Migraine is much more than a bad headache.\n\n\n\nMigraine is a neurological disease with extremely\n incapacitating neurological symptoms.It\u2019s typically a severe throbbing\n recurring pain, usually on one side of the head. But in about\n 1\/3 of attacks, both sides are affected.In some cases, other disabling symptoms are present\n without head pain.Attacks are often accompanied by one or more of the following disabling\n symptoms: visual disturbances, nausea, vomiting, dizziness, extreme\n sensitivity to sound, light, touch and smell, and tingling or numbness in\n the extremities or face.About 25% of migraine sufferers also have a\n visual disturbance called an aura, which usually lasts less than an hour.In 15-20% of attacks, other neurological symptoms\n occur before the actual head pain.Attacks usually last between 4 and 72 hours.\n\n\n\nFor many sufferers, migraine is a chronic disease that significantly diminishes their quality of life.\n\n\n\nMore than 4 million adults\u00a0experience chronic daily migraine \u2013 with\u00a0at least 15 migraine days per month.Medication overuse is the most common reason why\u00a0episodic migraine turns chronic.Depression, anxiety, and sleep disturbances are common for those with chronic migraine.Over 20% of chronic migraine sufferers are disabled, and the likelihood of disability increases sharply with the number of co morbid conditions.\n\n\n\nThere are 3 main types of non-drug treatments for\nmigraine.\n\n\n\nLifestyle Advice\n\n\n\nSee a doctor for a proper diagnosis. Migraine is a diagnosis of exclusion, which means doctors must eliminate other reasons for your symptoms before arriving at a migraine diagnosis. If your symptoms are bad enough for you to be evaluating treatments, you should make sure you actually have migraine and not something else.Keep a detailed\u00a0headache diary\u00a0so that you can analyze patterns to try to learn your common\u00a0headache triggers.Stick to the\u00a0same eating and sleeping schedule\u00a0every day \u2013 even on the weekends. Don\u2019t skip meals or change sleep patterns.Drink lots of water to\u00a0stay hydrated. Dehydration is a very common migraine trigger.Exercise\u00a0regularly.Keep your\u00a0weight down. An increase in BMI (body mass index) may result in an increase in the frequency of migraines.\n\n\n\nTherapies\n\n\n\nThese therapies promote general good health and well-being. They can improve your quality of life. Their success in treating migraine is difficult to measure and may depend on many things, like\u00a0the therapist, the length of treatment, and your commitment to regular practice.\n\n\n\nThese therapies can be\ntried alone or in combination:\n\n\n\nPhysical therapyAcupunctureYogaTai ChiMassageStress management: relaxation techniques, breathing, visualization, meditationBiofeedbackHypnotherapyCognitive Behavioral Therapy\n\n\n\nExercise\n\n\n\nExercise programs are\nfrequently recommended to promote health, control weight, and prevent disease.\nMigraine sufferers typically are less physically active than those who don\u2019t\nsuffer. They often avoid exercise, worrying that the exercise itself will\naggravate or trigger a migraine.\n\n\n\nSufferers who follow\ncertain common-sense guidelines can improve their quality of life and increase\ntheir aerobic endurance and flexibility without aggravating or triggering their\nmigraines. Here are some tips:\n\n\n\nKeep your exercise low-impact. Use equipment like stationary bikes or ellipticals that minimize pounding movements. Try Tai Chi, Yoga, isometric or band exercises.When using a treadmill, increase the incline rather than the speed to minimize pounding movements.Stretching and weight-bearing exercises are important, but be careful of the neck area. This is a very tender and vulnerable spot that can directly affect migraines.Drink water and stay hydrated. Dehydration is a very common migraine trigger.Take it slow. Work up to longer and more intense exercise as your body gets stronger.Listen to your body \u2013 if an exercise aggravates your migraines, don\u2019t do it! But don\u2019t abandon exercise. Consult a trainer or physical therapist for alternatives.\n\n\n\nHormones have an impact on migraine in women. Many women\nfind their migraine symptoms are affected by menstruation, hormonal\ncontraception, pregnancy, and menopause.\n\n\n\nMenstrual\nMigraine: Menstrual migraine is an\nattack that occurs up to 2 days before and up to 3 days after your period\nbegins. It\u2019s usually more severe and more difficult to treat than other types\nof migraine. 7-19% of women get menstrual migraine. About 60% of\nthese women also have migraine at other times of the month, too.\n\n\n\nIn the same woman, attacks of menstrual migraine may differ from\ntheir other attacks in duration, severity, symptoms, and response to treatment.\nEstrogen itself is not the culprit. Hormonal fluctuations, and especially\nestrogen withdrawal, are thought to trigger the attack.