Beating the migraine

Helping make migraines manageable

Uddhav Marwaha

Uddhav Marwaha

— 4 min read

Your head starts feel heavier, you eyes start catching zig-zag cloudy patterns (auras) wherever you look and you slowly lose focus with the physical environment. This is a normal pattern for migraine victims. One of the most daunting things about migraines is that every doc you talk to will tell you there is no one approach to treating migraines.

Dealing with your first migraine

If you feel a migraine occurring before you get an aura, consider yourself lucky (at least I do). There’s a few things I’ve tried which can dramatically shorten the duration of the migraine. In order of potency:

  • Get away from a computer or phone screen as soon as possible. Dark, cold, and quiet spaces provide relief.
  • Migraine journal: maintain one! Write down the current date+time, last meal and time you ate, sleep pattern/quality, stress level, computer time, medicines/drugs/alcohol consumption, water consumption, and any inconsistent habits. Noting this and how you feel during the headache will help narrow down the stimuli which may trigger migraines.
  • Cold helmet: an ice pack for the head. Personally my favorite form of relief (always have it in the freezer). Here's one I like.
  • A cup of coffee
  • Release tension in your upper traps and suboccipital muscles with this simple “peanut stretch” (starting with 3 sets of 30 seconds)
  • OTC medications: Acetaminophen + Aspirin + Caffeine (this combo is sold as Excedrin), or Naproxen. Nausea is often a sign that a migraine is ensuing, so consume medication carefully per a doctors recommendation.
  • SOS/Rescue medicines (prescription-only): Rizatriptan, Sumatriptan, or other triptans are often prescribed to be taken before the aura phase of a headache. One theory about migraines is that they involve blood vessel dilation (widening). Triptans bind to serotonin receptors and help constrict cranial arteries, helping relieve the migraine pain. Read more here.

Migraines can vary in duration from hours to weeks, without much literature on research on why this happens. The migraine “hangover” often experienced is a phase following the most painful part during which mental concentration is still compromised but less so than during the headache itself.

Uncovering the causes

Ask someone to sporadically take a few pictures of your computer posture

If you’re spending 10+ hrs/day on a computer, it’s natural to adopt poor neck and back posture like shown above which can lead to tension building up in the suboccipital muscles. This inflames the occipital nerves building pressure and may cause pain behind the eye.

Suboccipital and traps tightness can cause headaches

The occipital muscles stretch all the way from the back of the head to the eyelid, responsible for forehead movements, so it’s important to stretch these regularly and prevent tension. Doing this stretch everyday is a gamechanger:

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Everyday relief stretch

Tie two tennis balls inside a sock to create a peanut like device which you can roll down your suboccipital muscles (neck) and upper traps to relieve tension. Here’s a good tutorial.

Lifecycle of a migraine

Typical migraine lifecycle

Research and referenced studies:

Kushwah A, Tomar A. Clinicopharmacological comparative study of rizatriptan versus conventional therapy in migraine. J Indian Med Assoc. 2014 Jan;112(1):17-8, 20. PMID: 25935943.

Freitag F, Diamond M, Diamond S, Janssen I, Rodgers A, Skobieranda F. Efficacy and tolerability of coadministration of rizatriptan and acetaminophen vs rizatriptan or acetaminophen alone for acute migraine treatment. Headache. 2008 Jun;48(6):921-30. doi: 10.1111/j.1526-4610.2007.01053.x. PMID: 18572432.

Diener H-C, Holle-Lee D, Nägel S, et al. Treatment of migraine attacks and prevention of migraine: Guidelines by the German Migraine and Headache Society and the German Society of Neurology. Clinical and Translational Neuroscience. 2019;3(1). doi:10.1177/2514183X18823377

On Auras:

Cortical spreading depression/depolarization (SD) is often attributed as the mechanism underlying the migraine aura, a visual sensation of shimmering dots, lines, or blobs. Auras are important to track in a migraine journal as they can influence the prophylactic treatments prescribed.

Spreading depolarization

Hansen JM, Charles A. Differences in treatment response between migraine with aura and migraine without aura: lessons from clinical practice and RCTs. J Headache Pain. 2019 Sep 06;20(1):96. [PMC free article]

Charles, A., Baca, S. Cortical spreading depression and migraine. Nat Rev Neurol 9, 637–644 (2013). https://doi.org/10.1038/nrneurol.2013.192

By User:S. JähnichenBrain_bulbar_region.svg: Image:Brain human sagittal section.svg by Patrick J. Lynch; Image:Brain bulbar region.PNG by DO11.10; present image by Fvasconcellos. - Brain_bulbar_region.svg, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=6049291

Lipton, R.B., Diener, HC., Robbins, M.S. et al. Caffeine in the management of patients with headache. J Headache Pain 18, 107 (2017). https://doi.org/10.1186/s10194-017-0806-2

Disclosure: I’m not a doctor. The content provided in this article is for informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional regarding any medical condition or treatment.

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