Finding the right migraine treatment plan is the Holy Grail of migraine medicine. However, there are times when it feels as full of problems as an Indiana Jones adventure.

Migraines, like those who suffer them, are not the same across the board. Subtypes, lifestyles, reactions to medications, and other obstacles can create frustration when you and your healthcare provider attempt to move forward in treating your migraines.

There are steps you can take to smooth your way to better health and find the right treatment plan for you.

Start with the Right Diagnosis

The reason you suffer migraines entails several factors:

• Your nerve pathways and brain chemicals
• Your genetics - there is a strong genetic component to migraines
• Environmental factors

Finding the way through this maze makes diagnosis and treatment a little tricky.

Different subtypes of migraines matter to the diagnosis as well:

• Migraine with aura
• Migraine without aura
• Chronic migraine
• Episodic migraine

Before treatment can begin, your physician needs to know precisely what is happening with you. The first steps include accurately communicating various components of your migraine experience, such as frequency, severity, level of disability, and the presence of vascular disease.

Your doctor may ask several questions:

• How quickly do attacks peak?
• How many are morning migraines?
• How many attacks are already full-blown by the time you seek a solution?
• Do you become nauseated, and how bad is it?

Answer these questions to the best of your ability. Doing so provides a map for the best way towards the most effective treatment plan. 

You can help by keeping a migraine diary to organize your experiences and symptoms. Be sure to keep track of:

• The frequency of your migraines - how many headache days a month do you have?
• The severity of the migraine - how badly does it hurt? How severe are your nausea and other symptoms?
• Duration - how long does each migraine last from the start of symptoms to the end of pain?
• Any drugs you took to relieve the symptoms, including the dosage.
• Any triggers you have identified.

For women, noting your menstrual cycles can benefit your diagnosis.

Treat Your Migraine Attacks Early

Early treatment is the key to stopping a migraine. As soon as you feel the onset of pain and recognize an attack, you should begin your treatment regimen. 

Unfortunately, by the time you realize you have a migraine, your digestive system may be paralyzed. Anything you take may just sit in your stomach without relieving your pain. At worst, nausea may cause you to vomit the medication before it takes effect.

Another issue is over the counter medications that may contain a migraine trigger, like caffeine. A hidden trigger exacerbates your problems by prolonging your pain or causing another migraine.

You and your headache specialist should determine other methods of relief in these cases.

How to Develop a Treatment Plan

If you have at least four headache days a month, getting a plan together is of the utmost importance. You and your physician may need to combine three approaches.

• Acute treatment, also called abortive treatment, stops the attack as it begins. 
• Preventative or prophylactic treatment reduces the number of attacks and reduces intensity. It may prevent the onset of future attacks.
• Complementary treatment for those migraineurs who want to avoid medication. Also, such treatment can be used safely with medication.

Complementary treatment includes changes in lifestyle to help you avoid triggers and maintain your health. It may consist of alternative substances to traditional medications.

Some patients prefer this pathway because they don’t tolerate certain medications well or want to avoid unpleasant side-effects. They may be allergic to a medication. Perhaps they can’t remember to take the drug on schedule. If the migraineur is pregnant or trying to get pregnant, medication might not be a good idea. Others may have an underlying medical condition that precludes certain drugs.

When starting oral medications, take it slow. Your doctor will start you on a low dose to determine if you experience side-effects and how severe they may be. You will be able to tell if the treatment is working. Depending on your reaction, your physician slowly increases the dosage to find the optimum for you.

When Treatment Fails

Migraines are tricky to treat. Your healthcare provider should help manage your expectations of the effectiveness of any treatment plan you undertake. Expecting the migraines to go away entirely unfortunately isn’t realistic.

However, you may be able to reach a 50% to 75% decrease in headache days or intensity. When you hold reasonable expectations, acute medications work better. You will have a reduction in the time migraines disrupt your ability to function.

Turn any failure into success by following proper headache hygiene. Avoid your triggers, get plenty of rest, and eat properly. Pay close attention to your symptoms so you can describe them to your healthcare provider. Update your migraine diary to help organize these symptoms and other elements of your migraine experience.

Communicate regularly with your headache specialist. As with any chronic health issue, your provider is there for a long-term journey. Regular updates help your physician track how well your treatment works and adjust it when necessary.

In your headache diary, be as specific as possible with the start and end times of your migraines, the medications you take, including the dosage and frequency, and the response you had to treatment.

A migraine diary helps uncover patterns that can lead to better treatment. It's also a useful tool for finding triggers and identifying effective lifestyle changes such as exercise and nutrition.

Tell your provider exactly how your migraines affect your life. Are you missing work? Are you not able to care for a child? What important life events have you missed due to migraines? Your physician needs to know how your migraines impact the things most important to you.

The goal of treatment is to relieve pain and restore function. Without knowing the details, your headache specialist is shooting in the dark. Be a full partner in developing your treatment plan. Communicate openly and regularly with your doctor, keep a diary of your migraines, including what may have triggered one, and let the doctor know exactly how migraines impact your life.

Finding the right migraine treatment plan is not without its difficulties, but with the right information and a little patience, you can find the right plan for you.