Dr Clare Bailey: How to head off the pain of migraines

I love the Christmas period – carol singers, putting up the decorations, the kids coming home. But it’s also a time when stress and alcohol levels are high and we are surrounded by indulgent treats – all of which can be triggers for migraine sufferers. Being left incapacitated for hours or days with a throbbing headache is not what I call festive fun.

Dr Clare Bailey migraines
Sally Caulwell

Migraines often start in childhood and affect one in five women and one in 15 men: six million people in the UK. Anyone with migraines will tell you that it’s not ‘just a headache’. Symptoms include a moderate or severe throbbing pain commonly on one side of the head, often with extreme sensitivity to light and sound, plus nausea and vomiting. It can also affect the way people think, giving a ‘brain fog’ which makes everyday life difficult. Sufferers often have to lie down in a darkened room away from light or sound until the migraine passes. They normally settle fully between attacks, but you may be left feeling tired for a few days afterwards.

Anyone can get a migraine but some people are more vulnerable than others: they have inherited genes which make it easier to switch on their ‘migraine machinery’. The causes of migraines are thought to involve temporary changes and inflammation around the nerves in the lining of the brain. Treatment usually includes catching them early and taking simple painkillers such as ibuprofen. Anti-sickness medication can also help. Speak to your pharmacist for advice about suitable over-the-counter treatments.

For severe attacks your GP may prescribe triptans, which reverse the changes and inflammation in the brain, lessening the pain and cutting short an attack. However, frequent use of any painkillers can cause headaches, so doctors recommend not taking them for more than ten days per month.

See your GP for advice on treating menstrual and hormonal related migraines. For attacks that happen on more than 15 days a month over three months, your GP may advise taking regular medication to prevent them, such as propranolol or amitriptyline. It helps to know your triggers, such as stress or disrupted sleep.

Headache specialist Dr Richard Wood recommends patients identify their triggers, which may include…

  • Stress (a major one).
  • Sudden changes, disrupted sleep, bright lights, loud sounds, extreme weather changes, intense physical activity, changes in routine or mealtimes (including skipping meals).
  • Certain foods, alcohol and caffeinated drinks.
  • Rising blood pressure or hormonal imbalances (such as the run-up to your period, or the menopause).
  • Dehydration, smoking, medications such as oral contraceptives.

More ways of managing migraines include…

  • Losing weight: research shows that migraine symptoms lessen with weight loss if you are overweight.
  • Keeping a diary with the time and date of the attack, the symptoms, their severity, how long they last, what you ate, medication or vitamins, your sleep pattern, menstrual cycle, exercise and treatment.
  • See more at migrainetrust.org

A prescription for an unlikely bestseller

I am reading The Prison Doctor, written by my friend Dr Amanda Brown, who used to be a GP in the community before taking her stethoscope behind the walls of some of the UK’s most notorious prisons. It has become a surprise bestseller, written with both humour and deep concern for the lives of her incarcerated patients.

It’s a poignant, compassionate read, giving an insight into the complicated and damaged lives of some of the offenders, alongside their need for someone to listen to them and be kind. Stories emerge of self-harm and personal crises.

Amanda is so unassuming that I had no idea what a challenging and amazing job she does, without judging. She also brings to life the community of extraordinary and committed people who work with her. A thoroughly enlightening and engaging book.

The Prison Doctor is published by HarperCollins, price £8.99

If you have a question you would like answered, email drclarebailey@you.co.uk