Integrative and Complementary Treatments for Migraine Are Needed – Psychology Today

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Integrative and Complementary Treatments for Migraine Are Needed – Psychology Today

Ego and self-serving biases shape the life story we share with the world—and with ourselves. The good news: An internal reckoning will help us better comprehend who we truly are.
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Posted November 24, 2021 | Reviewed by Ekua Hagan
Part of learning tolerance and sometimes even acceptance of our relationship with migraine is coming to realize that living with it requires a lot of work for our medical professionals, but, even more, for us, as we struggle to keep up with appointments to see headache specialists/neurologists for consultations, medications, Botox, nerve blocks, and infusions. Then there are the different combinations of preventative and abortive medications we try until the right mix breaks the cycle or keeps us from moving from episodic to chronic migraine.
Because these treatments alone often don’t offer enough due to the complex symptoms associated with migraine, many migraine sufferers turn to complementary and integrative medicines including devices like Cefaly, mind/body treatments such as yoga and mindfulness meditation, manipulation and hands-on treatment by chiropractors and physical therapists, and dietary supplements like magnesium and vitamin B2.
Interestingly, many migraine patients don’t converse with their headache specialists/neurologists about using some of these treatments: In a recent social media survey, 90% of patients with migraine said they use complementary and integrative medicines like meditation, yoga, and vitamins, but only about 20% discuss these treatment strategies with a health care provider: “It is important for providers to be conversant with complementary and integrative medicine (CIM) treatments and the available evidence-based data,” Deena E. Kuruvilla, MD, a neurologist at Yale-New Haven Health, and colleagues wrote in BMC Complementary Medicine and Therapies (Miller) It seems critical that the patients/doctor have a relationship of trust, where they share what options they’ve tried in order for their medical professionals to have a complete history and potentially suggest other options, as well.
The evidence is currently most promising for the mind/body treatment options of mindfulness, yoga, and tai chi. Mindfulness meditation may be as effective as pharmacological treatment for medication-overuse headache after the offending medication is withdrawn. While older research has shown magnesium and riboflavin to be helpful in migraine treatment, new research is promising to suggest potential benefits with melatonin, vitamin D, higher dosages of vitamin B6, and the combination of magnesium/feverfew 100 mg. Physical therapy (PT) continues to have strong evidence of support (Wells).
What follows is a partial selection of integrative/complementary treatments:
I have seen my physical therapist for weekly/sometimes bi-weekly treatment for several years, after being referred by my headache specialist. My work with her (Jenni Tuller) is an integral part of my regular migraine treatment. What’s important here is to find the right physical therapist, one who truly understands the complexities of migraine and stays current with the research and physical therapy treatments that are effective.
I have used the Cefaly device since it first became FDA approved and widely available in 2014. The recommended one-hour session with the Cefaly device is one I use almost daily for both preventative and acute treatment. While some people may find the stimulation a little disconcerting or uncomfortable at the beginning as it builds through the first half of the session, I find it soothing and somehow comforting to feel the electrical stimulation as it follows the trigeminal nerve.
As always, what remains important in the various treatments one uses to manage migraine is to stay abreast of the options out there as well as to look to the hopeful new treatments down the road. Be sure your medical professional team stays abreast of these, as well, and always encourages you that there are alternatives to what you are now trying. Because there is no cure for migraine, no one avenue of treatment will likely prove enough in the management of migraine. Seek as many varied treatments as you can to care for your mind and body while coping with this disease.
References
Brooks, Megan. “Migraine Nerve Stimulation Device Now Available Over-the-Counter.” Medscape Medical News. October 2020. https://www.medscape.com/viewarticle/939037. Accessed 24 November 2021.
Kuruvilla, D. and Wells, R.E. (2019), Evidence-Based Integrative Treatments for Headache. Headache: The Journal of Head and Face Pain, 59: 971-972. https://doi.org/10.1111/head.13555.
Miller, Janel. “ Many patients with migraine do not ask providers about complementary, integrative medicine.” Migraine Resource Center. February 2021. https://www.healio.com/news/primary-care/20210224/many-patients-with-mi…. Accessed 24 November 2021.
Pace, Anna, MD. “Dr. Anna Pace Discusses Additional Treatment for Patients Beyond their Typical Regimen.” American Migraine Foundation. October 2019. https://americanmigrainefoundation.org/resource-library/integrative-mig…. Accessed 24 Novermber 2021.
Physical Therapy Services of Rochester. https://www.ptsrochester.com/headaches/ Accessed 24 November 2021.
“Vagus Nerve Stimulation for Migraine and Cluster Headache” American Headache Society. June 2021. https://americanheadachesociety.org/news/vagus-nerve-stimulation-for-mi…. Accessed 23 November 2021.
Wells RE, Beuthin J, Granetzke L. “Complementary and Integrative Medicine for Episodic Migraine: an Update of Evidence from the Last 3 Years”. Curr Pain Headache Rep. 2019 Feb 21;23(2):10. doi: 10.1007/s11916-019-0750-8. PMID: 30790138; PMCID: PMC6559232. Accessed 22 November 2021.

Kathleen O’Shea is a Professor in the English/Philosophy Department at Monroe Community College in Rochester, New York, and the editor of So Much More Than a Headache: Understanding Migraine Through Literature.
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Ego and self-serving biases shape the life story we share with the world—and with ourselves. The good news: An internal reckoning will help us better comprehend who we truly are.

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