Empowering Migraine Relief: Education, Awareness and Cost-Effective Solutions

By Courtney Koeberl, DPH-4 UW-Madison pharmacy student & Network Health intern
02/13/2025 

Do you ever find yourself reaching for Advil or Tylenol when a headache strikes, hoping it will fade with time or a little rest? It’s easy to dismiss a headache as no big deal, but what if it’s more? Headaches are just one piece of the puzzle when it comes to migraines, a condition that can profoundly impact your quality of life if left untreated. In this article, we’ll dive into the fascinating science behind migraines, their symptoms, prevention strategies and treatment options, empowering you to take charge of your health and become your own best advocate.   

Migraine Definition & Treatment Overview

A migraine is a chronic condition that causes recurring headaches and other symptoms like nausea and light sensitivity, often interfering with daily life. People can manage migraines through lifestyle changes, over-the-counter medications or prescribed treatments. There are two main types of migraine treatments: acute treatment and preventive treatment.

Acute treatment aims to stop or reduce the severity of a migraine once it starts, providing short-term relief by targeting pain, inflammation and symptoms like nausea. Preventive treatment, on the other hand, is taken regularly to reduce the frequency, intensity, or duration of migraines over time. It works by addressing the underlying causes of migraines to prevent future attacks.

Migraine Trends

Migraines affect approximately 17 percent of females and 6 percent of males annually, with the highest occurrence in individuals aged 20-39 years. They can run in families, indicating a hereditary component. Globally, migraines rank second for years lost to disability, highlighting their significant impact on daily functioning.

What Causes Migraines?

The exact cause of migraines is not fully understood, but it’s believed to involve multiple factors and areas of the brain. It starts with a wave of brain activity called cortical spreading depression, which causes temporary changes in brain function and leads to visual disturbances (aura).

This process triggers the trigeminovascular system, a network of nerves and blood vessels in the head and face, causing pain, inflammation and blood vessel dilation. Neurotransmitters like serotonin and norepinephrine are also involved. Genetics play a significant role, as certain gene mutations can make people more likely to experience migraines. Environmental factors and other health conditions can also trigger or worsen migraines.

Contributing Factors

Physical Factors

• Stress
• Neck pain
• Sleep disturbances
• Intense exercise

Environmental Factors

• Changes in weather/air pressure
• Bright lights or sun glare
• Strong odors
• Smoke
• Heat

Dietary Factors

• Skipping meals
• Certain foods (e.g., caffeine, salty foods, alcohol, aged cheeses)

Hormonal Changes

• Estrogen fluctuations in females

Health Conditions

• Underlying disorders (e.g. epilepsy, asthma, depression, anxiety)

Migraine Symptoms  

Migraine symptoms can vary from person to person and may include any of the following.

• Headache
  • Severe, throbbing, or pulsating pain, usually one sided
• Aura
  • Visual disturbances
• Nausea and vomiting
• Sensitivity
  • To light (photophobia)
  • To sound (phonophobia)
  • To smells (osmophobia)
• Fatigue
• Dizziness
• Neck pain

How Are Migraines Diagnosed?

Migraine diagnosis is based on medical history, symptoms and physical exam. Doctors look for recurring headaches with specific features like severity, duration and symptoms such as nausea, light sensitivity or aura. No single test confirms migraines, but imaging may be used to rule out other conditions. Doctors also consider the four phases of a migraine: the prodrome (early warning signs), aura (visual or sensory changes), headache (pain and other symptoms) and postdrome (fatigue or fogginess after the headache). These phases help guide the diagnosis and treatment. Below are the most common types of migraines.

• Migraine without aura: The most common type, characterized by a severe, throbbing headache, usually one-sided, without visual disturbances.
• Migraine with aura: Similar to migraine without aura, but with added visual or sensory disturbances that occur before the headache begins.
• Chronic migraine: Occurs when a person experiences 15+ migraine days paper month for at least 3 months,
• Menstrual migraine: Triggered by hormonal changes around menstruation.
• Others
  • Hemiplegic migraine: Causes temporary paralysis or weakness on one side of the body.
  • Vestibular migraine: Associated with dizziness and vertigo.
  • Migraine with brainstem aura: Involves speech difficulties or double vision.

