Managing Chronic Migraine

What is chronic migraine?

Chronic Migraine is used to describe a condition where individuals are prone to repeat migraine attacks over time frequently. The diagnosis of Chronic Migraine requires headaches and other migraine related symptoms to be present for 15 days of the month for a total of 3 months. (NICE GUIDELINES). The Migraine Trust suggest that 2 in 100 people suffer with Chronic Migraine, yet little is known about the cause. Although it is important to note, there are many different types of migraine and headaches, all with different diagnostic criteria(see post: ‘Which Type of Headache or Migraine do I have?).

Ask anyone who has ever had a Migraine and they will tell you how dibelitating it really is. Symptoms include: An unbarable deep pain behind the eyes and around the temples. Extreme sound and light sensitivities, dizziness and nausea. Blurry vision, impaired speech, tachycardia, hot sweats and a desperate need to lie down have also been known. Now imagine feeling like that all the time. Like you’re unable to function for half of the month.

MEDICAL CONDITIONS THAT ARE KNOWN TO BE ASSOCIATED WITH CHRONIC MIGRAINE

• Heartrate / Blood Pressure Conditions like POTs (Postural Orthostatic Tachycardia Syndrome)
• Sleep Related Conditions like Sleep Apnoea
• Chronic Pain Conditions like Fibromyalgia
• Mood Related Disturbances like Anxiety, Depression, PTSD
• Neurological Conditions like ME/CFS
• Inflammatory Conditions like Endometriosis

OTHER THEORISED CAUSES AND INSTIGATORS OF MIGRAINE IN GENERAL COULD INCLUDE

• Overuse of medications (If someone has been taken them for a long time)
• Starting a new course of medication (Side Effects)
• Neuropeptide release causing pain sensitivity and inflammation of brain tissue (howthisworks)
• Sudden changes in lifestyle, behaviours or diet
• Hormone Imbalances like having too much Estrogen
• Eye Strain or Sight Related Problems (Not wearing glasses when need to for example)
• Bright lights or a dry environment that affects the eyes
• Being hyper-focused or overstimulated for too long
• Dehydration or poor nutrition
• Food Allergies
• Spicy foods
• Strong smells
• There is a potential link to genetics some sources claim that if your parent has chronic migraine you are 50% likely to get it too.

HOW TO MANAGE LONGTERM WITH CHRONIC MIGRAINE

MY EXPERIENCE

I was diagnosed with Chronic Migraine in 2020 and this is my experience. I was having up to 25 migraines a month for about 4 months before I went to the doctor. This is because I had a lot of other conditions and just saw pain as being a normal part of my life. I blamed dehydration, too much screen time, my other conditions or just ‘over doing it’. I was always seeing my doctor and I didn’t want to burden her with stupid little things like a migraine, even though they were having a huge detrimental affect. They were making me so depressed, I was barely able to get out of bed. I was throwing up 3/7 days a week and I was fainting a couple of times a month around my period. I ended up mentioning it at an appointment when we were talking about other things and that eventually led to my diagnosis. I was given medications one to help prevent migraine attacks (Propanolol)* and one to treat migraine attacks (Zolmitriptan)**. They minimized the symptoms massively. I stopped vomiting straight away and after a month of taking the medications the migraines started to reduce in frequency quite quickly. The issue I have now is remembering to take the Zolmitriptan on time! I believe MY Migraines may be linked to my other conditions POTs and Endometriosis, the medication has defiantly helped.

WHAT I WISH ID KNOWN SOONER

I made a HUGE mistake in my early Migraine days UNDERESTIMATING the benefits of a cold flannel (Yes you heard me right! Those horrendously severe pains really can be affected by something as simple as a cold flannel). You see one of the way migraines work is vasodilation (they increase the size of the blood vessels to increase blood flow to the brain). The application of a COLD compress can help to constrict some of those blood vessels and ease some of the pressure. HEAT on the other hand such as the application of a hot compress or drinking of a hot drink would only be good for headache type pain, which uses vasoconstriction to narrow blood vessels, reducing blood flow. You can find out more about the differences between Migraines and Headaches here: ‘Which Type of Headache or Migraine Do I Have?’

Medication will ONLY work if it is taken at the sudden onset of a Migraine Attack, if you wait too long nothing will help. You need to learn to predict or get a sense of when a Migraine is about to come on and take some medication then. Due to the differences in physiology between headaches and migraines, medications are not interchangable. Medications for headaches work in a different way to those for migraine. Taking medications for headache when you have a migraine can actually make your migraine worse. 300mg of Aspirin is said to be equally as effective as prescription drugs and I’ve personally found Anadin Extra (which contains 300mg of Aspirin + Caffeine + Paracetamol) highly effective but it is VERY IMPORTANT to note that many people can’t and shouldn’t take aspirin. It is a blood thinner and can have morbid effects on anyone with blood disorders and when used alongside other medications including Ibuprofen, and it’s a definite no no for under 16s.

It can be miserable life living with chronic migraines, its important to see your doctor to rule out any other potential issues that could be causing you these symptoms. Don’t despair we have found a few things that have worked for us that you could try,

HERE ARE SOME THINGS TO TRY (***that have worked for me)

• Cold Therapies (Cool compress, taking yourself outside if its colder then inside for a while)***
• Cooling Herbs in a tea such as mint, chamomile, catmint***
• Earth Kind Sanctuary’s ‘Head Relief’*** (Link below)
• Cooling Eye Gel***
• Sleep Mask for light sensitivities***
• Eating some ice-cream or have an icy drink***
• Avoid or cut down your intake of spicy foods
• Keep Hydrated
• Routine (Particularly where sleep is concerned)***
• Tens Machine
• Talk to your Doctor about prescribed medications (This might consist of things like Triptans, Propanolol, , High dose of Aspirin, NSAIDs or Amitriptyline)***
• Acupuncture
• Riboflavin (Vitamin B2) 400mg
• Magnesium
• Avoiding or reducing intake of alcohol, sugary and high stimulating foods such as spices
• Co-enzyme Q10

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*Propanolol is a beta blocker. It is used for the prevention of Migraine Attacks and is usually taken daily. In higher doses it can also help with heart issues, such as Arythmia and Tachycardia. It’s important to note that Propanolol is part of the steroid family and is a medication that may ban you from sports. It also affects your blood chemistry and can make you give false alchohol or drug test results.

**Zolmitriptan is a triptan. It is used for the treatment of Migraine Attacks. It also helps with sensory sensitivities. Zolmitriptan is usually taken as an oral dispersable tablet (IE You leave it to melt on the tongue). This is a fast acting way of the medication getting into your system. For one off use only at the sudden onset of a Migraine.