Frequently Asked Questions about migraine

It’s common for migraine to change over time. It often improves as you get older. But many people can experience a worsening of symptoms at some point in their lives, even with no obvious trigger. If you are concerned about changes to your symptoms, it‘s worth speaking to your GP to review your treatment plan.

Yes, it could be. It’s possible to have a migraine attack without head pain. This is sometimes referred to as a ‘silent migraine’. You may get the symptoms of aura – such as visual disturbances, numbness and tingling – without getting a headache. We have more information about migraine with aura.

Migraine attacks usually last between four hours and three days. While not common, an attack can sometimes continue for longer than three days. Sometimes, attacks can go on for as long as a few weeks. This is referred to as a prolonged and persistent migraine, or ‘status migrainosus’. If your usual treatments are not working and your migraine is continuing longer than three days, contact your GP or specialist for advice. In severe cases you may need to go to A&E.

If you are getting frequent headaches, it can be difficult to tell if your symptoms are due to migraine or medication overuse headache (MOH). MOH is when you get frequent headaches as a result of taking painkillers and triptans too often. Regularly taking painkillers or triptans on more than two days a week can increase your risk of MOH. It’s important to seek advice from your doctor if you are getting frequent headaches, or if you are needing to use acute medicines more often. They will be able to assess whether you may have MOH.

There is no best treatment for migraine. It will depend on your own situation what works best for you as an individual. You may need a combination of treatments. These can include acute treatment to stop or shorten attacks and preventive medicines to reduce the number of attacks. It can often be trial and error trying different medications to find the best treatment for you.

You may find it helpful to take acute medicines to stop or reduce symptoms of a migraine attack. They include simple painkillers like paracetamol and ibuprofen, triptans, and anti-sickness medicines. Acute medicines are most effective when you take them at the start of a migraine attack. Talk to your doctor or pharmacist about the most appropriate medicine for you.

As well as taking pain relief medications, there are lots of other things you can do that might help. These include applying heat or cold packs to your head, making sure you are drinking enough fluids to keep hydrated and eating little and often. It can also help to do some gentle exercise every day.

There are several different forms of magnesium supplement. It can be worth trying different types to see if one works better for you. It’s difficult to say which one works better for migraine as no studies have looked at this directly. But different types may suit different people better. Check with your GP or pharmacist before starting supplements so they can make sure it is safe for you. We have more information about magnesium on our supplements.

It can take up to eight weeks for preventive medicines for migraine to start working, and up to 3 months to see the full benefit. However, not all preventive medicines will work for everyone. Your doctor will monitor you to see whether your medicine is helping to reduce how many migraine attacks you get. If it doesn‘t help, your doctor may suggest increasing the dose or trying a different treatment.

It’s unlikely that your doctor would currently prescribe you gepants and CGRP mAbs at the same time. This is due to a lack of evidence on how well this combination works, or how safe it is. If you are taking either one of these medicines and they are not helping, talk to your doctor. They may suggest trying a different medicine, or combining it with a different type of preventive medicine.

Your doctor will advise you what migraine medicines are safe for you to take. But there are no known interactions between triptans and gepants or CGRP mAbs. This means these medicines are usually considered safe to take together. You will usually need to carry on taking acute medicines for migraine, even if you are taking a preventive like CGRP mAbs or gepants.

Generally, if you have migraine symptoms, a brain scan is not needed. This is because migraine does not show on a scan and it will not help with a diagnosis. A scan is usually only needed if you have certain symptoms that could suggest another cause. If you are concerned about your symptoms, discuss this with your GP. They will assess you and advise whether they think any further investigations would help. We have more information on getting a diagnosis for migraine.

Most people with migraine can be cared for by their GP. But there are several reasons why your GP may refer you to a headache clinic or neurologist. These include if you have complications, unusual symptoms, or there is doubt about your diagnosis. Your GP may also refer you if treatments they have prescribed haven’t helped. Different areas may have different criteria about referral. You can discuss this with your GP.

If you feel your GP is not being helpful, you can ask to speak with the practice manager or request an appointment with a different doctor. If necessary, you can file a complaint about your GP service. Ask the surgery for their complaint’s procedure. Your local Healthwatch can help with making a complaint.

If you are unable to access treatment you think you are entitled to, the Patient Advice and Liaison Service (PALS) at your hospital may be able to help. If they are unable to resolve the issue with the hospital, they can help you raise a formal complaint.

Migraine can have a huge impact on wellbeing. Trying to find a treatment that works is very challenging for many people. This can add to feelings of anxiety and stress. Many people with migraine find emotional support helpful. This may include counselling, cognitive behavioural therapy (CBT) or other psychological approaches. Watch our YouTube session to find out more about the impact of migraine on mental health and coping mechanisms that may help.

You can access mental health services through the NHS. There may also be local charities in your area that offer free counselling sessions. If you are looking to book private counselling, use the British Association for Counselling and Psychotherapy (BACP) or Counselling Directory registers to find a qualified therapist. You can also get mental health support from professionals via Qwell, and for children via Kooth.

Certain foods may appear to trigger migraine attacks for some people. Common food triggers people identify include cheese, red wine and chocolate. Foods containing monosodium glutamate, nitrates or tyramine have also been suggested as triggers. But this isn’t the same for everyone. And it’s unlikely that any one thing will trigger migraine on its own – it’s usually due to a combination of factors.

The best way to identify any potential triggers is to keep a note in a headache diary and see if you notice any pattern. It’s also important to note that that skipping meals, irregular eating, or a poor diet in general can all have a negative impact on migraine. You may find it helps to make sure you are eating regularly, with healthy snacks available throughout the day.

Migraine may be defined as a disability under the Equality Act 2010 if it fulfils certain criteria. It must have a ‘substantial’ and ‘long-term’ (more than 12 months) negative effect on your ability to do normal daily activities. Whether your migraine is classed as a disability will usually depend on how frequent and how severe your migraine attacks are. A report from your doctor or an occupational health practitioner can help to decide whether your migraine is a disability.

If your migraine is classed as a disability, it means you are legally protected from discrimination. It also means your employer must also consider reasonable adjustments to support you in the workplace. These can include changes in the workplace to reduce triggers and changes to your role. Your employer may also agree to disregard a certain amount of sickness absence related to your migraine. It may help to ask for a referral to an occupational health service for an assessment.