Ever have a migraine attack bearing down and you blank on what to reach for to treat the attack? The misery and neurological changes that come with migraine attacks have the ability to wipe out thoughts of basic reliefs we know can help. This happens to me all the time and I end up relying on my Migraine Strong partners, Danielle Aberman and Jennifer Bragdon, to help remind me of things I can try. Having an at home migraine treatment plan in place helps me when my people aren’t available to make suggestions.
So what can we do to make sure we have our ducks in a row BEFORE we have an attack? This article will help you create a list of ideas that have worked for you to keep on hand for your next attack. It will also help you assemble a migraine toolkit to reach for during your next attack whether it’s lurking in the background or full-blown.
** While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.
Timing of the Treatment
We have all been advised to take our prescribed abortive medications at the start of pain rather than wait until “the horse is out of the barn.” That’s great advice when you have infrequent attacks. But, what do you do when you have frequent or chronic migraine. Doctors and insurance companies typically limit certain abortives that may lead to medication-overuse headache (rebound). Some medications are limited due to the high cost. So what do you do when you are limited to 6, 9 or 12 doses per month? It can be tricky.
If you have infrequent migraine episodes
Given that everything is relative, let’s declare that infrequent migraine is 4 days with migraine symptoms or fewer. If you have a prescribed medication, you will likely have enough to cover 4 days of attacks, so it is usually best to take the advice of your doctor and treat early, as prescribed.
However, if you know you will have unpleasant side effects from the medications or other reasons for being very reluctant to medicate, keep reading. Being informed and organized will help you limit medications when you must.
Treating the attack
It probably goes without saying, but medication is probably what most of us reach for first. Having a set migraine cocktail which works for you is really important. For some, that will be a prescribed triptan, ergotamine, CGRP blocker or prescribed NSAID like naproxen, diclofenac or others recommended by your doctor. Non-prescription NSAIDS like Excedrin, naproxen sodium (Aleve), ibuprofen or supplements like ginger or magnesium are what some others think of right away.
If nausea or vomiting are common migraine symptoms, an anti emetic medication such as ondansetron (Zofran) or promethazine (Phenergan) among others, can help. These medications can treat the migraine attack as well, without any risk of rebound. And if dizziness or vertigo is your primary symptom, a low dose vestibular suppressant can be very effective.
There’s a lot that can go into a migraine cocktail. Knowing the best combination of prescribed and/or over-the-counter medications is very important. Develop this cocktail with the help of your doctor for maximum effectiveness.
Treating the symptoms
Once the medication is on board, what are other options you can use to treat the migraine symptoms? These symptoms can often overwhelm us or linger for a long time.
As with all migraine attacks, each person experiences the symptoms and relief individually. For instance, neck pain with migraine. Some people swear by heat, others by ice and still others a combination of these and a topical treatment like Icy Hot, CBD lotion or peppermint oil.
Let’s see what we can come up with for your migraine rescue kit and routine!
Building your at home migraine treatment plan or migraine rescue toolkit
The first thing to do is make a list of all of the medications or treatments that have ever worked for you. This can include:
- Prescription medications
- Over the counter meds (for example, Benadryl, ibuprofen, acetaminophen, meclizine etc.)
- Ice hat
- Heating pad
- Topical treatments
- Caffeinated beverage
- Migraine glasses
- Eating certain snacks or a meal
- And the list goes on and on. Whatever you find helpful.
Ranking migraine treatments
Once you have a list of helpful treatments, you rank them in order of how you typically use them. This might look different for each attack depending on how quickly it is coming on or what symptoms you are experiencing. My list looks something like this. For some attacks I only use a few things and others require a bunch of items!
Eileen’s at home migraine treatment plan list – chronic migraine
- Ubrelvy – I take this when I first feel symptoms. If it’s a fast moving attack, Ubrelvy won’t work for me.
- Frovatriptan – This prescription medication will work most of the time.
- Coke Zero or Diet Coke – sometimes this is the first thing I take if I don’t have meds with me. The artificial sweeteners are not a trigger for me. And the bubbles help more than other forms of caffeine.
- Goldfish crackers – Weird, right? These crackers help me with nausea brought on by the attack or the medications. And the crunching helps relieve pain or distract from it…at least while I’m eating them.
