ANNOUNCER: Many migraine sufferers are using alternative treatments to prevent and alleviate their migraine attacks.
ALEXANDER MAUSKOP, MD: We usually combine non-pharmacological approaches, alternative therapies, and medication. So we will start with the behavior modification, biofeedback, regular exercise, dietary factors can play a role, maybe supplements such as magnesium, riboflavin, feverfew.
ANNOUNCER: Changing in lifestyle is one approach that can reduce the frequency of migraine episodes.
ALEXANDER MAUSKOP, MD: One of the most effective treatments for prevention of headaches is changing your behavior and learning how to relax.
JULIA SAMTON, MD: The number one trigger for migraine headache is stress and anxiety. So, oftentimes, I will really try to educate people about stress reduction, which can involve many different behaviors, one of which is exercise. We recommend a half an hour of aerobic exercise a day, which is a great stress reducer.
PAUL-HENRI CÉSAR, MD: Other lifestyle adjustments you can make are things like posture, how you sit at the computer, taking breaks, making sure you are relaxed when you're typing, driving, things like that. Because sometimes neck pain can play into migraines, and patients will often find that, when they're having neck tension, that they'll have migraines triggered from that.
ANNOUNCER: Diet can also play a part.
MARK W. GREEN, MD: When we talk about migraine, we're talking about someone who has an excitable brain and is more sensitive to change than other people. So we talk about keeping things constant. When we talk about caffeine, we say, "Don't have too much caffeine, but keep the same dose every day."
PAUL-HENRI CÉSAR, MD: Diet can affect migraines because there are certain foods that trigger migraine, including chocolate and sandwich meat, MSG, which is also called "natural food flavoring." So those can trigger migraines and make them come more frequently, if you don't realize it's a trigger and you continue to eat those foods.
ANNOUNCER: Studies have shown that non-drug alternatives may also be effective for some people in the prevention of migraines.
PAUL-HENRI CÉSAR, MD: You have to remember that even herbal treatments have their side effects and more isn't always better. So it's reasonable to add them to see if they help, but just to remember that they can cause side effects, and it's important to tell your doctor that you are taking them.
ANNOUNCER: Although not FDA-approved for migraine treatment, botulinum toxin, known as Botox, has also been shown to be effective in the prevention of migraines.
ALEXANDER MAUSKOP, MD: It's extremely safe. The only drawback, at times, is the cost, because insurance companies sometimes will not cover it.
ANNOUNCER: Alternative therapies such as biofeedback, acupuncture and physical or massage therapy can also help prevent migraine attacks.
JULIA SAMTON, MD: What I truly encourage my patients to do, that there's very good data for, is biofeedback, because that is a legitimate way that others learn to mediate their response to stress and anxiety.
ALEXANDER MAUSKOP, MD: Acupuncture is an ancient treatment that's been shown to be effective for the treatment of pain in a very scientific way, in many, many studies. So acupuncture is quite effective, especially for people who do not tolerate or do not want to take medications.
PAUL-HENRI CÉSAR, MD: Physical therapy can be helpful sometimes. Sometimes massage therapy, some patients get benefit from. So they have a role in both acute and preventive for migraines, especially if patients have chronic migraines that are poorly treated by the medicines or they're sensitive to medications. These are almost their only option and it's really learning about having to live with the migraines and that the migraine is not controlling you, but you're controlling them as best you can.