Lifestyle advice: reducing migraines by avoiding triggers

Migraines are quite often triggered by specific factors in food and drink, or from behaviour. We recommend that patients steer clear of coffee and other caffeinated drinks, and reduce their alcohol intake. Eating a healthy diet, taking regular exercise and making sure you get enough sleep so that you aren’t over-tired are also important.

Drug treatment for acute migraine

Twenty years ago, acute migraine was treated with ergotamines, which had terrible side effects and dangers. The modern group of triptan drugs have now revolutionised acute migraine treatment. These are effective and safe, and have relatively few adverse effects.

Preventive treatment for chronic migraine

Chronic migraine can have a devastating impact on quality of life. Although more effective preventive treatments are now available, these need to be taken over a long period, sometimes indefinitely, to keep the migraines under control. Patients can have problems tolerating some drugs so we start at the lowest dose possible and increase slowly over time until we can see a reduction in migraine frequency.

Many different drug treatments are available as preventative therapy in chronic migraine, so it is usually possible to find a regime that suits most patients.

Occipital nerve blocks

Occipital nerve blocks can help patients with migraine and also those who experience cluster headaches. The treatment involves the injection of a steroid and a local anaesthetic into the two occipital nerves which run up to the back of the head from the neck.
The injections are done as an outpatient treatment, and only take a couple of minutes.