Alternative and Complementary Treatments for Headaches and Migraines

Articles On Non-Drug Migraine & Headache Treatments

Medicines can ease migraines and other types of headaches, but people often use complementary and alternative treatments to get relief.

Stress leads to some of the most common types of headaches, including migraines and tension headaches. So scientists have studied alternative treatments that aim to reduce stress, such as biofeedback and relaxation, and found that they often work well. Some people get relief from nontraditional headache treatments including acupuncture, massage, herbs, and diets.

Electromyographic (EMG) Biofeedback

Biofeedback helps you use information (feedback) about muscle tension, skin temperature, brain waves, and other body signals to ease your stress. A technician places small metal sensors, called electrodes, on your skin to measure those signs. A machine shows that data as numbers, electrical waves, or sounds on a screen.

Studies show that with biofeedback, you can learn to relax certain muscles and reduce stress that is causing a headache or making it worse.

Most studies on biofeedback show that it shortens headaches and makes them happen less often in children and adults. In general, its effects seem similar to those of many drugs that treat headaches, and it can be part of early treatment for migraines.

You can work with a specialist at the psychology, psychiatry, and integrative medicine departments of many medical centers to learn how to use biofeedback.

Botox

Though it’s best known for the role it plays in smoothing out frown lines, onabotulinumtoxin A (Botox) can also help treat chronic migraines. That means you have both:

• A history of migraine headaches
• Headaches (including tension-type) on most days (15 or more) of the month, of which eight are migraines

Doctors think Botox works for migraine headaches because it blocks chemicals called neurotransmitters that carry pain signals from your brain. Botox is like a roadblock in that pathway. It stops the chemicals before they get to the nerve endings around your head and neck. But Botox won't work for you if you:

• Get headaches 14 or fewer days each month
• Have other types of headaches, like cluster ones

You’ll get the treatment every 3 months for a year or more. It consists of shots in these areas:

• Bridge of your nose
• Forehead
• Temples
• Back of your head
Neck
• Upper back

It may be a couple of weeks after the first shots before results show up.

Stress Management

Life events that increase stress, anxiety, and depression have been linked with chronic migraines and other headaches. Studies show that a combination of stress management and some antidepressant drugs eases headaches and the use of pain medications. Along with a regular practice of relaxation, it may also help to get enough sleep and eat a healthy diet.

A specialist in psychology, psychiatry, or integrative medicine can teach you how to use relaxation training.

Yoga

Studies show that people who do yoga along with taking medicine for migraines have fewer and less intense headaches than people who take medicine alone. About 10% of people who get migraines or bad headaches practice yoga.

Yoga, which began in ancient India, involves deep breathing and meditation. You move slowly and hold poses. It trains you to focus on your body and be aware of how you're moving and how it feels.

Yoga can do more to lower stress and boost mood than some more intense forms of exercise. Gentle yoga can be a good way to start. One example of how this works is a style called Hatha yoga. It starts with breathing exercises, moves to poses, and ends with a resting period.

You may be tempted to begin yoga by watching a video. But it's usually better to go to a class with a teacher. Tell them about your migraines. They’ll guide you through poses and change them if needed. For instance, you probably shouldn't do poses that strain your neck or put tension on it.

It's probably best to stay away from intense classes that involve heat, a lot of activity, or more advanced poses. These things could trigger migraines. Be sure to drink plenty of water during and after class.

Before you give yoga a try, talk with your doctor about it. And remember to be patient. You may need to practice yoga often for several months before your migraines get better.

Acupuncture

This form of traditional Chinese medicine has been around for thousands of years. It’s based on the idea that your body has a natural flow of energy called chi that travels along routes known as meridians. If one of these pathways is blocked, your chi is unbalanced, and acupuncture can fix it.

During acupuncture, a practitioner inserts fine needles into certain points on your body.

Research shows that acupuncture may trigger your body to release chemicals that block pain, like endorphins. It also may tell your brain to give off other chemicals and hormones that send signals between different types of cells, including those of the immune system.

Acupuncture seems to help with a variety of health problems. The World Health Organization recognizes more than 30 conditions it can improve, including allergies and tennis elbow. Other studies, though, suggest that it mainly helps people because they believe it will work. This is what doctors call the placebo effect.

What makes acupuncture a unique pain treatment is that its effects may be long- lasting. In one study, it eased long-term pain in the neck and shoulder areas and the headaches it caused, and the effects lasted for months.

If you try this approach, be sure to look for an experienced, well-trained acupuncturist who uses sterile needles. Many states require a license, certification, or registration to practice it, so check the laws in your area.

Acupressure

This treatment involves massaging certain points on the body to relax muscles, balance your natural energy flow, and relieve stress and pain. It’s also been part of Chinese medicine for more than 2,000 years.

A 2010 study showed that acupressure did a better job treating migraines than muscle relaxers, even up to 6 months later.

Find these pressure points and massage yourself, or have someone do it for you. Even 4 or 5 seconds at a time can help ease your pain. You can do it several times a day:

Feng chi, or GB20 -- short for gallbladder 20 -- refers to an area on the back of your neck. Feel the side of your head to find the ear bone, called the mastoid. Follow it to where your neck meets your skull. Use your thumbs to apply firm pressure and rub the area for a few seconds.

Jian jing, or GB21, is commonly used to treat stress, neck pain, and headaches. It’s in your shoulder muscle, and you massage it by pinching the muscle between your thumb and middle finger.

He gu, or LI4 -- short for large intestine 4 -- is a point on your hand that, like GB21, can be targeted to relieve headaches, stress, neck pain, and more. You’ll find it in the thick part of the muscle between your thumb and index finger. Don’t massage here if you’re pregnant -- it could induce labor.

