I was chatting about migraines recently and was asked what my triggers are and what my treatment program is. I thought that I had written this out a while back but my treatment options have changed since then, so here you go.
Any one of these on its own usually won’t cause a migraine, but combine any two or three and it’s almost guaranteed:
- Sinus pressure
- A stiff neck
- TMJ (from clenching teeth)
- Change in air pressure
- Inadequate or flickering lighting
- Lack of sleep
- Strong scents
A common example is waking up with a stiff neck from inadequate pillow support. By itself it’s annoying- add poor sleep, a stiff jaw or heavy air pressure and I need to start treatment immediately (if it’s not already too late).
I had a meeting Wednesday in a dim room with an slightly out-of-focus projection screen and I was sitting at a bad angle. Add heavy air pressure and I was hurting pretty bad.
Severity determines where I start on this scale:
- A snack (in case it’s blood sugar- mine is wonky once in a great while)
- Drink a glass of water- being dehydrated can cause or aggravate a headache for me
- One serving of caffeine (usually tea or soda- careful not to overdo since it can make things worse in larger quantities)
- A decongestant, since I almost always have sinus pressure with my migraines
- Tylenol (if I haven’t already taken some for rheumatoid arthritis pain)
- B complex and iron – these are part of my lunch pills and often help with moderate headaches
If I have tried all these options and I am still on track for a migraine (or already have one), then pretty much my only option is prescription medicine (Sumatriptan) and a nap (if I can sleep). I’ve discovered that if it is still only muscle stiffness and I don’t have to drive sometimes a muscle relaxant helps, but that pretty much jumps me straight to the nap stage of things, so it ends up with pretty much the same result. All other OTC pain relievers are off-limits for me due to my other prescription meds for my RA, since toxicity is a real concern.
Of course, I try to avoid triggers as much a possible, but sometimes they’re inescapable. I try to stay aware of progress so things don’t get out of hand and I’m much better about paying attention than I used to be, but with spring allergens and storms, it’s been a rough week or two so far.