The Risk of Inadequate Migraine Treatment

Under-treating or over-treating migraines can lead to more frequent headache days.

Treating migraines the right way is a key step in helping you avoid more frequent migraines in the future.

Updated on February 14, 2023

If you experience migraines, you probably know how important it is for your sense of well-being to treat them as quickly as possible. But it’s not only important that you treat your headaches; how you treat them matters, too. Treating migraines the right way is a key step in helping you avoid more frequent migraines in the future.

Episodic versus chronic migraines

Episodic migraines involve anywhere from zero to 14 headache days per month. Chronic migraine entails having 15 or more headache days per month. Chronic migraine affects roughly 3 percent of people in the United States, and an estimated 3 percent of people who have episodic migraine see their headaches turn into chronic migraine each year.

Even if your migraines aren’t considered chronic, you can still bear a hefty burden of pain and impairment, according to a 2021 study published in the journal Headache.

The study examined factors including pain intensity, disability, and impairment across numbers of headache days. People with 7 or fewer headache days per month had significantly lower disability and pain scores that those with 24 or more headache days per month. But those who had 8 to 14 headache days per month (still considered episodic migraine) and those who had 15 to 23 headache days (considered chronic migraine) had no significant differences when it came to the intensity of their pain, the way in which their pain interfered with their lives, and the impairment of their activities. Although people at the higher end of the episodic migraine range may have similar pain and impairment to many people with chronic migraine, they may not be getting the type of treatment they need.

Downsides of ineffective treatment

People who experience episodic migraines may reach for over-the-counter (OTC) rescue medications to help ease each episode. This may seem like the easiest way to handle the pain, but the approach can sometimes cause rebound headaches.

Similarly, people may find over time that their go-to medications, whether prescription or OTC, don’t have the same effect they once did, leading them to use more of them. This overuse of medication can contribute to the development of chronic migraine.

Getting effective migraine treatment 

So what is the right migraine treatment? The answer isn’t simple. No two people and no two migraines are the same. There are some commonalities, however, in all successful migraine treatment programs. These approaches include the following:

Know—and manage—triggers. Because migraines affect people in different ways, it’s important to be familiar with how they affect you personally. This includes knowing what triggers your migraines, getting enough rest, and keeping stress levels low.

It also means being your own advocate. Keep a migraine journal to track your pain and speak to your healthcare provider (HCP) about the symptoms you’re experiencing.

Be proactive. One of the best ways to treat your migraines is to stop them before they start. As soon as you realize a migraine may be in the forecast, attempt to head it off. Make sure you take all prescribed medications before the pain becomes too debilitating.

Understand your options. There is no one specific migraine treatment that’s right for everyone. But knowing which options are available to you, whether it’s medication, natural remedies, or even Botox, can help you craft your personal treatment plan.

Build a team. Whether it’s friends and family, a neurologist, primary care physician, or counselor, make use of the supportive people around you. They can help keep you on track and be there on days when the migraine pain sidetracks you.

The bottom line

A migraine treatment plan is as unique as you are. To avoid both under- and overtreating your migraines, consult with an HCP. Discuss how often you have migraines, how much they affect your daily life, and how to most effectively treat and manage your migraines.

Article sources open article sources

American Migraine Foundation. Common Types of Migraine and Related Symptoms. December 5, 2018.
Cleveland Clinic. Chronic Migraine. Last reviewed on July 16, 2019.
May A, Schulte LH. Chronic migraine: risk factors, mechanisms and treatment. Nat Rev Neurol. 2016;12(8):455-464.
Ishii, R, Schwedt, TJ, Dumkrieger, G, et al. Chronic versus episodic migraine: The 15-day threshold does not adequately reflect substantial differences in disability across the full spectrum of headache frequency. Headache. 2021;61:992-1003.
National Institute of Neurological Disorders and Stroke. Migraine Information Page. Last reviewed January 20, 2023.
Andreou AP, Edvinsson L. Mechanisms of migraine as a chronic evolutive condition. J Headache Pain. 2019;20(1):117. Published 2019 Dec 23.
American Migraine Foundation. Headache Journals: Tracking Your Migraine. May 2, 2019.
Medline Plus. Migraine. Page last updated May 5, 2021.
American Migraine Foundation. Why You Need a Migraine Support Network. May 24, 2018.

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