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What to do when nothing’s working for your migraines

Everyone knows that there will occasionally be that killer migraine that doesn’t respond to treatments that usually works for you, but what do you do when your usual treatments just aren’t working for your usual migraines? When nothing seems to be helping or your treatments aren’t working anymore, it’s time for a reassessment.

Review your headache pattern

Using a migraine diary, like the one on this site, start keeping track of your migraine episodes and all the medications you’re using — both prescription and over-the-counter. Over time, your headache pattern can change and those treatments that may have worked well for the type of migraines you got when you were 20 may not work as well for migraines during middle age.

You might also discover that you’re using medications more than you thought. Keeping a diary is a great way to make sure that you’re not using your acute migraine medications (like Excedrin or the triptans) more than just a couple days each week. When people begin overusing these medications—even when it’s “just” over-the counter medications like Tylenol or Excedrin—you can develop medication overuse headaches. Medication overuse headaches typically don’t respond to taking more medication. Also, overusing acute migraine therapies can prevent other treatments from being effective.

Review your medications

Write down a list of everything you take for your headaches to review with your doctor—prescription drugs, over-the-counter therapies, and nutritional supplements and herbs. Sometimes, a bad combination of therapies keeps individual treatments from working well. Other times, the drug dosing is wrong.

You should also review what you used in the past for your migraines to see what might be worthwhile trying. Often when patients tell me, “My doctor told me I tried EVERYTHING for my migraines and nothing helps,” it turns out that they tried a couple blood pressure medications and six different antidepressants, but there are still a lot of classes of medications they haven’t tried.

Review your other health problems

Sometimes treatments stop working because you have other health problems causing symptoms that also need to be treated. Headache is one of the most common symptoms for medical conditions and can be caused by infections, anemia, hormone problems, autoimmune problems, etc. If your treatments stop working or you have tried a few standard migraine therapies and they really don’t make a difference, see your doctor for a complete physical to make sure nothing else is going on.

Also, be sure to let your doctor know about other pain problems you may be having. I’ve learned to never let patients tell me, “Well, I do have other pain problems, but I’m just here for my headaches.” If you have widespread pain from fibromyalgia, for example, you probably get migraines, too. And if your doctor tries to treat your migraines separate from your other fibromyalgia symptoms, you probably won’t get a lot of relief. Do you also have problem low back pain? The imbalances in the spine joints and muscles from your back can affect your head and neck muscles and shouldn’t be ignored.

Get a fresh look

If you and your healthcare provider have stalled with what do to next—take a break and get a second opinion. A fresh look often brings up new ideas that haven’t been tried. Even we doctors who consider ourselves to be headache experts send our own problem patients to our colleagues for another opinion. A new perspective can often be very helpful. So don’t be afraid to ask for a second opinion when you and your doctor are getting frustrated.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Tammy Jo Walker Thomas
    8 years ago

    I’m so tired. Just so tired of hurting all the time. I feel I’m at the end of my rope. I’m only 38, but I’ve had these migraines for 29 yrs. I’ve tried so much and nothing has been working for the past couple of years. Its basically just trying to get through each day, each week, and each month.

  • Kathy Jo Horton Bishop
    8 years ago

    I too have been through everything, meds, herbs, vitamin supplements, elimination diets, low tyramine diets….you name it my body does not respond to most meds in a favorable way…and even PT made matters worse….I’m pretty much out of options……I have no life…. my families life is impacted severely by my chronic migraines…

  • Terry Stage
    8 years ago

    Just read some of the blogs, I have tried just about every thing also. I’m now getting botox injections The first time it was wonderful I had no migraines at all, it was then that I realized how much they effect ones life. Last month I received my third injection (given every 3 months) My migraines have come back. My neurologist gave me samples of Surmavel DosePro needle-free injections I have not tried them after receiving an injection for nausea and Surmavel at which I was in bed around 5:30 pm and didn’t wake up until around 7 am. I have a family to take care of. But I’m going to use it tonight because I can’t get rid of the migraine I have had all day. It has been over a month now with out being without a migraine. I very tired.