Zhong zhu, or TE3 -- short for triple energizer -- is another hand point. It's between the knuckles of your pinky and ring finger. Massaging this can help relieve temporal headaches and neck and shoulder tension.

Chiropractic

When your spine works well, it helps lower stress on your whole body. Chiropractors use their hands or tools to manipulate your spine and other joints. Studies suggest that spinal adjustment may help lessen the number of migraine attacks, how strong they are, and how long they last. A chiropractor also may offer massage and muscle therapies, along with advice on foods to eat, exercises, and ways to relax. Studies have not shown that one chiropractic technique helps with migraines more than another. You may find one that works best for you.

Daith Piercings

One unusual approach to treating migraine pain is piercing a cartilage fold on your ear just above the ear canal. It’s called a daith piercing. The idea is that it targets a specific pressure point, like acupuncture or acupressure, but in a more permanent way.

The piercing hits an area near the vagus nerve, which travels from your brain to multiple organs. It controls some of your body’s hormones. Stimulating this nerve has been a way to treat headaches in the past.

Although some people with frequent migraines say the piercing has helped, there are no studies or research to prove that it’s an effective treatment.

Massage

Clinical trials haven’t shown convincing evidence that massage treats headaches. But it’s a great way to reduce stress and relieve tension. It especially helps with tightness of tender muscles, such as those in the back of the head, neck, and shoulders, and it boosts blood flow in those areas. For some people, massage may relieve headaches caused by muscle tension.

Mind-Body Techniques

If you know the saying “laughter is the best medicine,” you already get the idea behind mind-body techniques. When you feel good, your health benefits. This is the mind-body connection.

A wide range of therapies fall into this group, including yoga and meditation. Others include:

Biofeedback. This uses electrical sensors that give you information about your body. With it, you can learn to relax and control different parts of your body such as your heart rate and muscles. Your therapist may look at your breathing, brain waves, temperature, or muscle contraction.

Hypnosis. This method puts you in a trance-like state where you have great focus and concentration. You can get so relaxed that you are open to suggestions, such as how much pain you may feel.

Cognitive behavior therapy. A therapist helps you identify your stressful thoughts and feelings. You will find new ways to see them so you can change how they make you feel.

Relaxation training. This includes deep breathing exercises through the diaphragm. You contract and relax different muscle groups. It also includes guided imagery and mindfulness.

Herbs

People use a variety of herbs for migraine and headache treatment and prevention. Most of the studies on effectiveness and safety have looked at two:

• Feverfewis the most popular herbal way to prevent migraines, and studies have shown that it may be helpful, with only mild side effects. But there is no convincing data that it is more effective than a placebo (a fake pill). Scientists need to do more research on these treatments.
• Butterbur got the nod for making migraines less frequent. Use only products that have been processed to remove plant chemicals called pyrrolizidine alkaloids (PAs). They can cause liver damage and other serious illness. Keep in mind that there isn’t much information about the long-term effects of butterbur.

Before you try any herbs or supplements, talk to your doctor to be sure they’re safe for you and they won’t interfere with other medicines you’re taking.

Aromatherapy

In this type of treatment, you breathe in essential oils -- concentrated liquids made from flowers, roots, leaves, and other parts of plants -- or rub them on your skin to help you relax and change how you perceive pain. But be careful when you put oils on your skin. Some can irritate it.

• Peppermint. Mint has been used to treat health issues for thousands of years. A few studies have found that it might ease pain from tension headaches if you put it on your temples and forehead. Because it’s concentrated, use only a few drops.
• Lavender. One of the most popular essential oils in aromatherapy, lavender has been used for anxiety, for pain, and to help people sleep. A lot of research has looked at lavender's health benefits. But most of the studies have been very limited. One study found that breathing in lavender essential oil might be a safe way to ease migraine symptoms.
• Rosemary. This is commonly used to treat a range of issues such as indigestion, pain, cramps, and hair loss. One small study says that rubbing rosemary oil on the skin relieved pain in people who were on hemodialysis, where a machine cleans your blood when your kidneys aren’t able to. Some people use it for headache relief, though there’s little research that says it helps with migraines.
• Chamomile. This is a popular choice for anxiety, stomach issues, and trouble sleeping. Because anxiety and stress may trigger migraines and other headaches, easing those worries may help ease pain. Although chamomile has often been used to treat migraines, there’s little research to show that it works.
• Eucalyptus. It’s used to clear a stuffy nose, and it’s been paired with medication to help ease things like bronchitis and asthma. Studies have found that applying a mix of eucalyptus oil, peppermint oil, and ethanol to your head might help you relax and think more clearly if you have a headache. Don't put eucalyptus oil right on your skin. You could have an allergic reaction. Make sure it’s diluted first.
• Sage. This popular spice is also widely used to relieve tension, stress, muscle cramps, and menstrual changes. Some people may turn to sage for relief of the headaches that come along with these conditions. But there’s little research on the subject.

Diet Changes

Certain foods, such as chocolate, aged cheese, citrus fruits, and red wine, may trigger headaches for some people. If this is true for you, try to identify and avoid food-related headache triggers. (The same goes for other things that bring on headaches, including stress, lack of sleep, and fatigue.) You can start by keeping a careful diary of your headache symptoms and eating habits.

Researchers have done only a few studies to test if diet changes can ease headache pain. Some found that people who ate less fat had fewer migraines. Others suggest adding omega-3 fatty acids to your diet. Supplements that might help include magnesium, riboflavin, coenzyme Q10, and melatonin. Again, more research is needed to know if they’re safe and effective.

Your best bet is to eat a well-balanced diet. Don’t skip meals or fast. Each can trigger a migraine. Talk to your doctor before you start a new diet or take any new medications, including vitamins, herbs, and supplements.

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