Of all the medical conditions that send patients to their doctors, chronic headaches (including migraines) are among the least likely to be treated effectively.*

Problem: Most chronic headache sufferers would like to simply pop a pill to relieve their pain. Although there are many helpful medications, each can have side effects and is designed to reduce headache pain rather than prevent it.

Solution: After treating thousands of headache patients, I devised a natural "triple therapy that helps prevent migraines from developing in the first place

Latest development: Now that I've prescribed this therapy for more than 15 years, I have added other treatments that complement the original program.

What you need to know...

When The Pain Won’t Go Away

Approximately 15 million Americans have chronic headaches (occurring on at least 15 days a month).

The most common forms, in order of prevalence, are tension-type headaches (head pain caused by tight muscles-for example, in the neck-often due to stress).. and migraines (throbbing head pain accompanied by other symptoms, such as nausea or dizziness, and sometimes preceded by light sensitivity and visual disturbance known as an "aura").

*To find a headache specialist or headache support group near you, contact the National Headache Foundation (888-643-5552, www.headaches.org).

My Natural Therapy

Doctors don't know the exact cause of migraines, but the most popular theory focuses on disturbances in the release of pain-modulating brain chemicals, including the neurotransmitter serotonin.

In reviewing the medical literature, I found several references to the mineral magnesium, which has been shown to prevent migraines by helping open up blood vessels in the brain. Studies indicate that half of all migraine sufferers are deficient in this mineral.

Within a short time, I also discovered several references that supported the use of riboflavin (vitamin B-2), which plays a role in energy production in brain cells.. and the herb feverfew, which promotes the health of blood vessels.

My advice: Each day, take a total of 400 milligrams (mg) of magnesium (as magnesium oxide or in a chelated form-if one form causes diarrhea, try the other)...400 mg of riboflavin... and a total of 100 mg of feverfew, divided in two doses with meals. Many people take this therapy indefinitely. Ask your doctor about the appropriate duration of treatment for you.

Caution: Feverfew may interfere with your blood's ability to clot, so consult your doctor before taking this herb. Riboflavin may turn your urine bright yellow, but the change is harmless.

For Even More Pain Relief

  • Coenzyme Q10 (CoQ10) is a substance that, like riboflavin, is believed to fight migraines by boosting energy production in brain cells. Research has shown that 100 mg of CoQ10 three times a day reduces migraine frequency.

My advice: Take a total of 300 mg of CoQ10 daily, in one or two doses.

  • An extract from the root of the butterbur plant is another supplement that has shown promise as a remedy for migraines. In one study, 75 mg of butterbur taken twice daily for four months helped reduce the frequency of migraine attacks.

Although the exact mechanism of action is unclear, the herb might help reduce inflammatory substances in the body that can trigger headaches.

Butterbur is sold in the US under the brand name Petadolex (888-301-1084, www.petadolex.com).

My advice: Take a total of 150 mg of butterbur daily, in one or two doses.

Other Helpful Strategies

All the natural therapies described earlier help prevent migraines, but you're likely to achieve even better results if you adopt a "holistic" approach that includes the following steps. These strategies also help guard against chronic tension headaches but are overlooked by many doctors. My advice…

  • Get regular aerobic exercise. Exercise supplies more blood to the brain and boosts levels of feel-good hormones known as endorphins, which help fight migraines. Physical activity also helps release muscle tension that contributes to tension-type headaches.

Scientific evidence: In data collected from 43,770 Swedes, men and women who regularly worked out were less likely to have migraines and recurring headaches than those who did not exercise.

Helpful: Do some type of moderately intense aerobic activity for at least 30 minutes five times a week.

  • Use relaxation techniques. A mind-body approach, such as progressive muscle relaxation (deliberately tensing then releasing muscles from toe to head)..guided imagery (in which you create calm, peaceful images in your mind)...or breathing exercises (a method of slow inhalation and exhalation), can ease muscle tension and relax blood vessels to help prevent migraines and tension headaches.

Also helpful: Biofeedback, which involves learning to control such involuntary functions as skin temperature, heart rate or muscle tension while sensors are attached to the body, helps prevent migraines and tension headaches. Biofeedback usually can be learned in about eight sessions and should be practiced daily by migraine and tension headache sufferers. To find a biofeedback practitioner near you, consult the Biofeedback Certification Institute of America (866-908-8713, www.bcia.org).

  • Try acupuncture. There's good evidence that this centuries-old needling technique can reduce the severity and frequency of migraines and tension headaches. It typically requires at least 10 sessions to see benefits. Ask your health insurer whether acupuncture is covered. If not, each session, typically an hour long, will cost $50 to $100, depending on your location.

If you feel that you are developing a migraine or tension headache: Perform a

A simple acupressure treatment on your A self to help relieve headache pain.

What to do: Place your right thumb on the webbing at the base of your left thumb and index finger, and your right index finger on the palm side of this point. Gently squeeze and massage this area, using small circular motions, for one to two minutes. Repeat on the right hand.

**To find an acupuncturist near you, go to the National Certification Commission for Acupuncture and Oriental Medicine Web site (www.nccaom.org) and click on "Find a Practitioner."

Oxygen Helps Cluster Headaches

Cluster headaches involve excruciating bouts of pain. Sumatriptan (Imitrex) injections can cause side effects (nausea, chest pain).

New finding: 78% of patients got adequate or complete pain relief, with no side effects within 15 minutes of treatment with high-flow 100% oxygen delivered via a face mask...versus 20% relief with placebo (high-flow air). Highflow oxygen is available but underused-so talk to your neurologist.

The Secret to Fewer Headaches

When combined with painkiller medication, acupuncture reduced the number of days people had migraine or tension headaches by 40% or more, compared with painkiller use alone.

Referrals: American Association of Acupuncture and Oriental Medicine, 866-455-7999, www.aaaomonline.org.

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