  • Dominique Forti
    8 years ago

    I live in Paris, and just read this article. Agree, totally useless, anyway, the whole medical profession is useless, all those drugs are useless. I have 20 migraines a month, I’m fighting not to take triptans, I am on oxygen (useless), I take Anti inflamatory tablets, I have a diary, and it depresses me even more. I cannot take treatment for migraine anyway cause I took so much of all those stupid drugs that I have closed angled glaucome on each eye. They talk bullshit all day long, the truth is that they have no solution but to let us suffer. I just have my eyes left to cry now and wonder why I survived my cancer, if it is to keep on suffering like that. The drugs firms just recicled their crapy drugs to make more sale that’s all they do, but at the end of the day. WHERE ARE THE TREATMENTS?

  • Jenni Shadford
    8 years ago

    Was hoping for more from this article but it’s all the usual advice.

    Has anyone here tried coloured lenses? I read an article today about potential benefits for those who are photophobic, either triggering or symptoms. Would be interested to hear experiences…

  • Cindy Bonderoff
    8 years ago

    i am trying colored L(yellow) glasses for use on the computer but nope has not helped.

  • Kathy Jo Horton Bishop
    8 years ago

    do you a astigmatism? reason I was asking cause flourescent lighting like in commercial buildings can trigger a migraine…I’ve found that sunglasses and colored lenses are my best friend…the colors that have worked the best for me..blue the deeper the color the better and some of the gray colored almost black lenses and a few of the brown but I’ve found that any amber colored lenses actually make things brighter I hope this helps….

  • Lisa Murrey Brown
    8 years ago

    I have no relief either I am going to the best Drs around at the Cleveland Clinic Headache Clinic I am now trying botox injections however they are every 3 months I am in severe pain before it is time for my next dose, I do think the injections have helped as far as the pain but I still get the migraines….One thing I have that I have not seen or I have missed on here…I have a growth on my Pineal Gland they are calling a cyst since it has not grown since it was found in 03… I have read up on it and Drs say its not the cause of my headaches but nothing is helping and have read people who have them removed their headaches go away… my cyst is 1.3 cm x 1.5 cm x 1.3 cm they say it is too dangerous to just go in and remove it unless it is growing…I have it monitored by a nuero-oncologist….

  • jbinsley77
    7 years ago

    Lisa- I too am getting Botox injections. mine don’t last the full 3 months either. they work about 2 months or so give or take. I also have cluster headaches and my neuro gives me a set of injections when my botox wears off in my neck- nerve blocks and that carries me over. they hurt much worse than any botox shot, and I can’t work the rest of the day but it’s worth it. Not sure if your insurance will cover it for just migraines or not.

  • Lisa Murrey Brown
    8 years ago

    Christine Knackstedt I think they are just saying these cysts can’t cause the migraines b/c they don’t know…it’s a shame…yeah I don’t want to have brain surgery but if it could take my migraines away….I would…I am sooooo tired of the pain nothing works, when I get a migraine I am down for 2-3 days…if not more…and that is outside my daily headaches…no need to be sorry vent away…I can explain to my friends what it is like but they have no idea how bad it really is…only someone who suffers them can understand….

    Do you have your cyst monitored to see if it grows? I was told if it does grow I would have to have it removed b/c it could cause encephalitis and if it does grow there is more of a chance of it being cancer….I think they are wrong and I think this is what is causing my pain…nothing helps…what if it is b/c of this growth…they wont listen…they dismiss it as if i told them i bumped my head on the car when i got in it…maybe someone should listen…ohhhhh well …. It is hard to work and go to school and take care of my family…but I try…

  • Christine Knackstedt Fortino
    8 years ago

    Lisa, I too have a Pineal Gland cyst, found in 02. When my migraines starte. I am now 42 & get them.at least 15 -20 days of the month. And much like everyone has said, this article was useless..I have also researched having. It removed. Have tried every med in the last 10 years. On disability, cant work full time. It has ruined my”life as I knew it” cant plan for any special events because I may get a migraines, I am engaged to the sweetest man in the world but we cant even set a date. I do that moving from PA a year ago to FL, they have gotten much worse. This should be a happy time in my life, but NO because of the migraines. Sorry for venting so long, but at least we know how we all feel on here.

  • Barbara Byers Hand-Pitts
    8 years ago

    I have been having migraines like crazy since I have had Bell’s Palsy I had 1 when I got BP so I went to the ER and they did a CT scan and nothing showed up. but I have had a migraine every day or every other day since I can not get in to see my Dr till the 28th… I have had 26 in 6 weeks.

