Palliative Care and Treatment for Migraine

Migraine has been a very common disease for the present time. So, in this article, we have provided complete information about palliative care and treatment for migraine.

Trepanation is a technique that had been used in ancient times for the palliative care and treatment of headaches and migraines. In this process, the physician drills a hole in the skull of the patient. It was a belief that this will cause the infected blood to drain out of the head. Consequently, alleviating the pain. However, the procedure was invasive and the results were not as expected.

Up to now, it is clear that some of the headaches do not have a definite underlying cause. Hence, we can treat them easily with over-the-counter painkillers. Migraine is a type of pain involving either the left side of the head or the other. The duration of migraines varies from person to person. It might last for 3 hours in one person or take a couple of days to resolve in the other. Fortunately, we do not need any invasive procedure to get rid of it. But first of all, let’s have a look at the types and causes of headaches that you can encounter.

Types and causes of headache:

1. Primary headache:

The exact cause of pain is unknown in a primary type headache. In other words, we can deduce that the headache is the problem itself. 

2. Secondary headache:

In a secondary headache, the underlying cause is different. We can only treat this by eliminating the main problem. 

Pathophysiology of migraine:

Headache can be triggered by a number of stimuli. They include loud noise, stress, work overload, certain strong fragrances, high-intensity lights, bad sleeping patterns, underlying infections, and consuming substances that can disturb the brain’s activity. All these triggers can cause a change in the firing rate of neurotransmitters. These chemicals are bound to noci-receptors present in the blood vessels of the brain. These receptors initiate an inflammatory process leading to swelling and inflammation.

As a result, the person might suffer from intense pain at one side of the head called migraine, or cluster headache occurring around the eyes, or pain in the back of the head making it tender, or tension headache in which the pain localizes on the head occupying band like area. 

A headache in which there is throbbing, pulsatile pain occurring on any side of the head, and not involving the full head is a migraine. It can be accompanied by an aura. An aura can be visual, sensory, or speech disturbance. This might persist for almost 40 minutes before headache. However, some people experience migraines without aura. In such patients, migraine accompanies severe pain which aggravates by physical workouts. Hypersensitivity towards light and sound are also features of migraines without aura. It is an observation that women are more prone to migraines than men. 

Symptoms of migraine:

The symptoms of migraine have been classified into 4 stages. However, this point is to be kept in mind that these stages might be absent in some individuals.

1. Prodromal stage:

This phase is characterized by restlessness, mood changes, cravings, and yawning.

2. Aurora stage:

There are flashes of lights or odd sensations accompanying this phase.

3. Headache stage:

This phase is the main phase where there is an aching sensation on one side of the head occurs.

4. Recovery phase:

It is the time in which one recovers from the symptoms of migraine. The patient feels tired and experience mood changes in this period.

The time interval of these symptoms differs in different individuals.

Palliative care and home remedies for the treatment of migraine:

Based upon the causative factor, the treatment of migraine can be sorted easily. If the migraine is secondary, eliminating the major cause can cure the headache, however, the primary headaches can be complex and they need a proper diagnostic procedure prior to moving towards a treatment. The palliative care options and remedies for treating migraine are below;

  • Staying and trying to sleep in a dark quite room can help in reducing the noise and intense light and hence, can help in alleviating the pain.
  • Avoid the triggers that initiate migraine.
  • Make a journal and record about the time and factors that were present at the prodromal stage.
  • Use OTC painkillers such as ibuprofen or aspirin to reduce the pain.
  • Talk to your doctor if none of the above steps help.
  • If you are encountering with headache for more than a week, consult a health care professional as soon as possible.
  • Take proper and regular meals. Note that a healthy diet is essential for fighting with any underlying disease.
  • A good workout hour reduces the chances of ongoing migraine attacks. But in most of cases, it is for prophylactical use only, because migraine elevates with exercise.
  • Fix your cad sleep schedule and try to get 6 to 8 hour of sleep daily.
  • Meditate to reduce the chances of stress related headache.
  • Take painkiller in the initial stage or prodromal period.

Prescription medications:

The treatment for Migraine attacks is following:

  1. Nonspecific painkillers:
  2. NSAIDS: These include OTC medications such as aspirin, ibuprofen, ketorolac, naproxen.
  3. Anti-emetic medications: they are given to individuals in which migraine is accompanied with nausea and vomiting. Emesis can lead to poor absorption of NSAIDS o migraine relieving medications, that’s why anti-emetics(prochlorperazine) are not good for long durations.
  4. Migraine specific medications:
  5. Triptans: the medicines block the chemicals that initiate inflammation and swelling in the vasculature of head. They include rizatriptann, eletriptan and almotriptan. However, patients having cardiovascular problems should avoid them.
  6. Ergot alkaloids: ergotamine is an ergot derivative that alleviates migraine pain. This is available in the form of sublingual tablets. Another ergot derivative used for this purpose is dihydroergotamine.


These medications might have certain side effects or might not be suitable for some patients. Hence, it is necessary to consult a healthcare professional before taking them.

Prophylaxis of migraine:

Treating an ailment before its commencement, or preventing it is prophylaxis treatment. These medicines can help reduce Migraine:

  • Propranolol
  • Anti-depressants
  • Anti-convulsants

When to see a doctor:

Migraines can be an indicator of any underlying disorder. Sometimes, strokes are related to migraine pain. The symptoms include numbness of arms or legs along with migraines. In such a case, you are in need of a medical emergency.

Take home note: 

Headaches can affect the quality of life to a great extent and they can result in significant healthcare costs. However, they are treatable and preventable. In case, you are experiencing a migraine, you can take measures to alleviate it by limiting yourself from triggers. OTC medicines can be a good treatment for acute migraines. If the pain still persists, it is an indicator that you might need to consult a doctor.

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