- Remove hair ties, or put hair up. When my neck is involved, I can’t stand to have my heavy hair touch it. Gently pulling on my hair at the root also can help my head feel somewhat better.
- Allay Lamp
- Migraine glasses
- Heating pad
- Ice hat
- Calm app guided meditation – The body scans are my favorite.
- WeatherX Ear Plugs – I use these for weather related attacks. The app sends a notification when to use them.
- Massaging my head and gently pressing on the pain points.
- Peppermint oil
- Neck rub creams
- Topical magnesium
- Second line prescription meds (diclofenac, promethazine and cyclobenzaprine). I also have ketoralac (Toradol) injections to use at home if my attack continues to progress. This migraine cocktail works for me if the others fail. I usually have to lie down and nap because the promethazine and cyclobenzaprine make me sleepy.
An at home migraine treatment plan to stay out of the ER
The above list has helped me avoid the expense and misery of the Emergency Room on more than one occasion. I have specific instructions from my doctor on what to do and take when my attacks are heading toward status migrainosus, an attack that lasts more than 72 hours and does not respond to treatment.
Having a preventive that works to reduce your attack frequency is another key treatment. Talk with your headache specialist about what medications they can prescribe to keep you out of the ER. Having this plan in place should be a priority for your doctor if you experience frequent, a few times a year, long attacks that are hard to break.
Danielle’s at home migraine treatment plan list – episodic migraine
Danielle currently has infrequent migraine thanks to menopause. During perimenopause and early menopause she had times of frequent and chronic migraine. This checklist preserved her precious few triptans and need for very limited use of NSAIDS to avoid rebound.
- Caffeine from a large cup of strong coffee
- Remove all hair accessories
- Take ginger capsules or strong ginger tea made from the spice
- Ponaris Nasal Emollient (snorted like Scarface!)
- Favorite migraine sticks applied to wrists and neck
- Icy Hot on neck
- Chew strong peppermint gum like the Ice Cubes brand
- Drink a glass of water almost every hour
- Weather permitting, spend some time in nature getting fresh air
- Ask for a gentle neck rub
- Comforting food like ice cream or cinnamon toast
- Snuggle time with pets
- Sing all the words to some favorite songs
Danielle is very grateful that she is still able to successfully “scare away” the “lurking migraine” quite often with the above methods. Because of damage to her GI system from years of excessive NSAIDS, she makes her best effort to pay attention to the early signs of an attack and use the checklist. However, she knows that if pain quickly moves to her jaw, it’s time for a triptan and perhaps a triptan taken together with Aleve (naproxen sodium).
Jennifer’s at home migraine treatment plan list – vestibular migraine
- Magnesium glycinate and magnesium chloride foot soaks (when attacks happen at home). Pure Encapsulations magnesium glycinate & Now magnesium chloride flakes are my current brands of choice.
- Ginger- I use Gaia Herbs Ginger Supreme
- Black coffee- Caffeine is no longer a trigger for her dizziness. In fact it helps her abort attacks that include pain and head pressure.
- The Allay Lamp- at the very first sign of symptoms Jennifer reaches for the four strategies listed above. When they are not enough to abort an attack she moves on to the strategies below.
- Calming strategies- Jennifer gets pretty anxious alongside her vestibular migraine attacks because she never knows how far they’ll escalate. Sometimes they escalate to severe head pressure, but other times it’s dizziness with or without severe head pain to worst case scenario, vomiting and hard room spinning vertigo. She likes the comforting scent of migraine sticks, super soft weighted blankets (this also helps with grounding to end dizziness), snuggling with her dogs, deep breathing & grounding techniques.
- Ice or heat neck & head wraps. Jennifer finds this weighted heating pad is very soothing.
- Reglan- for nausea
- Zolmitriptan (Zomig) nasal spray if vomiting is too persistent to keep medications down.
- Valium- if dizziness & vertigo are present. A very small dose works for her. She takes just a quarter of a 2mg pill.
- Peppermint- Peppermint Angel Mints candy and topical peppermint essential oil (for nausea).
List making help
If you are new to treating migraine or just need some new ideas to try, think about posting a question in our Migraine Strong Facebook group. Be specific about what you are looking for or the expectations of the post. Most people in our group will happily share their treatments with you and offer suggestions. Think about trying some of the new options for your next attack.