Migraine: The best ways to break through the pain

Beat migraine with these treatments

IF YOUR usual methods don’t ease debilitating migraine symptoms, help is at hand – Marina Gask gives a heads up on the latest treatments.

 

Are you one of the eight million people in the UK who suffer from migraines? Migraine attacks can last for 72 hours and make your life a misery, with symptoms that can include visual disturbance, pins and needles, vomiting, vice-like pain, sensitivity to light, noise and smell, difficulty in speaking and numbness. It’s also rated by the World Health Organization as one of the top 20 most disabling lifetime conditions. 

“Migraine is an inherited tendency to have headaches with sensory disturbance,” says Professor Peter Goadsby, chair of the British Association for the Study of Headache. “It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger.” 

About 190,000 migraine attacks are suffered per day across the UK, yet incredibly 60 per cent of sufferers never consult their GPs, mistakenly believing nothing can be done. But if you’ve tried two or three of the usually prescribed medicines and your migraines haven’t improved, ask your GP about these newer treatments… 

Botox

Botox injections, or botulinum toxin, are only useful for those with chronic migraines (ie attacks on 15 days or more per month). Treatments are often every three months for 12 to 18 months before things are under control. Available on the NHS, it’s only administered by experts in a special headache or migraine clinic. 

HOW IT WORKS

It’s thought to help by relaxing overactive muscles or nerves in the scalp, face and neck. This in turn may affect levels of pain-modulating chemicals within the brain that contribute to migraines. 

Cefaly

Cefaly is a non-invasive electrical device. Migraine sufferers wear it over their heads for 20 minutes every day as a preventative measure and they can be used at the start of attacks to relieve symptoms. Available from cefaly.co.uk, the device costs £249 and has no side effects but awaits recommendation from the National Institute for Health and Care Excellence (NICE).

HOW IT WORKS

A small headband applies precise neuro-stimulation via electrical impulses at the centre of the forehead on to the supraorbital nerve, which has been implicated in migraine activity. 

Transcranial magnetic stimulation (TMS)

This is a portable hand-held device that was developed for the acute treatment of migraines and is being researched for preventative treatment too. It tends to work more reliably in migraines with aura. The real advance is that it can be used at home and it’s very well tolerated with no side effects. The NICE-approved eNeura TMS device receives NHS backing in some areas and costs £150 a month.

HOW IT WORKS

The device sends brief electromagnetic pulses to the brain, changing the way it behaves and arresting a proportion of attacks. 

Carole Hanna has been suffering from migraines since her early twenties

Carole Hanna, a 71-year-old retired teacher who lives in Devon with her husband John, has been suffering from migraines since her early twenties. She says:

“Migraines first hit me when I was around 23, with attacks often striking once a week and regularly lasting for over 48 hours each time. My doctor gave me a variety of painkillers and I also tried complementary treatments like acupuncture, which worked for a while. I sometimes got migraines with an aura that could last three to seven days and I used to go to bed with a hot-water bottle on my head and try to sleep them off.

I’ve also tried complementary therapies including faith healing, meditation, acupuncture, reflexology, massage chiropractic, aromatherapy, cranial osteopathy and homeopathy. 

But sadly, migraines are still a problem for me – there’s been no miracle cure. I know when one is about to start, as I yawn a lot and can’t work out what people are saying. Other times I get a grinding in my head, like someone’s stabbing me, and this makes me vomit. There have been times that the pain has been so bad, I’ve wanted to jump off a balcony and crush my head. 

Being a primary school teacher was particularly hard when I got a migraine. My migraines usually came in the afternoon just before story time and I’d have to get one of the children to read the story for me. I knew when it was going to be a bad day and would plan the work accordingly, but I would often have to miss staff meetings after school. Sadly, my migraines prevented me from achieving my dream of becoming a head teacher.

I now take prescribed medication and painkillers to help manage my attacks. I have to be careful not to take too much medication, as this has led to further headaches in the past. I feel I’ve wasted a lot of money on complementary therapies, but a course in meditation has given me the key to self-help. I speak out loud to the migraine and say I won’t be taking any tablets! It’s strange I know, but it sometimes seems to work.”

Jane started getting headaches from the age of 17

Jane Ebel, 55, is a music therapist who often works abroad. She lives in Salisbury, Wiltshire, with her husband Tony and has two grown-up children. Jane says:

“From the age of 17, I started getting headaches behind my eyes and was prescribed a strong painkiller, Solpadeine, but it made the migraines worse. In the early days, I lived through the migraines, but when they started to get worse I’d have to take a few days out – and this happened every 10 days. I’d try to plan trips and holidays, but it was difficult. 

An attack would start with an enormous pain from my shoulders up the back of my neck, over the top of my head and down to my left or right eye. It felt like having a vice on your head getting tighter and a knife through your eye. I’d start being sick and just carry on being sick for 24 hours as the pain moved around my head. 

I was getting so depleted from having them every 10 days, I couldn’t live a normal life. 

My GP prescribed sumatriptan and later another doctor tried to put me on to beta-blockers. I tried lots of different treatments including Botox, which left me with such a stiff neck that I could hardly move my head for a month. I went to a private migraine clinic in London, where they tried to get me on to a different raft of medication, including aspirin, and also offered a course of hypnosis. 

I even tried an elimination diet to find out what triggered them, but nothing worked.

By Christmas last year, I decided I had to do something. I’d read about Cefaly devices and bought one from eBay. Since then, I’ve gone from getting a migraine every 10 days, lasting 36 hours each, to just four in the last six months, each lasting 24 hours. I’ve broken the cycle and that’s given me huge confidence to get on with my life.

I now use the device at least twice a day, morning and evening, for 20 minutes each time. I can honestly say that using a Cefaly has been life-changing.”

Explore the three new migraine treatments

 

Future hope

Expect these three migraine treatments, currently undergoing clinical trials, to be available imminently…

CGRP treatments: For use in prevention, these mop up calcitonin gene-related peptide (CGRP), a protein that’s a key chemical in the migraine process. It’s administered as a single injection monthly.

Ditans: A new acute treatment that attacks a specific receptor to nerves to treat migraine, avoiding the problem with some current migraine treatments that constrict blood vessels.

GammaCore: This is a non-invasive nerve-stimulation device that’s been found to be effective in treating episodic migraine. 

For more information, visit migrainetrust.org and migraine.org.uk.