Why toughing out a migraine attack is a bad idea

When you struggle with migraine attacks or a combination of migraine attacks and headaches, you may have a hard time deciding whether to take medication when pain hits.

Most of the time, the best choice is to treat the problem as soon as possible.

People have different reasons for putting off medication. Maybe they just don't like taking medicine because it may be only partially helpful, or they don’t like the side effects. Or, often, people who live with migraine are repeatedly told that taking too many medications will result in “rebound” headaches, also called medication-overuse headaches.

But there are good reasons to avoid the temptation to tough it out.

Why you shouldn’t tough out a migraine attack

Many of the “rescue” medications, or medications that are taken once an attack hits, work better the sooner you take them. This is particularly true for migraine-specific medications, like triptans and newer treatments.

They tend to be more effective when they're taken early in the migraine attack. If you don't take the medication right away, it can become difficult to get the attack under control, and an uncontrolled migraine headache can spread like a wildfire.

At times, this can lead to something called central sensitization, which causes the entire scalp to hurt and creates hypersensitivity to the environment. In some instances, it can affect the whole body. This happens because the trigeminal system in the brain, which supplies nerves throughout the head, gets triggered during an uncontrolled migraine attack.

Rebound headaches and migraine medications

If you take rescue medications more than 10 days a month, you can start to get medication-overuse or rebound headaches. This can happen with both over-the-counter and prescription pain medicines, such as triptans and opiates.

That doesn’t mean you shouldn’t treat your migraine headaches. You just should be treating them differently. Well before you hit that limit, you should seek out care from a neurologist or your primary care doctor to talk about preventive medication, better rescue medication or both.

The most important thing is to recognize when migraine headaches are making a significant impact on your life and get help to control them. If you’re having four or more migraine attacks per month, it’s time to start thinking about a new approach.

Do you have migraines with vomiting, or is it cyclic vomiting syndrome?

What if I’m unsure whether I’m having a headache or a migraine attack?

Headaches and migraine attacks have different symptoms. But if you suffer from both, you may be concerned that a headache will turn into a migraine attack. If you’re having just a few headache days per month, you can take something each time. But if the number’s climbing toward that 10-per-month threshold, and you’re having to consider medication each time, you should be on preventive treatment.

Non-medication options for treating migraine

Though they can be expensive, several devices help control migraine pain by stimulating different nerves in the brain, head or upper neck. Available are Cefaly, Relivion, gammaCore, Nerivio and transcranial magnetic stimulation devices.

Other options for relief include essential oils, such as peppermint or lavender rubbed into the temples or behind the neck, massage techniques, acupuncture, and heat or ice.