one trigger.

Dr. Schulz suggests that migraine sufferers maintain daily logs detailing their activities, and food and beverage consumption to help pinpoint triggers.

The triggers vary widely but could range from weather changes to eating something specific to variations in blood sugar -- meaning that regardless of whether a person's blood sugar is generally high or low, a change in what is typical for them could spark a migraine. In some women, their menstrual cycle may trigger migraines each month.

"Red wine and beer in particular can cause problems, and also meats that have nitrates such as sausage or bacon," Dr. Schulz said. "It's cheese in other people, and missing a meal is also really common."

Poor sleep or staying up all night can also trigger migraines the next morning, which Dr. Schulz said he sees frequently among college students who may have stayed up all night cramming for an exam, only to develop a migraine on test day.

Other individuals may not even be aware that they have migraines, but have learned to avoid certain behaviors they know will lead to them not feeling well, such as patients who avoid red wine because they believe it makes them hung over the next day, when in actuality it's a migraine.

"Some people even get them when they relax after being on the go all week, or maybe they're drinking less coffee," said Dr. Schulz. "It varies a lot from person to person."

Staying hydrated also seems to help many patients avoid migraines, and getting plenty of sleep each night can be essential for many sufferers.

After doctors have pinpointed what triggers a migraine, reducing the number of incidences becomes much easier because patients can work to avoid triggers.


Prescription medication is needed in many cases. Depending on the frequency of migraines, patients may benefit from taking daily preventative medication -- regardless of whether or not they have a migraine -- to reduce the number they suffer from. Preventative drugs range from beta blockers, usually used to treat the heart, and seizure medications to anti-depressants and Botox injections.

For patients that do not suffer from migraines regularly, pain relievers such as triptans, a combination of sumatriptan and naproxen sodium (Treximet) that can be taken for a few days to treat acute pain after the onset of a migraine, may be more appropriate.

Some of the acute treatments begin offering relief within minutes, but last for a shorter period of time, while others don't kick in as quick but offer longer lasting treatment.

Other patients may be able to get by by taking over the counter migraine medication such as Excedrin, or taking an over-the-counter pain reliever and drinking caffeine.

"There are quite a few categories of medicine to choose from. Young athletes might not want medicines that will slow them down," Dr. Schulz said. "For some people just taking Tylenol is enough."

Getting rid of a migraine

Getting rid of migraines may seem tricky, especially for individuals who have suffered from lengthy debilitating episodes. Outside of medication, there are two methods that work well for getting over a migraine -- taking a nap or consuming ample amounts of caffeine.

These two techniques may seem miles apart, and they are. That's because each works in a different way in helping a person get over a migraine.

Migraines are brought on by blood vessel dilation. When vessels begin dilating inside the brain, patients don't yet feel the migraine. But once the blood vessel dilation begins expanding outside the brain where pain sensors are located, and there is dilation in both areas, usually about half an hour after it began, the individual begins to feel the pain associated with migraines.

When the blood vessels are constricted, there is no pain. The trick to getting rid of a migraine is to either stop the blood vessel dilation within that small window before the pain has completely set in, or to coax the blood vessels to constrict after they have become completely dilated.

So while taking a nap or consuming caffeine may sound as though they're on opposite ends of the spectrum, that's because they are helping in different ways.

Caffeine helps by prompting blood vessel constriction, while taking a nap helps to reverse blood vessel dilation.

"Some people use other tricks to help get their blood vessels constricted. If you use caffeinated products you may be awake and jittery, but that may help (the migraine) from progressing," Dr. Schulz said.

Use of caffeine -- ranging from a soda to a pot of coffee depending on the person -- generally is most useful for individuals who are able to detect the onset of a migraine. Some patients are able to tell they are developing a migraine hours or even days ahead of time. For others that realize they have a migraine only after it is in full force, taking a nap may be the best option.

"For most people migraines are very treatable, though they are an annoyance," Dr. Schulz said.

Review Date: 
November 16, 2011