  • Dee Forster
    8 years ago

    Yes this article was clearly written for a beginner migraineur. I have been to 16 doctors over the past few years and tried 26 different medications and so many procedures with no relief. I just keep getting worse. Going to a headache clinic this week to be evaluated by a team of doctors so I’m hoping they can help.

  • Cindy Wallace Holt
    8 years ago

    Dee what clinic did you go to? I live in Northeast Tn and there aren’t any headache clinics close by. I went to the chiropractor today, and of course he promised he can get rid of migraines. I wanted to say yea right! But right now I’ll try anything. It’s been a very rough week, I’ve had a migraine everyday. I’ve broke down and cried several times which isn’t me, but there comes a time you think Lord I can’t take it any more! I’ve tried almost everything!! Seeing another neurologist but getting the same from him….have you tried? and ? and ? and I say yes I’ve just about tried it all doctor! I know there is Hope out there I just have to find the right doctor and the right treatment for me. God has made me a very strong person and I refuse to let migraines bring me down! God Bless each and everyone of you!! It’s such a blessing to talk to others and read your blogs about your experiences with migraines. Hang in there!

  • Kim Alchin Barnes
    8 years ago

    I’m in the same boat only haven’t been to so many dr’s cause I know they won’t be able to help me, as I’ve had no luck with any in 14 years. Did you have any luck with the team of doctors Dee?

  • Pamela Curtis
    8 years ago

    Heh… I *have* been through nearly everything. I’ve been on every attack aborting/preventing/holistic/what name you (http://migraines.org/treatment/treatctm.htm). I was a part of the Occipital Nerve Stimulator study. Headache diary? How about a study prescribed PDA with full scientific tracking and PET scans to boot? How about two surgeries to test and install the device?

    I really wish this article had been written with us in mind, instead of being a teaser for the same-old-same-old.

    There are some of us out here on the edge where that title is absolutely true and the doctors have told us, “I have nothing left for you.” I’ve heard that half a dozen times now. But new drugs come to market, new research comes to light, new therapies are discovered….

    Sure, a lot of people exaggerate in what they’ve done for their treatment. But that doesn’t mean everybody does. There are plenty of us out there who are holding on to hope because that’s all we’ve got. We don’t need Headache 101. We need the advanced answers.

    What a disappointment.

  • Pamela Curtis
    8 years ago

    Paulette Young – have you tried the occipital nerve stimulator? That’s what finally fixed my daily migraine.

  • Paulette Young
    8 years ago

    I’ve been there also. Not sure what is left for me, well I do have ideas, but the medical field won’t be of help.

  • Kristin Dieng
    8 years ago

    I agree with Pamela as well. I’ve read this same Migraine 101 article a million times and appreicate this website because it’s geared towards those of us with chronic migraines that everyone else seems to ignore. We’re sick of people telling us “have you tried putting ice of your head?” “or have you tried feverfew?” We are the ones that have literally tried it all, in my case are almost suicidal with pain and depression (how do I possibly continue working so my family can keep paying its bills AND be a wife AND be a mother to 3 sons AND withstand the pain itself???) when the drs have nothing else for us?

  • Vondalee Smith
    8 years ago

    I agree Pamela. I have been on everything, I went to UCI for a long time. After numerous doctor and specialists, I was sent to Pain Mgmt and only after upping and upping meds did I finally have come relief from my chronic daily headaches and recurrent migraines. I was on a fentanyl patch and 3 percodans a day, and I was still in the ER about 2 times a month for breakthru migraines. But I couldn’t live on all of that medicine anymore, plus my meds for bipolar & anxiety, while I was working full-time, taking care of 2 teenagers and my grandfather. This article was useless!

  • Erin Fleming Block
    8 years ago

    I was in the same place you are Janice. I had been to three different neurologists, two pain management Dr’s, an acupuncturist and a sleep specialist. We did find that I have sleep apnea which was causing me to wake up with full blown migraines. But it still wasn’t completely helping. My primary Dr. put in a special request with my insurance to see a neurologist at UCSD (We’re in San Diego). And this neuro, being at the collegiate level who also spends half his time conducting research and writing articles, really knows what he’s doing. He knows all the latest treatments and even told me that some of the meds the other neuros had me try wouldn’t have worked anyway because they were meant for my types of migraines. So if there is a way to get in with a Neurology Department at a clinical or collegiate hospital, they may be more able to help you. Good luck and keep pushing your Dr.