\n\n\n\nMenstrual migraine is generally treated with the same\nmedications that are used for other types of migraine. If a woman\u2019s\nmenstrual migraine is so severe that it doesn\u2019t respond to these medications,\nhormonal contraceptives might be considered as a treatment.\n\n\n\nHormonal\nContraception\n\n\n\nWhile birth control pills remain the most popular form of hormonal\ncontraception, hormones can also be administered vaginally, by patch, or\ninjection. The impact of hormonal contraception on migraine varies from woman\nto woman. Some find they have fewer headaches, while others experience more\npain, and some find there\u2019s no effect at all.\n\n\n\nOral contraceptives can trigger a woman\u2019s first migraine attack,\nespecially if she has a family history of migraine. Contraceptives which reduce\nor eliminate periods are sometimes used to treat severe menstrual migraine.\nWomen with migraine should be careful when choosing a hormonal contraceptive,\nand weigh the risks and benefits of a particular contraceptive with their\ndoctor.\n\n\n\nPregnancy and\nNursing\n\n\n\nMigraine sufferers should discuss their pregnancy plans with their\ndoctors. Some migraine medications may impact the ability to conceive and may\nharm the fetus.\n\n\n\n60% of pregnant sufferers find their migraines improve significantly\nin their first trimester, and more than 75% find they improve or even disappear\nduring the rest of their pregnancy. Unfortunately, this is not the case for\neveryone. 15% report their migraines worsen during the first trimester, and about 25%\nnotice no change. Usually, sufferers return to their pre-pregnancy migraine\npatterns after they give birth. Regular nursing may delay the return of\nmigraines.\n\n\n\nMenopause\n\n\n\nMigraines often worsen during per menopause, the years before\nmenopause, with intense hormonal fluctuations. But the prevalence of migraine\ndecreases significantly during menopause, when menstruation ends and hormones\ncease fluctuating. Migraines improve or go away entirely in 67% of sufferers.\nWomen who go through natural menopause often find their migraine symptoms\nimprove dramatically, while women who experience a surgical menopause often\nsuffer more. The effect of estrogen replacement therapy on migraine varies.\n\n\n\nLater Life\n\n\n\nThe prevalence of migraine drops markedly after age 60 to 7.5% in\nolder women. Few sufferers have their first migraine after age 65. It\u2019s\nimportant to consult a doctor to explore the causes of headaches in later life\nto rule out other medical problems.\n\n\n\nMigraine often goes undiagnosed in kids and teens.\n\n\n\nIn childhood migraine,\nhead pain may be less severe than other symptoms, like unexplained nausea\nor vomiting, abdominal pain, or dizziness. These non-headache symptoms are\nreferred to as migraine equivalents. Like adults, children may\nexperience migraine with or without aura, a visual disturbance which can\noccur about an hour prior to the headache. But migraine without aura\nis more common.\n\n\n\nBefore a migraine begins,\nparents may observe changes in their child\u2019s behavior, including loss of\nappetite, irritability, yawning, food cravings, lethargy, withdrawal, and mood\nswings. Sensitivity to light, touch, smell, and\/or sound is also common.\nOther indicators may include sleep walking, sleep talking and night terrors.\nInfant colic and motion sickness may be warning signs of a predisposition\nto childhood migraine or an early form of it.\n\n\n\nThe most common migraine\ntriggers in children are inadequate or changed sleep, skipped meals,\nstress, weather changes, bright lights, loud noises, strong odors, and hormonal\nfluctuations. Contrary to popular belief, there is little evidence linking\nspecific foods to migraine.\n\n\n\nDiagnosing Migraine in Kids and Teens\n\n\n\nDiagnosis is made through\na patient history, physical exam, and by ruling out other explanations for the symptoms.\nSometimes diagnostic tests, such as blood tests, EEG, lumbar puncture, and\nneuroimaging are also used to assist in the diagnosis. Migraine tends to run in\nfamilies, so family history of migraine is a risk factor.\n\n\n\nA history, preferably\nconducted with both the child and the parent, should include:\n\n\n\ndescription of the pain (including location, nature, and timing)severityfrequency and duration of episodesidentifiable triggerssymptoms at the onset, such as aura, lethargy, or nauseaimpact on quality of life (disability)previous treatmentsthorough family history\n\n\n\nIt\u2019s important to explore\nwhether there\u2019s a pattern to the attacks. For example, attacks may occur after\na car ride or when the weather changes. Girls may have attacks associated with\ntheir menstrual cycle. Parents and kids should keep a joint headache diary to\nassist the doctor in diagnosis and treatment.