Non-Pharmacological Migraine Treatments

Non-pharmacological treatments may be useful for the acute treatment and prevention of migraine, and for reducing a patient’s reliance on poorly tolerated or unwanted pharmacological therapies. They can be tried before drug therapy or concurrently.

Although a variety of non-pharmacological therapies are available, the efficacy of most has not been established in appropriately designed clinical trials, and any proposed effectiveness is based mainly on self-assessment by patients. Furthermore, once a migraine attack is established, drugs are often the mainstay of treatment for many patients, and it is important that patients do not underestimate how well an appropriate pharmacological therapy can relieve migraine.

Behavioural interventions

Behavioural and lifestyle changes that may help reduce the frequency of migraine attacks include:

• regular sleep
• regular exercise
• regular meals
• avoiding alcohol
• avoiding migraine triggers
• avoiding excessive use of OTC medications
• limiting caffeine intake
• limiting stress.

Although such changes may reduce the frequency of attacks, it is unlikely that these alone will be effective in preventing attacks altogether.

Physical interventions

Physical therapy (including chiropractice and osteopathy) and relaxation therapy (involving breathing exercises, directed imagery or muscular relaxation) may be helpful in managing migraine attacks. Similarly, biofeedback and cognitive-behavioural therapy may also be effective.

Alternative therapies used by many migraine sufferers include:

• hypnosis
• herbalism
• homeopathy
• transcutaneous electrical nerve stimulation
• acupuncture.