  • Janice Worden Lamb Clemens
    8 years ago

    I am beyond frustrated with the medical profession. I have seen 2 neurologists who have tried numerous medications which have not given me any relief other than prednisone. I cannot stay on a steroid as I know what it does to bone health.(I am a nurse). I went back to my primary doctor in the hopes that he would understand what I am going through with these migraines. (He is a friend and also my employer). He pretty much blew me off. He said if the neuro couldn’t help what did I think he could do for me, I also cannot afford to go back to the neuro as our health insurance has changed and the co-pays are higher. My primary says it is all stress related as well as arthritis in my neck and he reallyhas no answers for me. I said fine then I would go off all my meds except the blood pressure med and the thyoid med, as those I have to stay on. Now my headaches are just getting worse and worse and I am getting more frustrated.

  • Cindi Moyer
    8 years ago

    Cindy Wallace Holt – your story matches mine. Just started nerve blocks, but they aren’t much help. My good days are better, maybe? Also on Klonipan for sleep! Too “funny” as I read that you are going to a chriopractor… I was thinking about that!!! I have some arthritis in my upper back/neck that might help but I doubt it but thot I’d give it a try. You never know what might work for a season. Thanking God His mercies are new every morning and prayerful some breakthru will happen for all of us!

  • Terry Stage
    8 years ago

    Cindy Wallace Holt I understand how you feel, I too have gone through what you have. I’m now going to Knoxville Neurology Specialists my doctor there is a very caring doctor.

  • Janice Worden Lamb Clemens
    8 years ago

    I am so glad someone actually understands what I am going through…but unfortunately the closest migraine specialist is 4 hours away, which I would willingly go see except they are not in network for my insurance, and right now I cannot afford to the expense to go and then pay out of pocket . My husband got laid off right before christmas due to his health problems, he has hep C and is currently going through the treatment for it, so it is all we can do to keep our heads above water with our bills. So when I can afford to go I will until then I guess I will do what I have been doing, living with the headache everyday…thank you to all that offered me the suggestions though..god bless and happy new year……. Jan

  • Cindy Wallace Holt
    8 years ago

    Kristin Dieng, you are blessed to find a migraine specialist. I am still searching for one that isn’t too far from where I live (northeast Tn) near Gatlinburg Tn. I’m in so much pain tonight, so I have been researching everything I can find on the internet about migraines. There has to be something out there to help me! What migraine meds do you take? Right now the only thing I have is Toradol, zanaflex, and the neurologist put me on Klonipan to help with sleep. I was taking amtriplyine but that didn’t do anything. I’ve done the botox injections, DHE iv treatment, Nerve blocks, now going to a chiropractor. Have taken imitrex, maxalt, relpax, zomig, frova, topamax, zonegran, midrin….my list goes on and on! I pray one day there will be a cure! God Bless! Cindy~

  • Kristin Dieng
    8 years ago

    I agree with Teri. I soent 10 years seeing neurologists. Often they simply read through their medical books and test medicine after medicine on you. They don’t know anything about migraines. They’re well meaning. but not experienced. You need a headache/migraine specialist. I have found that they often have big egos and so often aren’t the friendlist, easiest people to deal with, but they DO know how to help you better than anyone else. I don’t want to give false hope, as I still suffer from chronic migraines and haven’t found the right medicine sto help me, but I’m in a LOT better shape with migraine specialists than I ever was with regular neurologists.

  • Teri Robert
    8 years ago

    I hear you and well understand your frustration, Janice. I’m not even sure how many neurologists I saw over the years without any of them being helpful. When I started researching Migraine online, I discovered that neurologists aren’t necessarily Migraine specialists, BUT there are Migraine specialists. The true turning point for me was making the decision to see a true Migraine specialist even though he was an eight-hour drive away. He helped me take control and get my life back. Take a look at http://migraine.com/blog/is-it-time-for-a-new-migraine-doctor/ Hang in there. There really IS hope!

  • AbsolutelyNew
    8 years ago

    Here’s a proven drug-free headache treatment: http://www.absolutelynew.com/content/products/headache-reliever. Was developed by a leading neurologist and headache expert (in partnership with Absolutely New Inc.) and people love it!

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