How Effective is Combination Therapy for Migraine Management?
Last updated: September 2023
The quest for effective ways to manage migraine disease for me has been long and progressive. In the early days of my seeking treatment, I was inexperienced. I knew what migraine attacks were, but I underestimated the pervasive reach of this disease.
How did my quest for migraine treatment begin?
I foolishly looked at treatment options as a 'one and done' solution. My doctor was also not an expert in headache disorders, nor did he want to be bothered by a guy with "just a headache." I quickly learned all I could about migraine disease, where to go for treatment, and how to get the best treatment possible. I stumbled frequently, but my wife was there to lift me and advocate for me. This bumpy start began the process of building a treatment plan with multiple pieces.
What was the focus of my first treatment plans?
Looking for a magic bullet to eliminate my migraine attacks was futile. Looking back now, I can see how silly that notion was. This was not a cold, virus, or broken bone. This disease needed a strategic plan to help me manage its many facets. My headache specialist is a great help in finding suitable therapies to combine to help me manage this illness, and my body has proven resistant to various treatments. But we never give up. Like most on this journey, I started mainly focusing on drug therapies. Hundreds of drugs can be used to treat migraine. Some are meant explicitly for migraine, whereas others were not, but they were found to be effective for some people. The combinations seemed endless to me. It took many trials and failures before finding a few beneficial drugs.
How do combination therapies work for me?
Just like my triggers stack up to cause a migraine attack, the pieces of my combination therapies help to prevent and lessen the effects of my attacks. I don't need to use every component of my combination therapy to help during an attack cycle. Sometimes I can succeed in using two or three parts; other times, I may need four or more.
What therapies are in my treatment plan?
My primary therapies are drugs, neuromodulation, mindfulness, meditation, chiropractic, TENS, supplements, and stretching exercises. The medications that are effective for me currently are Emgality, Nurtec ODT, Zofran, acetazolamide, and Namenda. The neuromodulation device I use is Nerivio. I use a mindfulness app called Aura. Chiropractic care is specialized with adjustments done using actuators vs manual adjustments by an Orthogonal chiropractor. My TENS unit is a basic two-channel device that helps with my neck and shoulder muscle tension. I have targeted my supplements based on blood tests. These include vitamin D3, CoQ10, magnesium glycinate and L-threonate, and B2. My stretching exercises are based on physical therapy recommendations, yoga, and pilates.
Has my combination changed over the years?
The variations of combination therapies are vast. Since migraine disease is so individualistic, finding a combination that is right for you is an exciting process. It is like creating a migraine playlist that helps me manage migraine and its symptoms. It also allows me to pick and choose which pieces work best for me over time. Over the past thirty years, my migraine disease has morphed many times. Aspects of therapy that were once effective are no longer benefiting me. Migraine disease is a lock that has reprogrammable combinations, in my case.
What medicines and treatments do you use to help manage your migraine disease? Let's discuss our different combination therapies in the comments!
In the past year, has insurance made it difficult to get your migraine treatment?