Over-the-counter and prescription medications can ease migraine and other types of headaches, but complementary and alternative treatments may help, too.
Stress can lead to some of the most common types of headaches, including migraine and tension headaches. So scientists have studied alternative treatments that aim to lower 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. Here’s what you need to know.
Electromyographic (EMG) Biofeedback for Migraine
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 for Migraine
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 for at least 3 months, 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 is not FDA-approved 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
- Back of your head
- Upper back
It may be a couple of weeks after the first shots before results show up.
Stress Management for Migraine
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 may help ease headaches and lessen 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 for Migraine
Some 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 start to get better.
Acupuncture for Migraine
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. But research is ongoing to see if any effects last more than a year.
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 for Migraine
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 for Migraine
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 for Migraine
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 for Migraine
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 for Migraine
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 for Migraine
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:
Feverfew is 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 from the American Academy of Neurology in 2012. But they reversed this recommendation in 2015 after concerns about liver toxicity came up. 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. Some small studies suggest that coenzyme Q10, magnesium, and the B vitamin riboflavin may help lower the number of migraines. Foods rich in omega-3 fatty acids have also been linked to a decrease in the number of migraines.
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 and Essential Oils for Migraine
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. Do not use undiluted essential oils on the skin, because they can burn or irritate. Some people may also have an allergic reaction to the oils. And never consume essential oils, nor put them where children or pets can get to them.
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.
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. It can irritate or burn. 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.
Traditional Chinese Medicine for Migraine
Traditional Chinese medicine (TCM) has been used for centuries. Chuanxiong is the most common herb used in TCM for the relief of headaches. There is some research that suggests it’s effective.
Reflexology for Migraine
Reflexology is a type of massage where a therapist applies pressure to your feet. The idea behind it is that pressure to certain spots on your foot will relieve pain in other areas of your body. Reflexology may ease stress, help you relax or sleep better, and relieve pain. A small study showed that women with migraines who had reflexology treatments twice a week for 5 weeks had less frequent, shorter, and less intensely painful headaches.
Foot Baths for Migraine
Soaking your feet in a warm bath sounds relaxing. But does it ease or prevent migraines? One study showed that people with chronic migraines who soaked their arms and feet in hot water, followed by an ice massage on their heads, and took headache medications every day for 45 days had less frequent and less intense headaches, compared to people who took only medications to treat their headaches.
Caffeine for Migraine
Are you worried that your morning cup of joe or afternoon cola break will trigger a migraine? In fact, a little caffeine can ease pain for some people. Caffeine is used in many over-the-counter headache and migraine medicines. Don’t chug coffee to prevent headaches, though. Your body could go through caffeine withdrawal, which could lead to a headache later on.
About 20% of people with migraines say foods and drinks are a headache trigger. If you think caffeine sets off migraines for you, try cutting it out for a while to see if things get better.
Headbands for Migraine
In one small, older study, people with migraines wore a snug headband that applied pressure to areas of their scalp. The headband eased migraine pain 87% of the time. But when people removed the headband, their migraine pain steadily came back.
Cold Caps for Migraine
This gel-filled cap fits snugly on your head and chills your scalp. In one recent small study, half of the people who used it felt some relief from migraine symptoms in only 25 minutes. The other half felt nothing and had to take a pain medicine to treat their headache.
Diet Changes for Migraine
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.