Non-pharmacological points for patients and healthcare professionals

MIGRAINE MANAGEMENT — Migraine is a highly prevalent disorder with an enormous burden on societies. Different types of medications are used for controlling both acute attacks and prevention. This article reviews some non-pharmacological recommendations aiming to manage migraine disorder better and prevent headache attacks. Different triggers of migraine headache attacks, including environmental factors, sleep pattern changes, diet, physical activity, stress and anxiety, some medications, and hormonal changes, are discussed. It is advised that they be identified and managed. Patients should learn the skills to cope with the trigger factors that are difficult to avoid. In addition, weight control, management of migraine comorbidities, lifestyle modification, behavioural treatment and biofeedback, patient education, using headache diaries, and improving patients’ knowledge about the disease are recommended to be parts of migraine management. In addition, using neuromodulation techniques, dietary supplements such as riboflavin, coenzyme Q10 and magnesium, and acupuncture can be helpful. 
Non-pharmacological approaches should be considered in migraine management. Furthermore, the combination of pharmacological and non-pharmacological approaches is more effective than using each separately.

CONCLUSIONS
Non-pharmacological approaches are gaining popularity for managing migraine alongside medication. These approaches include identifying and managing trigger factors, lifestyle modifications, behavioral treatments, education, and using headache diaries. Techniques like neuromodulation, dietary supplements, and acupuncture can also help. Non-pharmacological methods offer advantages like preventing medication overuse headache, reducing costs, aiding those who don’t benefit from or can’t take medications, managing migraine during pregnancy, and enhancing the effectiveness of treatments. Combining pharmacological and non-pharmacological approaches is recommended for comprehensive migraine management.

Due to the impact of migraine on society and patients, appropriate management and treatment should be considered.