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Kristina Gallagher from Doctor Unite, Huma Sheikh Commented on a Post
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Huma Sheikh

One important treatment for migraine is preventive therapy. This can involve a number of different types of treatments, including oral medications, injections like botox or the new cGRP inhibitors, as well as neuromodulation techniques.

However, many people prefer not to take preventive therapy for a number of reasons, including side effects or difficulty with compliance. Even when taken correctly, a migraine preventive is considered successful if it reduces the frequency of migraine by 50%. This can mean some patients are still having significant migraines per month.

Complementary techniques including mindfulness, acupuncture and yoga have gained a lot of popularity in the last few years as being efficacious and a significant treatment modality as adjunct therapy for migraines.

Do you recommend mindfulness or other complementary techniques for migraine? What are your favorite resources to offer to patients?

References
Expert Rev Neurother. 2020 Mar; 20(3): 207–225.
Published online 2020 Feb 12. doi: 10.1080/14737175.2020.1715212
PMCID: PMC7213534
Mindfulness in Migraine. A narrative review
Rebecca Erwin Wells,* Elizabeth K. Seng, PhD, Robert R Edwards, Ph.D., David E Victorson, PhD, Charles R. Pierce, MS, Lauren Rosenberg, M.A., Vitaly Napadow, PhD, Director, and Zev Schuman-Olivier, MD, Director

