Earlier this year, the Migraine World Summit was held for 2025. This year there were again, several presentations from a variety of people, mostly doctors and researchers, updating the audience on the latest in migraine understanding. I confess this year was a little disappointing given so much of the material was placed behind a paywall. The 30-minute videos that were available for free, for example, chewed up a lot of time introducing, advertising, then farewelling the presenter and their subject, so there was really only 20 minutes of advice per episode. That said, there still was some really interesting material which I’ll summarize over the next few months.
Perhaps one of the simplest but most interesting presentations I watched was the one in which Dr Thomas Berk ran through the reality of strange treatment options, and what tends to work (and what doesn’t) when it comes to treating migraine pain.
The interview started with a general introduction, noting that many “cures” are circulating the internet, including placing cold peas on your neck whilst your feet are in hot water (I’ve written about it before here), or putting raw onion on your forehead (!?). Dr Berk noted that this sort of information can trivialize the pain that migraine patients suffer, because it doesn’t recognize the reality of how hard it can be to budge the pain, and it can make you feel guilty that you aren’t able to simply help yourself out of the situation and hurry up and heal.
Whilst acknowledging that there’s no shame in saying you’ll “try anything” to get better (I nearly had the palate of my mouth massaged – but my gag reflex was too strong!), he noted that many of the “solutions” online were not helpful, scientific, or based on medical advice. Even more subtly, he noted that not all doctors are created equal. Whilst they might be trying to help, not all of them specialize in migraines, so even highly trained practitioners (chiros and physios etc) might not understand some of the underlying biological aspects of migraine. He even went so far as to suggest the average general practitioner receives only a small amount of headache-related training at university, and as such, many are using out-of-date advice when treating their patients.
Dr Berk’s main advice on whether to follow the suggestions of people online is to check their qualifications first, be skeptical if they receive financial kickbacks from selling other people’s products or are touting their supplements as the ONLY solution, look for testimonials, or better yet, scientific data to back up their claims. Whilst there can’t be randomized control trials for every possible migraine approach, many reputable approaches HAVE been tested – so check if the proposed solution is one of them.
Lastly – trust your intuition… does this REALLY make sense to you???
That said, Dr Berk acknowledged the mind is a powerful thing. The “placebo effect” is real. Some people can heal because they believe they are being treated in a way which will allow them to heal. Perhaps hope alone can reduce stress and improve the vagal nerve condition, which in turn might reduce migraine pain.
When asked what his pet peeve migraine-hack was, Dr Berk replied “putting your feet in hot water” – whilst it is a comforting thing to do, the vascular theory of blood vessels getting dilated and pulling blood from your head to your feet is a 25+ years out-of-date approach to migraines. We now believe that migraines are an inflammatory condition that can cause dilation in the brain, but tricks with hot water are no longer supported by science.
[Disclaimer – this is a good place to remind you I am not a doctor or researcher – I am only repeating my own understanding of what I discover – please speak to a trained professional to make sure that you get the right advice, relative to your own unique condition.]
Perhaps one of the most interesting asides, was potentially also the riskiest to share. Dr Berk and the interviewer discussed if there was such a thing as a “migraine cocktail” that could be used to break a particular nasty migraine attack. He replied that a combination of magnesium, electrolytes, antihistamines and anti-inflammatories could help. He mentioned some brand names, but they were probably from the USA as I didn’t recognize any of them – sorry. He also wasn’t clear about dosages, or whether you take them all at once or in a particular sequence.
[Disclaimer – AGAIN – don’t follow medical advice from anyone other than your own doctor who knows the details of your condition and the other medications that you are currently taking, as mixing medicine can have negative consequences.]
In terms of general over the counter things that could help, Dr Berk suggested aromatherapy (lavender and peppermint) because it helps with inflammation and is soothing. Ice-caps worked for some people, not, he said, because they shrink blood cells or change blood flow, but because they acted as a distraction through the new sensation. Topical muscle-creams helped for a similar reason. And lasty, ginger for nausea is another option.
The interviewer then ran through a list of treatment suggestions that are often floating around and asked Dr Berk to give a 0 to 3 rating for each one, with 0 being no help at all, and 3 suggesting there was some truth to it being useful in reducing migraine pain. I’ve reordered the answers from 3 to 0 to give some clarity to the list:
- Bio-feedback – 3 – low risk with great evidence it helps through guided breathing, meditation, relaxing, reduced heart rate – highly recommended as a treatment option.
- Antihistamines – 3 – helps, but be careful about other conditions, and don’t try to drive a car after taking the tablets [um… hello… can I suggest you shouldn’t be driving a car whilst suffering a migraine attack?!?]
- Blue light filters – 3 – we know that blue light upsets migraine patients, so orange lenses can help – but make sure they are real glasses, not just tinted plastic lenses. Alternatively, look at using screen protectors, or adjusting the setting on your devices.
- Ginger – 2/3 – if you can tolerate it, it can be helpful combatting nausea.
- Cola – 2 – helps and doesn’t hurt – used for hydration and caffeine (so long as you aren’t having extra caffeine elsewhere as too much can trigger / worsen a migraine.)
- Motion sickness wristbands – 2 – there is some anecdotal evidence that the acupressure helps the vagal tone, and there is no harm trying.
- Menthol gel – 2 – it does have some anti-inflammatory value, and the spearmint essential oils they often use can help from an aromatherapy point of view.
- Salty food – 2 – eating during an attack is not as helpful as drinking due to nausea. Getting the salt via electrolyte drinks is a preferable approach, but yes, salt can help.
- Massage – 2 – this can help those with muscle tension and can help relax you overall and encourage deep breathing, however it’s not for everyone and sometimes issues such as pinched nerves are the cause of the migraine and massage may make it worse.
- TENS units – 2 – Transcutaneous Electrical Nerve Stimulation units can help people who have muscle-tension related migraines. For many people, it acts as a form of massage.
- Daith piercing – 1 – looks cool and may make you feel better, but there is no science behind it.
- Ear seeds – 0/1 – without knowing for certain what chemicals or hormones are in them, they could cause more harm than good.
So then, any last comments? A couple. One is, if your friends and family offer advice which sounds a bit dodgy to you, (but you know it’s coming from a place of care and concern), then reply “thanks, I’ll mention it to my doctor” and then follow it up with your doctor if you’re interested. Dr Berk also reminded the listeners that misinformation is everywhere. Social media is a tricky place to look for answers to something as complex as migraines. As a minimum, consider hanging out in migraine community chats (or blogs!) where real people with real lived experience are comparing notes. Your best bet, however, is to listen to doctors who specialize in headaches and migraines; “there’s rarely anything NEW out there, so we can tell you about what exists and what is likely to work for you.”
Lots to think about.
[If you’re curious about which items on the solution list I’ve tried and am a fan of: ginger and menthol gel are my go-to items on this list, and mindfulness is my version of biofeedback.]
Take care taking care people, and know that I’m sending love, whether you’re wearing an ice-cap or a piece of raw onion on your forehead, you do you (safely),
Linda xox
PS – You can read more about migraine misconceptions over on Neurahealth.co with Dr Berk discussing the issue with Migraine Meanderings a year ago: Dispelling Migraine Myths: Insights from Dr. Thomas Berk’s Conversation with Migraine Meanderings.
PPS – One of the first blog posts I ever wrote was about receiving (un)solicited advice for migraines and how you can imagine yourself as either a ‘spongey-camel’ or a ‘colander-duck’: https://themindfulmigraine.blog/2024/02/19/unsolicited-advice-for-migraines/
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