Migraines are a common head that effects, about 6% of men and 18% of women get a migraine in a given year, in the united states.

1. Manual Therapy
Spinal manipulation is a useful tool in migraine prophylaxis. One study demonstrated a “significant reduction” of migraine intensity in almost half of those patients receiving spinal manipulation. Nearly ¼ of migraine patients reported greater than 90% fewer attacks. Spinal manipulation has demonstrated similar effectiveness but longer-lasting benefit with fewer side effects when compared to a well-known and efficacious medical treatment (amitriptyline).
- Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impactof Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. Link
- Chaibi A, Benth JŠ, Tuchin PJ, Russell MB. Adverse events in a chiropractic spinal manipulative therapy single-blinded, placebo, randomized controlled trial for migraineurs. Musculoskeletal Science and Practice. 2017 Jun 1;29:66-71. Link
A Harvard study found that SMT significantly reduced migraine days as well as pain intensity. And SMT is safe; a study to define adverse events following chiropractic spinal manipulation for migraines found that “adverse events were mild and transient, and severe or serious adverse events were not observed.”
1. Acupuncture
Several recent studies have shown that acupuncture is another viable tool for managing migraines.
- Vázquez-Justes D, Yarzábal-Rodríguez R, Doménech-García V, Herrero P, Bellosta-López P. Analysis of the effectiveness of the dry puncture technique in headaches: systematic review. Neurology. 2020 Jan 13. Link
- Xu S, Yu L, Luo X, Wang M, Chen G, Zhang Q, Liu W, Zhou Z, Song J, Jing H, Huang G. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ. 2020 Mar 25;368. Link
- Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. Link
2. Eat Smart & Maintain an Ideal Weight
Dietary fats trigger the synthesis of prostaglandins which are known migraine triggers (19). Low-fat diets have been shown to play a role in migraine prophylaxis. (20,21) Weight loss may decrease the frequency of migraine and other primary headaches (tension, cluster). (16-18) Patients on a low sodium (DASH) diet report a decrease in headache frequency vs those on a high sodium diet. (23) One new study showed that “adherence to the Harvard Healthy Eating Plate advice, particularly the reduction in carb, red and processed meat consumption, is useful in migraine management, reducing migraine frequency and disability.” (47)
3. Drink Water
Drinking more water and drinking less soda and sugar beveragesis all ways a good idea. . A study published earlier this month, showed “The results showed that the severity of migraine disability pain severity headaches frequency and duration of headaches were significantly lower in those who consumed more total water.” (Khorsha F, Mirzababaei A, Togha M, Mirzaei K. Association of drinking water and migraine headache severity. Journal of Clinical Neuroscience. 2020 May 20. Link)
4. Vitamin D
Vitamin D is important hormone in the body. that right its a hormone and is involved in many different processing the body. Vitamin D deficiency is associated with migraine attacks. Vitamin D supplementation in a dose of 1000-4000 IU/d has been shown to reduce the frequency of migraine attacks.
- owaczewska M, Wiciski M, Osi?ski S, Kamierczak H. The Role of Vitamin D in Primary Headache–from Potential Mechanism to Treatment. Nutrients. 2020 Jan;12(1):243.
- Ghorbani Z, Togha M, Rafiee P, Ahmadi ZS, Magham RR, Djalali M, Shahemi S, Martami F, Zareei M, Jahromi SR, Ariyanfar S. Vitamin D3 might improve headache characteristics and protect against inflammation in migraine: a randomized clinical trial. Neurological Sciences. 2020 Jan 2:1-0.
5. B Vitamins
Riboflavin (Vit B2) may help prevent migraines. (26, 29-38) Dosage recommendations vary, however, the average dose used in the studies was 400mg/day. Vitamin B6 supplementation (with or without concurrent B9 and B12) has also demonstrated prophylactic benefit.
- Maizels M, Blumenfeld A and Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: A randomized trial. Headache 2004; 44: 885–890.
- Smith C. The role of riboflavin in migraine. Can Med Assoc J 1946; 54: 589–591.
8. Magnesium (400-600mg)
Magnesium a mineral that can help with headaches. Magnesium play a role in energy production , bone formation, nerve function and blood vessel function. An umbrella review found strong evidence that “Magnesium supplementation can reduce the intensity/frequency of migraine.” Dosage recommendations vary, however, the average dose used in the studies is 400-600mg/ day for the prevention of migraine in non-pregnant patients.
- Ko¨seoglu E, Talaslioglu A, Go¨nu¨l AS, et al. The effects of magnesium prophylaxis in migraine without aura. Magnes Res 2008; 21: 101–108.
- Esfanjani A, Mahdavi R, Ebrahimi Mameghani M, et al. The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis. Biol Trace Elem Res 2012; 150: 42048.
- Peikert A, Wilimzig C and Ko¨hne-Volland R. Prophylaxis of migraine with oral magnesium: Results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia 1996; 16: 257–263.
10. Melatonin (2-3mg)
Melatonin is a important hormone release by the brain during sleep. Melatonin should be taken 30 minutes before bed. One systematic review and meta-analysis concluded: “Melatonin may be of potential benefit in the treatment‐prevention of migraine in adults.” Study doses varied widely (0.05-50mg), however, the typical dose used in the studies was 2-3mg, taken before bedtime. Liampas I, Siokas V, Brotis A, Vikelis M, Dardiotis E. Endogenous Melatonin Levels and Therapeutic Use of Exogenous Melatonin in Migraine: Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2020 Apr 30.
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