  • from Doctor Unite 1 month
    Most of my pts love non-med suggestions. We have great handouts on mindfulness and stress reduction. Our integrative medicine docs also offer acupuncture.
  • 1 month 2 weeks
    Thank you for all the insights, these are great. Migraine truly need a wholistic complementary approach.
  • 1 month 2 weeks
    Thank you for all the information, migraine really needs a wholistic approach with lifestyle modifications as well.
  • from Doctor Unite 1 month 2 weeks
    For refractory patients I use physical therapy directed towards migraines. A trained physical therapist in this can really make a difference.
  • from Doctor Unite 1 month 2 weeks
    I recommend a combination of relaxation techniques, massage therapy and medication to help prevent patients from recurrent migraines.
  • 1 month 2 weeks
    I believe practicing meditation, or mindfulness, can be very helpful as migraine preventative treatments. This is an "extension" of biofeedback and relaxation techniques that have been recognized for decades as being helpful in migraine. The difference is that these practices can be incorporated as a routine part of our lives, instead of being utilized only when needed - such as when feeling stressed.
  • 1 month 2 weeks
    Food diaries, identification of triggers, watching blood pressure, sleep hygiene, breathing exercises and meditation, all those can help and steer patients away from needing medications.
  • 1 month 2 weeks
    I'd say about 90% of my migraine patients are on a preventatve
  • 1 month 2 weeks
    Frustratingly, by the time many patients have been referred to a neurologist their HA are profound enough that they are no longer interested in complementary therapies; however, once some component of HA control is achieved, I have had success introducing alternate therapies. I have seen most benefit with acupuncture, yoga, and meditation. While I suspect patients would see further improvement with guided meditations and hypnosis, in my region we don’t have enough practitioners trained in these modalities to be able to routinely offer/prescribe them.
  • from Doctor Unite 1 month 2 weeks
    Massage therapy is beneficial to relieve stress and anxiety.
  • from Doctor Unite 1 month 2 weeks
    There are some new medications that can be helpful in migraine prevention. I have also found acupuncture, physical therapy, music therapy, and relaxation techniques to be helpful
  • from Doctor Unite 1 month 2 weeks
    I have a massage therapist who works for me in my office. Migraine patients who have appointments with her do much better.
  • from Doctor Unite 1 month 2 weeks
    I have used meditation in patients. Stress is a big factor with migraines and I recommend phone apps such as CALM. Also, yoga and tai chi help the patient to relax and focus. Many of my patients benefit from therapeutic touch/ massage.
  • 1 month 3 weeks
    I usually recommend REGULAR sleep and exercise. Many times getting more sleep or doing more exercise fails because it is random, and you brain can't get into a routine. I emphasize it's not the amount of sleep or exercise, or even the type of exercise, but doing consistently at the same time, get your brain in a routine, and prevent the inflammation that occurs with random changes in your schedule
  • from Doctor Unite 1 month 4 weeks
    Unfortunately most of my patients can not afford complementary techniques as most insurances do not cover them. When I do recommend I usually refer to a local acupuncturist.
  • 1 month 4 weeks
    Unfortunately I don't have a favorite resource for this but I do suggest that the patients perform a quick internet search for a local yoga studio and any websites on mindfulness techniques
  • 1 month 4 weeks
    Yoga, meditation, and other relaxation techniques have a huge upside potential with little to no risk. They are active however as opposed to a medication which is somewhat passive so it requires a little motivation and work on behalf of the patient. These techniques, while not curative, can ease some symptoms and even offer a "break" from the "pain" due to focusing on something other than their symptoms. I fully support these types of conservative treatment options and have seen good results.
  • from Doctor Unite 1 month 4 weeks
    Yoga ca certainly help reduce stress and can help with migraine prevention. I have also recommended acupuncture and physical therapy as well as music therapy
  • from Doctor Unite 1 month 4 weeks
    Yoga ca certainly help reduce stress and can help with migraine prevention. I have also recommended acupuncture and physical therapy as well as music therapy
  • from Doctor Unite 1 month 4 weeks
    Yoga ca certainly help reduce stress and can help with migraine prevention. I have also recommended acupuncture and physical therapy as well as music therapy
  • 1 month 4 weeks
    I also find that patients are interested in trying non-prescription prophylaxis. Concerning the alternatives you mentioned, I have found acupuncture about as effective as any other modality (medication, supplements...). Yoga has been effective in a minority of patients. The main barrier to yoga and mindfulness for my patients is time constraints. Secondly, finding instruction. When I discuss options with patients, after hearing about everything, the majority of patients opt to try supplements (magnesium, C0Q 10...) and lifestyle modification (sleep habits etc) rather than sign up for that special yoga class. I have tried recommending sort of "meditation light" approaches - lavender oil, breathing exercises etc. Patients have told me that these relax them but do not help the migraines. I am recently trying the approach of telling patients that you get out what you put in. If you want to reduce migraines you have to make a commitment to an approach. That means putting in the time to try something (MBI) and then accepting about a 50% chance of success.
  • from Generation NP 1 month 4 weeks
    I have also seen that it might help patients to relieve migraines the use of other Complementary techniques including the use of listening to soft relaxing music of their choice.
    Thanks
  • from Generation NP 1 month 4 weeks
    For the adjunctive complementary therapy to medications of migraine headaches: I have used mindfulness and prayer. Thanks,
    Mayelin Gomez DNP, APRN
  • from Doctor Unite 1 month 4 weeks
    Diet and complementary methods might help
  • from Doctor Unite 1 month 4 weeks
    I do encourage diet modification, improved sleep, mindfulness and yoga. I have found combination of magnesium and riboflavin to very useful for prevention. I do work with a mind body medicine specialist who is excellent In coaching our patients and educating mindfulness.
  • from Doctor Unite 1 month 4 weeks
    I feel my patients would rather try a non pharmaceutical
    approach first,so therfore I recommend Magnesium meditation exercise diet modulation or otc meds like excepting migraine .If unsuccessful will try Triptans etc
  • from Doctor Unite 1 month 4 weeks
    yes, do recommend mindfulness such as relaxation, Yoga, meditation, etc for migraine prevention, but only works if regularly involved
  • from Doctor Unite 1 month 4 weeks
    I strongly encourage mindfulness, meditation and stress reduction techniques with patients, as stress and anxiety are clear triggers for many patients. Patients are often concerned about some of the side effects of migraine preventatives. There are many apps which can help patients easily practice some of these techniques on their own, such as as Calm, Peloton, Equinox, etc.
  • from Doctor Unite 1 month 4 weeks
    Anthony Giampolo has a point. The patients need to set aside time and put in the effort. If the patient does not feel like it is helping they will become discouraged and that is when they need reassurance or maybe make some modifications to their treatment.
  • 2 months
    I feel that complementary techniques are extremely helpful to patients for the following reasons: it forces them to take time for themselves (even if it is only 5-10 minutes at a time), resets their outlook and empowers them to be in control. Migraineurs often feel that migraines are in control of their life rather than that they are in control of their migraines. i spend time during office visits reassuring them that jointly we can improve their QOL and sense of control. Many also need words to encourage empowerment since their lives have often been overshadowed by demeaning comments that fail to realize the impact of their headaches. If they are new to these techniques, I will frequently encourage them to start with breathing practices which are available in many places including the Apple watch. If they prefer a more physical path, I refer them to Yoga with Adriene (available on you tube) which is specifically for migraine. The app that I have found most effective for meditation is Insight Timer which offers 70,000 free meditations/talks as well as live sessions with various teachers. There are some online CBT offerings but those for migraine have been studies but are not available yet. I have often referred migraineurs to in person CBT and found this beneficial not only for migraine but also for sleep.
  • 2 months
    Complementary therapies may be helpful for some patients with migraine headaches. However, some such complementary approaches require time and effort of the part of the patient which may limit a patient's long-term adherence to such therapy. In addition, insurance coverage for such complementary therapies may not be a considered to be covered benefit for many patients. Utilizing shared decision making, selection of a therapy consistent with a patient's preferences can often be helpful in improving the patient's migraine condition.
  • 2 months
    Yes I typically do recommend mindful meditation. There are several applications on the telephone that I will often recommend to patients. This includes headspace or COM. I do believe that reduce anxiety and cortisol levels can certainly impact migraine headaches in a positive way. I’ll also just encourage patients to Google this has mindful meditation and mindfulness is very trendy right now and there are many resources available to patients.
  • 2 months
    These are great insights!
  • from Doctor Unite 2 months 1 week
    On of the best migraine talks I ever presented discussed the "look" of a chronic migraine patient. He stated they will frequently have their arms crossed and appear to have their mouth and jaw tight. He stated they sit like this due to underlying stress and this position ensures they will be tightly wound. From my experience, he was right. I will point this out to patients and discuss relation techniques. During this appointment, almost without exception, you will have to remind them to uncross their arms and let their jaw and face relax. Sometimes it is an eye opening experience for them.
  • from Doctor Unite 2 months 1 week
    I prefer meditation as a means of calming and stress reduction with a concomitant positive effect on migraine sufferers. I recommend many free apps but the main one I suggest is Insight Timer.
  • from Doctor Unite 2 months 1 week
    Relaxation techniques, yoga, music,and medication all help prevent migraines
  • from Doctor Unite 2 months 1 week
    Yes, I definitely incorporate mindfulness of migraines. Setting aside time during the day to perform relaxation techniques. Some sources that are available are the American Migraine Foundation, Miles for Migraine, and Migraine Trust.