Acute Treatment Options for Migraines

Acute migraine treatment focuses on quickly relieving pain and symptoms, restoring normal function and minimizing side effects. All migraine patients should have access to this treatment. For mild to moderate migraines, doctors may prescribe analgesics, NSAIDs or a combination pain relievers. For more severe cases, triptans are typically the first choice, followed by CGRP antagonists or dihydroergotamine.

The table below describes various acute treatment options. Ultimately, the doctor should consider the patient’s history, severity of the migraine and other factors when choosing a medication, while also incorporating patient preferences regarding cost, side effects and accessibility.

It’s important to avoid opioids and butalbital-containing products due to their lower effectiveness and potential for abuse. Overusing acute treatments can lead to medication overuse headaches, worsening the condition.

*COST KEY (Rough Estimates)

$ = Under $50     $$ = $50-150     $$$ = $150-500     $$$$ = Over $500

Preventive Treatment Options for Migraines

Migraine preventive treatment is recommended for patients who experience frequent migraines, have contraindications to acute treatments or have not responded well to or have overused acute treatments.

The goal of preventive treatment is to reduce the frequency, severity and disability caused by migraines, decrease reliance on acute treatments and improve their effectiveness when needed. It can also enhance the patient’s overall quality of life.

The table below describes preventive treatment options. Just like with acute treatments, doctors should take a comprehensive approach when prescribing preventive medications, considering factors like the patient’s medical history, allergies, comorbidities, cost and access to medications. Incorporating patient preferences is also crucial to ensuring the treatment plan is both effective and manageable.

*COST KEY (Rough Estimates)

$ = Under $50     $$ = $50-150     $$$ = $150-500     $$$$ = Over $500

Nonpharmacologic Strategies for Migraine Management

Here are some non-pharmacologic strategies to try for migraine management. These can be used alongside medications or on their own. Some options are free, while others, like acupuncture, may have a cost.

Biofeedback: Learn to control bodily functions (i.e. heart rate or muscle tension) to reduce pain, available through online apps or websites.

Progressive relaxation training: Relax muscles by tensing and releasing them to reduce stress and tension.

Cool compress: Apply a cool cloth to your forehead or neck for relief from migraine pain.

Rest in a cool, dark, quiet environment: Take breaks in a calm, soothing space to minimize environmental triggers.

Hydrate: Drink plenty of water to stay hydrated throughout the day, as dehydration can trigger migraines.

Acupuncture: Tiny needles are placed in specific areas of the body to alleviate pain and promote healing.

Headache diary: Track triggers and symptoms to identify and avoid headache-causing factors.

Deep breathing exercises: Practice deep breathing or meditation to manage stress and promote relaxation.

Caffeine control: Limit caffeine intake carefully, avoiding both excessive consumption and withdrawal, which can trigger migraines.

Sleep hygiene: Maintain a regular sleep schedule to ensure you get enough restful sleep each night.

Avoid migraine triggers: Identify and make a conscious effort to avoid common migraine triggers.

Supplements for Migraine Treatment

Supplements can be a low-cost option for migraine relief, but they carry potential risks. Potential supplements include magnesium, riboflavin and coenzyme Q10. It’s important to consult your doctor before trying any supplement to ensure it’s safe for you.

Wrapping Up: Resources & Support for Effective Migraine Management

In conclusion, migraine education and awareness are essential for managing this condition effectively. There are various treatment options available, including both pharmacologic and non-pharmacologic strategies, as well as cost-saving alternatives like supplements and lifestyle changes. Network Health is here to support you with any questions you may have - feel free to reach out and call us anytime!

For additional resources, we recommend these patient-friendly migraine education materials: American Migraine Foundation and Migraine Disorders. You can also learn more about the MIDAS questionnaire which helps doctors assess the impact of migraines on daily life and guide appropriate treatment decisions.