Migraine Awareness Month

June 2021

Migraines are intensely personal. From chatting with many individuals who experience all kinds of different migraines, a common thread is often the only way to get through them is on your own. The presence of others and their sounds, smells, their touching, their ideas, even their well-meaning attempts to soothe you can often make the migraine worse.

It can feel like your brain is unable to cope with anything, trying to receive any information from the world hurts physically, and emotionally. The piercing and uncontrollable brain, eye, and other sensory pain that can be experienced, leaves many migraine sufferers unable to do anything at all. Many describe needing to ‘hideaway in a dark quiet space’ and ‘just sleep it off’.

During a migraine is possibly the worst time to try and find a new remedy. It can be most helpful to build an informed TOOLKIT OF POSSIBILITIES when you are free from migraine and practice any of the ideas or skills you find helpful, or that feel like they could work for you so that you are good enough at them to really use them during a migraine.

So, what possibilities can you add to your migraine toolkit so you can get through your migraine, your way?

BIOFEEDBACK

Biofeedback training teaches you how to rebalance your body and brain by showing you how your own nervous system is working. Biofeedback technology has been developed over more than 60 years. Over this time a lot of research has been done into its effectiveness as a treatment specifically for migraine.

Biofeedback training reduces migraine by improving resilience to stress, reducing muscle tension and putting your nervous system back in balance. Watching your own nervous system respond and seeing the training is working motivates you to keep practicing and using the techniques at home. Biofeedback is definitely a possibility you want in your migraine toolkit.

DIET

Food can be a tricky topic for many of us. Eating is so linked to our pleasure systems, and it is something we do so many times a day, we don’t really want to have to think too much about something we feel is good for us maybe being bad. Those suffering from migraines have probably been asked a lot if they have any ‘trigger’ foods, and these can include anything from chocolate to even an apple. It’s some of the little things that might be in these foods that could be the tiny culprits contributing to a migraine, things like nitrates; sulphates; tannins and some amino acids.

The wonderful thing about food and the gastronomical time we live in, is there are some delicious alternatives we can experiment with - particularly on the chocolate, cheese, meat and wine scene. New studies are emerging looking closely at diet and migraine. Generally, a good place to start, when looking at diet and brain health, is the Mediterranean and MIND Diets. Both diets, interestingly, emphasise plant-based foods cooked from scratch.

EXERCISE

Exercise, like diet, can be a mixed bag for those living with migraines. The impact of exercise can feel a little unpredictable for some, but it absolutely shouldn’t stop you from trying. The strength of the evidence in support of exercise for good brain health, and the positive effects for those with migraines, is undeniable. It may just be a matter of finding the right exercise, that is right for the individual, and doing it at the right time. Let’s look at four different types of exercise and uncover a little more about why they may benefit individuals with migraine.

Endurance: You might like brisk walking; hiking; running; Zumba; HIIT; F45; a step class or something similar. Both high intensity and moderate intensity training programs improve cerebrovascular health, can reduce the number of days of migraine, and can reduce the intensity of migraine pain.

Strength: Getting around your gym circuit; perhaps resistance training; push/pull training, or powerlifting. There is limited evidence to specifically support strength training for the reduction of migraine, though this type of exercise is beneficial in combination with aerobic exercise and stretching for an all-around approach to physical and brain fitness.

Flexibility & Balance: Things like yoga; Pilates; body balance; stretching; dance; ballet; even gymnastics often cover both major exercise types. These types of exercise also lend themselves to increased experiences of ‘flow states’ and may induce feelings of relaxation long after the class has finished. These same states are frequently evident in a healthy nervous system and may therefore alleviate migraine through combating stress. When yoga is included as part of a holistic approach to migraine treatment there is good evidence to support that this is better than medical therapy on its own.

SLEEP

Lack of sleep, poor sleep quality, and even getting too much sleep can all increase risk of migraine. If we want our sleep to improve, unfortunately, we can’t just think about it when our head hits the pillow. There is a science to a great night’s sleep and it starts when you wake up that day.

Your own sleep hygiene is a useful part of your day to review if you have concerns about how your poor sleep is impacting your migraines. Some tips in this list may be the change your daily routine needs to help you get the restorative rest your brain needs at night:

Go to bed and wake up at the same times every day
Wake up and get out into the sunshine in the morning
Get a good amount of outdoor exercise during the day
Reducing stimulating foods and beverages – like caffeine and chocolate, not having them at all, or limiting them to before midday
Decrease evening blue light exposure by using settings, apps and glasses/screens
Being completely screen free in the 2 hours leading up to bedtime
Diming the lights through the home if sunset comes later ie. during the summer season
Having a warm bath/shower then slip into a cool bed and bedroom
Being read to, or reading, a paper book before bed
Promoting and then riding the ‘wave of drowsiness when it comes (this is the work of melatonin in action)
Make your bedroom ONLY about sleep and relaxation, a real sanctuary for sleep
Try a relaxation, mindfulness or meditation exercise designed for sleep in bed
If you have concerns that there may be something more serious happening when you try and sleep start by visiting your GP and discussing a sleep study. These are now more readily available than ever.

Your personal migraine toolkit can have any number of helpful things for you in it, the possibilities above are just a few. Migraine and Headache Australia describe the successful treatment as ‘not just a matter of taking a tablet, but a case of each individual developing a migraine management plan that will probably involve lifestyle changes and complimentary therapies as well’.

Further research will continue to be done on brain-based therapies for migraine and the possibilities available for the treatment of your migraine will continue to grow. The Perth Brain Centre currently offers comprehensive functional neuroimaging and brain-based therapies that are tailored to your brain and your needs. There are three easy steps to help get you started today.

About the author - Ms Emily Goss (Occupational Therapist, Senior Clinician, The Perth Brain Centre).