I’ve had only a few rare migraines and the occasional mild headache over the years, so I consider myself lucky. But several close friends and family members have struggled with severe migraines for many years and are still searching for the holy grail of cure. Headaches and migraines are often the reason why people seek me out for help when their conventional care isn’t working or the side-effects are worrisome. So, I’ve been very motivated over the past 15 years to research treatment strategies in the field of natural medicine to help my patients. My experience, in a nutshell, has been that it’s not a one-size-fits-all approach but one that will be tailored to the individual and needs to be flexible over time to provide maximum support for those using medication and others who are trying to manage without.

Headaches versus migraines

There’s considerable disagreement about what differences exist between headaches and migraines. Headaches can be felt in different areas of the head, they can have different qualities from dull to sharp to pulsating, etc. Some are considered tension headaches, others cluster headaches. They can be brief, intermittent or long-lasting. They may be caused by a wide variety of internal and external triggers, from postural misalignment to food and chemical sensitivities—not to mention possible side-effects of medications. Migraines usually include headaches, they can also be triggered by a wide range of factors or circumstances, and they may include visual, auditory and olfactory auras. Some people experience migraines without headaches (rare) that include auras and nausea & vomiting and other disturbances of the autonomic nervous system. Migraines are often considered a more severe form of headache disorder.

Conventional medical treatments

Your medical doctor or pain specialist will mostly focus on trying several different classes of pharmaceutical drugs with you, some to abort the onset of migraines, some to prevent migraines more longterm, and some to address other health issues that are suspected causes. These drugs include acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs), often available over the counter. Many people will try these drugs for headache relief even before talking to their primary care physician. While they are available without prescription, they are not benign drugs and you should not use them on a regular basis without consulting your physician.

Prescription drugs used to treat headaches and migraines include beta-blockers, drugs like sumatriptan/naproxen, and ergotamine. Antidepressant, antiseizure and antispasmodic drugs (such as Botox) are also used at times. The latest class of drugs, only recently approved by the FDA for the treatment of migraines, is called calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), a promising yet prohibitively expensive new strategy including the drugs eptinezumab, erenumab and fremanezumab.

Holistic strategies

Whether or not pharmaceutical interventions are working for you—or even an option for you, it is worthwhile to also consider natural approaches to help you feel better and reduce your need for drugs. This includes a search for triggers and reducing your exposure to them once identified. Stress management can play an important role. And botanicals, nutraceuticals and physical medicine, including acupuncture, bodywork and therapeutic exercise, should also be explored.

Herbal therapy promotes better functioning

Chinese medicine has been used to relieve pain for millenia. It provides a sophisticated framework for diagnosing and treating different manifestations of headaches. Chinese medicine is a holistic medicine, which means that we don’t look at your headache or migraine in isolation but in the context of your whole body-mind health and life circumstances. Based on this comprehensive analysis, we can use simple or complex prescriptions to address your pain and constitution concurrently. This is called a root-and-branch treatment.

Acupuncture relieves pain and restores balance

Acupuncture has been researched extensively in the last several decades for its therapeutic benefit for headache and migraine sufferers. The evidence is so compelling that it should be offered to everyone before pharmaceutical management is even considered. Numerous research studies evaluated in a 2009 Cochrane review, as well as several large German trials, have had the effect that acupuncture is now being promoted even by conventional neurologists and pain specialists in Germany. Acupuncture can improve the functioning of the autonomic nervous system and promote production of endorphins, the body’s natural pain killers. It has many other benefits that we don’t yet fully understand. To obtain maximum benefit from acupuncture, expect to receive treatments at least weekly for 8 to 12 weeks, followed by regular monthly maintenance visits.

Manual therapy releases blockages

A wide range of manual therapies can be of value, especially if the functioning of your musculoskeletal and fascial systems is compromised. These therapies range from commonly available massage and chiropractic to more specialized approaches like Eastern bodywork, trigger point or craniosacral therapy, and myofascial release techniques. Some of these techniques can be learned and practiced by patients in a simplified form. This promotes regular self-care and prolongs the benefits of care provided by a therapist.

Lifestyle medicine is the foundation

I often feel that addressing lifestyle choices should be the first step in the healing process. Lifestyle refers to different aspects of your daily living. Are you sleeping well and enough so that you feel rested and energetic during the day? Are you exposed to a lot of air and noise pollution or other toxins? Are you surrounded by healthy, caring people or do you experience a lot of social stress? How about your eating habits? That’s a complex, foundational topic! Are you drinking alcohol, smoking or taking recreational or prescription drugs? How about your exercise habits? Your mental-emotional well-being? The list appears to be endless. Yet, it’s important to be diligent and comprehensive to find out what needs to be changed in your life. It can be very helpful to do this investigation in partnership with your holistic doctor so that you leave no stone unturned and can prioritize your strategy.

Talking it over

People often feel better just from talking things over. They realize that they’re not alone with their problems and health challenges. Find health care providers who will listen to you and think creatively. Surround yourself with caring friends and family. And talk with others in similar circumstances, online or in person, to learn more about their trials and tribulations so that you can be inspired to search for the best approach to relieve your own headaches and migraines.

© 2019 Christiane Siebert