Complementary and Alternative Therapies for Migraine Treatment

Primary Steps for Primary Care | October 3, 2019 | cookchildrens

Migraine is a common reason for referral to pediatric neurology. Very often, lifestyle modifications such as improved sleep, regular exercise, adequate hydration and avoidance of migraine triggers can reduce the frequency of migraines. For some, despite these measures, migraines continue to occur many times per month and require further treatment. One approach to treatment includes daily medications used to prevent migraines from occurring. Reasonably, people with migraines frequently ask for complementary and alternative treatment options that do not include prescribed medication and there are fortunately many such options available. These options include, but are not limited to: nutraceuticals (vitamins), essential oils, massage therapy and acupuncture. However, scientific research regarding the effectiveness of these treatments is limited, therefore, many providers will recommend using these treatments in combination with traditional therapies, general healthy habits and biofeedback therapy. Below is a summary of the current evidence for several of these alternative therapy options.

Nutraceutical Therapy (Vitamin supplements)

Research does show the following vitamins to be helpful in prevention of headaches:

Riboflavin/Vitamin B2
Coenzyme Q10
Magnesium

Please discuss dosing recommendations with your neurologist, as dosing may be different dependent on age and weight.

Migrelief™ is an over the counter supplement that contains both magnesium and riboflavin. It can be obtained from online retailers, but again, discussion on dosing with your medical professional is recommended.

Research does not show any consistent data regarding butterbur or feverfew, though both are commonly reported to provide some efficacy for migraine prevention.

Essential Oils

Lavender is the essential oil studied the most for migraine. Research does show that lavender inhalation can be used to prevent headaches and also treat headaches when they appear. The method used for inhalation in these studies was to rub two or three drops of lavender oil on the upper lip or below the nose and inhale it's vapor. Inhalation for 15 minutes at the time of a migraine attack was shown to provide relief, and inhalation for 15 minutes daily was shown to help prevent headaches.

Acupuncture

There have been many research studies involving acupuncture in the treatment for headache. Studies have not shown that it is effective for headache treatment, however acupuncture has been difficult to study consistently due to the varied techniques and approaches. For this reason, acupuncture may be part of an alternative treatment strategy, but effectiveness, treatment approach, and frequency and duration of therapy are not well defined.

Massage Therapy

Research shows that massage therapy is helpful in preventing headaches and improving sleep. The research studies have used weekly to twice weekly massage to the neck and shoulder muscles, with treatments lasting 30 minutes.

Daith Piercing

This is a piercing located in the innermost cartilage fold of the ear. There have been no research studies to convincingly demonstrate the benefit of this piercing as a treatment for migraine. There has been an online survey, which showed that 47% of those who received the piercing had improvement in the frequency of headaches and 50% of those who received the piercing had improvement in the severity of headaches, though these studies are at risk for bias.

Keep in mind that the location of the piercing is at very high risk for infection.

It is important to discuss openly with your medical provider all treatment options. It is particularly important to discuss these complementary methods of treatment so you understand the known risks, the unknown risks, and the potential benefits so you can choose the treatments best suited for your unique condition.

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References:

Schoenen, Jean, Jacque, Jean, and Lenaert, M. “Effectiveness of high‐dose riboflavin in migraine prophylaxis: a randomized controlled trial.” Neurology 50.2 (1998): 466-470.

Sândor, Peter S., et al. “Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial.” Neurology 64.4 (2005): 713-715.

Peikert, A., C. Wilimzig, C., and Köhne-Volland, R. “Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study.” Cephalalgia 16.4 (1996): 257-263.

Sasannejad, Payam, et al. “Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial.” European neurology 67.5 (2012): 288-291.

Rafie, Shahram, et al. “Effect of lavender essential oil as a prophylactic therapy for migraine: a randomized controlled clinical trial.” Journal of Herbal Medicine 6.1 (2016): 18-23.

Cascio Rizzo, Angelo, et al. “Daith piercing in a case of chronic migraine: a possible vagal modulation.” Frontiers in neurology 8 (2017): 624.

Paolini, Brielle, Granetzke, Laura, and Erwin Wells, Rebecca. “Complementary and Alternative Approaches to Chronic Daily Headache: Part II—Manipulation-Based Therapies and Other CAM Therapies.” Chronic Headache. Springer, Cham, 2019. 253-272.

Linde, Klaus, et al. “Acupuncture for migraine prophylaxis.” Cochrane Database of Systematic Reviews 1 (2009).Lawler, Sheleigh P. and Cameron, Linda D. “A randomized, controlled trial of massage therapy as a treatment for migraine.” Annals of Behavioral Medicine 32.1 (2006): 50-59

Lawler, Sheleigh P. and Cameron, Linda D. “A randomized, controlled trial of massage therapy as a treatment for migraine.” Annals of Behavioral Medicine 32.1 (2006): 50-59.