Migraine season is upon us!
Let’s talk triggers, medications, and acupuncture for migraine
Whilst Migraines can strike at any point in the year, they are especially common over Christmas. Severity varies, but for many people a migraine is a show stopper that really disrupts festivities. Although the migraine headache itself may only last a few hours, the resulting fatigue may last for days. “Let-down” migraines are also common; this is when the migraine hits AFTER the hosting or big event.
If you experience migraines, now is the time to take a little preventative action…
The perfect storm
Everyone has different triggers, but Christmas creates a unique perfect storm. “Trigger-stacking” occurs when triggers accumulate (like a wobbly stack of bricks) and at some point the whole lot comes crashing down. Common migraine triggers include:
1- Stress: Online shopping, prepping christmas feasts, summoning energy for staff parties and family get-togethers, navigating crowds and commuting in dark and wintery weather. Not to mention financial pressures.
2- Emotional triggers play a part; for many people Christmas is an emotional rollercoaster. There may be family tensions, navigating difficult relationships (with ourselves and others). Grief and loneliness may surface and many people feel under pressure to create a “perfect” or “magical” Christmas.
3- Food and Drink: We often drink too little water at this time of year. Reaching for alcoholic, fizzy or sugary drinks, or caffeine as a boost. Busyness might also mean skipping meals, and yo-yo-ing blood sugars can trigger migraines. The link between specific foods and migraine is less clear, but many people swear that cheese, chocolate, citrus or dairy are triggers for them.
4- Busy and disrupted schedules: Routine matters for migraine brains, and routine often suffers at Christmas. Think about Christmas day itself; many people wake at the crack of dawn, cook for hours, eat late, consume excess alcohol and rich foods, and take very little exercise, before collapsing into bed at the end of a very long day. When the normal pattern of day to day life is disrupted, migraines may surface.
5 - Sleep: Hugely impacted by all of the above, and many people struggle to maintain a consistent sleep schedule. Alcohol, late nights and weekend lie-ins can all disturb the circadian rhythm and make migraine more likely
6- Lack of Exercise: Let’s face it, it is hard to motivate ourselves to exercise at this time of year. Days are shorter, we feel tired, and many other priorities compete for our time. We may simply move less at this time of year. Muscular tension (especially neck and back pain) is associated with increased migraine activity.
7- Screens: Computer work may trigger migraines. Some people also find harsh strip lighting or certain light conditions lead to an episode. It is common to get less exposure to natural light in winter, and to spend longer on our devices.
This is not an exhaustive list! You will know your own triggers, but it is important to recognise that it is not normally just one trigger leading to migraine, but a trigger-stacking effect. This is relevant when we consider prevention.
If you are busy and/or stressed, what simple timeout activity can you schedule which gives you some relaxation and headspace? This is personal, of course, but may include reading, writing, time in nature, regular hot baths or exercise… The key is to recognise the importance of this, schedule it and prioritise it.
Many food and drink choices may seem outside of our control during this period, but take a moment to reflect on this. How could you stay better hydrated? What would help you limit alcohol and caffeine? How can you maintain regular meals and eat food that nourishes you, whilst enjoying the hospitality and delicious treats of the season?
Daily routines will inevitably be compromised. But which elements remain within your control? Perhaps your bedtime could be non-negotiable. Consistent bedtimes and waketimes (even at weekends) can really help. Regular meals, breaktimes and exercise routines too. What is possible for you?
Finally, how can you dial the pressure down? Maybe aiming for less than perfect, caring less what others think. Bringing your own wellbeing up the priority list, and focusing on what truly matters to you and your loved ones this Christmas.
What about medications?
Medications can be used to treat an attack, or prevent migraines. You may be prescribed “triptans” or you may be taking over the counter medication (paracetamol, ibuprofen, aspirin or combination products). Medication taken during a migraine needs to be taken early because delayed gastric emptying means medicines are poorly absorbed. Nausea is often a feature and anti-sickness medications (anti-emetics) can help.
Preventative medications are available and work well for some people. These daily pills may reduce migraine frequency and are recommended if migraines are frequent (e.g. more than once weekly), severe, or are prolonged. Examples include Propranolol, Amitriptyline, Topiramate and newer drugs such as anti-CGRP treatments. As always, there are potential side-effects and contraindications to all of these medications, so do your research and discuss with your healthcare provider.
How does Acupuncture fit in here?
As someone who used to get classical migraines myself, I sympathise, truly. I have taken a particular interest in this over the years and, personally, regular routines and yoga help me most. If you have tried all the basics, looked at your own triggers, and are still struggling, acupuncture can help. Acupuncture can reduce migraine frequency and severity.
Medical research does support this. NICE (National Institute for Clinical Excellence) currently recommends acupuncture for the prevention of migraines. Unfortunately, despite being supported by UK national guidelines, acupuncture is normally not available in the NHS.
Western Medical Acupuncture may be used alongside, or instead of, medication. It is a very safe treatment and can be suitable for people who cannot (or choose not to) take medication. Each treatment course will be individualised, but is likely to include points in all four limbs and also the neck musculature. It is common to require a course of 5-10 acupuncture treatments, ideally weekly. The ultimate treatment, to really allow time for deep rest and self-care, would be a one-to-one restorative yoga practice coupled with acupuncture. Bespoke individualised treatments can be arranged, or standard acupuncture treatments are available. All in the lovely, calm setting of Shropshire Health Clinic.
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