You can do certain things that do not involve medications. Others involve techniques employed by trained practitioners. Many different kinds of "nonpharmacological techniques" are available, including behavioral and physical treatments.
- biofeedback therapy
- relaxation training
- cognitive-behavioral training (also known as stress-management training)
- cervical manipulation
Biofeedback therapy: Biofeedback is a technique where people learn to gain control of their body's internal functions. Specifically, biofeedback involves learning to sense changes in the body's activity, and using relaxation and other techniques to control the body's responses.
Biofeedback requires specific training sessions with a trained biofeedback therapist. This training usually takes one to two months of weekly 30-45 minute sessions, although many books and audiotapes are available to teach these techniques at home.
Biofeedback is monitored by measuring skin temperature and muscle tension. Changes in skin temperature and muscle tension indicate the level of activation of the patient's nervous system. Learning to control body functions, such as body temperature, is achieved by first learning to relax the skeletal muscles (muscles that support the bones). This relaxation is achieved through relaxation, visualization, and breathing techniques. Most important, though, is the daily practice of these techniques. The practice sessions can be only a few seconds or minutes long, but they need to be done frequently. A conscious effort is required in the first few weeks of training, but gradually, self-monitoring and very brief relaxation techniques become a subconscious habit.
Biofeedback allows many headache sufferers to lower tension throughout the body, which results in fewer headaches. Children adapt especially well to biofeedback training. They can often learn to prevent a headache in four to five sessions, and also they can learn to stop the headache once it begins.
Biofeedback therapy may be coupled with relaxation therapy. Relaxation therapy teaches a variety of relaxation strategies for reducing tension and stress throughout the body.
Cognitive-behavioral training (also known as stress-management training): This technique often is done with the help of a psychologist, psychiatrist, or other therapist. This training focuses on teaching migraine sufferers coping skills and other "cognitive" (thinking) strategies for managing stressful parts of their life.
Hypnosis: Hypnosis is now being studied in clinical trials for treatment of a variety of conditions including pain management. Little has been done so far about its use in preventing migraine.
Acupuncture: The ancient method of acupuncture recently received a boost in popularity because of the consensus statement released by a panel convened by the National Institutes of Health.
This statement strongly suggests that acupuncture is in fact a legitimate therapy proven to be effective for some conditions, and acupuncture deserves additional studies for other conditions.
The panel concluded that nausea and acute dental pain clearly respond to acupuncture. Many painful conditions, including headaches, may respond to acupuncture, but additional studies are needed.
Acupuncture treatment is done using very thin disposable needles, which cause very little discomfort or pain. For patients with chronic headaches, treatment involves 10 or more weekly 20-minutes sessions.
Electric simulation of the needles is frequently used instead of the traditional manual twirling of the needles. Issues of cost, convenience, and patient preference should be taken into account when deciding whether to try this mode of treatment. Some insurance plans may cover this form of therapy.
Massage: Many migraine sufferers have tight, stiff, tender muscles in the back of the head, neck, and shoulders. If you feel these muscles, they often have tight bands or knots that are tender to pressure. Pressure on these points in the muscle may cause pain in the head, which is similar to the pain of a migraine. These points are often called trigger points. Massaging these trigger points can reduce the pain and tightness in the muscles and can decrease head pain and migraine in some sufferers.
Massage therapy is a healthy maneuver to reduce stress and tension. Its value in treating migraine, however, is not fully determined. Massage initially can be done once to twice a week for 4 to 6 weeks. Stretching and strengthening exercises should be continued even after therapy sessions have ended. Massage techniques can be taught to a spouse or significant other.
The likelihood of behavioral techniques working as preventive treatment for migraine depends upon appropriate training and discipline for the person using the technique. Headache sufferers must be willing to try these techniques and must be committed to maintaining the training programs designed by technicians and other professionals in order for them to be successful.