Cedars-Sinai Blog

What to Do When You Feel a Migraine Starting

Black male holding his forehead suffering a migraine headache.

If you’ve had a migraine, you know just how debilitating the pain can be. You may feel like you’d do anything to make the pain go away—and stay away.

But you don’t actually need to do anything drastic. Some simple steps can lessen the blow of migraine symptoms. And a few lifestyle changes may help you reduce the frequency and severity of migraine headaches.    

If migraine symptoms continually interfere with your usual activities, you may need specialized care, says Dr. Nasima Shadbehr, a neurologist at the Cedars-Sinai Headache Clinic, which offers patients a comprehensive evaluation and targeted treatment. Dr. Shadbehr shares additional insight into migraines below.

Nasima D. Shadbehr, DO

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“Often, people may feel afraid to take medications for migraines, but medications can lose their effectiveness if you wait too long to take them.”

What is a migraine?

A migraine is a type of headache that causes a pounding or beating pain. The pain is typically on one side of your head. It can last for several hours or even days. Your migraines may be so intense that they disrupt your usual activities.

Signs a migraine is starting

Head pain is the main migraine symptom. But you may also have other symptoms, such as nausea or sensitivity to light. Often, these symptoms start a few days or hours before you develop a full-blown headache. When you notice these symptoms early, you can take steps to prevent migraine symptoms from worsening. 

Prodrome phase

Some people experience a prodrome, or “pre-headache,” phase up to several days before developing a migraine. During this period, you may have:

  • Difficulty concentrating, reading or speaking
  • Fatigue
  • Food cravings
  • Increased urination
  • Light or sound sensitivity
  • Nausea
  • Sleep disturbances

Aura phase

Up to one in three people who experience migraines also experience aura symptoms. Aura is a term for a group of symptoms that occur before or along with a migraine headache. These symptoms can include:

  • Dizziness
  • Weakness
  • Ear ringing (tinnitus)
  • Numbness or tingling
  • Speech changes
  • Vision changes, including blind spots or seeing bright flashing lights or wavy lines

Aura symptoms can sometimes mimic the symptoms of a stroke, and it is important to seek emergency medical care when experiencing new neurological symptoms. It is also important to talk to your neurologist to better understand migraine aura symptoms and how they can differ from stroke symptoms.

What to do when you have a migraine

If you experience migraines, it’s important to see a neurologist who specializes in headache disorders. A headache specialist can diagnose the type of headache you have and prescribe medications that help control or lessen your symptoms.

When you feel a migraine coming on, the most important thing to do is take your prescribed migraine medication as soon as you notice migraine symptoms, even during the prodrome or aura phases. Don’t wait until you have a pounding headache.

“Often, people may feel afraid to take medications,” notes Dr. Shadbehr, “but medications can lose their effectiveness if you wait too long to take them.”

After you take your medication, try to:

  • Drink lots of water
  • Lie down in a dark, quiet room
  • Take a small amount of caffeine
  • Use an ice pack or heating pad on your neck, shoulders or forehead

Can I prevent migraines from starting?

You can’t always control or predict whether you’ll get a migraine. But you can take some steps to prevent migraines.

“Avoid overusing your medications throughout the month,” Dr. Shadbehr explains. “Try not to take your over-the-counter medications more than 10 days a month to prevent rebound headaches.”

Rebound headaches are caused by medication overuse. When the pain-relieving effects of medicines wear off, your headache comes back. If you’re experiencing migraines more than a few times per month, speak with a headache specialist. They may recommend alternative treatment options to help you avoid medication overuse.

You may also stave off migraines with healthy habits. Try to:

  • Avoid skipping meals
  • Drink plenty of water
  • Exercise regularly, incorporating strengthening and stretching exercises
  • Maintain good posture to prevent neck and shoulder tension

Sleep at least eight hours a night with consistent bedtimes and wakeup times

Keep a headache diary

Dr. Shadbehr explains that it’s helpful to keep a log of your migraine symptoms so you can identify your triggers.

“About 20% of people, for example, have food triggers such as red wine, cheese or nitrates,” she says.

A headache diary keeps track of the details around your migraines, such as:

  • What you’re doing when migraines start
  • How long migraines last
  • What helps provide migraine relief

Over time, you may notice patterns in your migraine diary. Maybe you experience migraines after eating certain foods or during certain times in your menstrual cycle. Finding your migraine triggers can help you avoid some of them.  

How does stress affect migraines?

Stress is a major migraine trigger for many people. It’s nearly impossible to avoid all stress, but healthy coping techniques can help lower your stress. Try to:

  • Adopt a positive mindset
  • Manage your time with to-do lists, and let go of less important tasks 
  • Participate in hobbies you enjoy, such as painting, hiking or playing a musical instrument
  • Practice deep breathing or meditation for 10 to 15 minutes a day
  • Take regular breaks throughout the day

Visit a therapist or other mental health professional if you need extra support managing your stress or mental health

Schedule an appointment

It can be challenging to find solutions to your headaches. If you experience migraines and haven’t found relief, the Cedars-Sinai Headache Clinic can help. Led by skilled and compassionate headache specialists, the clinic offers a full range of advanced treatment options to help you get back to the activities you love.