Researchers recruited 82 participants, mostly women, predominantly in their mid-40s, who experienced between 4-20 migraine days per month. This is representative of migraine prevalence—more women than men get migraines, and one study found that after age 42, the condition is two-fold higher in women. Migraine is the second-leading cause of worldwide disability, and two-thirds of patients don’t find relief through medications, according to Rebecca Erwin Wells, MD, of Wake Forest Baptist Health, the lead author of the recent study appearing in JAMA Internal Medicine. “MBSR is associated with improvements in many chronic pain conditions,” she says. “Mindfulness may be particularly helpful for migraine, as it diminishes affective responses to stress, the most common migraine trigger.”
Promising Study Results
In the research, participants were split into two groups for eight weeks. One was instructed in mindfulness meditation and yoga, while the other received comprehensive education about headaches, including information on stress and common triggers. Both groups saw decreases in migraine frequency, but the mindfulness group had more significant outcomes in terms of:
Better quality of lifeLower disabilityHigher self-efficacyLess pain catastrophizingLower rates of depression
Most significantly, according to Wells, mindfulness decreased pain intensity and engaged brain regions responsible for pain modulation. But it’s also worth noting the effect of education alone, she adds. Researchers did not expect that drop in frequency for the information-only group, and it highlights how knowledge might provide empowerment that leads to beneficial behavior changes, says Wells. Simply knowing about headache triggers, for example, could cause migraine sufferers to be more proactive in implementing meaningful prevention tactics. Although more research needs to be done on these strategies, she notes, it’s possible that combining these techniques—putting MBSR together with more comprehensive education—could have a powerful effect on migraine sufferers.
Why Mindfulness Works (And When It Doesn’t)
In terms of why the MBSR group would have such significant benefits, it’s likely related to neurotransmitter release that’s been shown in previous research to have de-stressing effects, according to Ilan Danan, MD, sports neurologist and pain management specialist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. For example, one study found that yoga and meditation could play a major role in greater release of the neurotransmitter serotonin, which has been associated with lowered anxiety levels. Those who have migraines triggered by stress would see pain reduction as a result, Danan says. However, he adds, it may have less efficacy for migraines that have different triggers, which can include:
Strong smells like cigarette smoke or perfumeIrregular sleep schedule or sleep disturbanceHormonal changesCaffeine and/or alcohol consumptionWeather changesFoods like cheese or chocolateArtificial sweetenersNatural lightDehydrationGenetics/family history
“Even in cases when the migraine has different triggers than stress, though, these mindfulness-based practices can be helpful,” says Danan. “They may not change how often you get migraines, but anything that lowers pain level is worth considering. Also, sometimes feeling a migraine come on can cause stress, making the situation worse. So, addressing that stress can go a long way toward alleviating symptoms.”
Importance of Lifestyle Changes
While MBSR can be an important part of migraine management, so too can other lifestyle changes that ease symptoms and reduce pain, according to Danan. “There’s no question that lifestyle behavior can make a major impact, no matter what your trigger,” he says. The American Migraine Foundation calls it “headache hygiene,” aimed at reducing the frequency and severity of migraines. Strategies include:
Maintaining regular sleep patterns, including consistent bedtime and wake timeRegular exercise, but avoiding overexertionDaily “stress breaks” that can relax youNot skipping meals or going too long between mealsAvoiding known triggersAdjusting for sudden weather changesWearing sunglasses whenever you’re outsideStaying on top of hormonal changesEstablishing daily routines
With MBSR, some techniques might include a regular yoga practice a few times per week, deep breathing exercises during your stress breaks, mindful eating, and simply taking a few moments each day to pay attention, gently, to your surroundings and your tasks.
When to See a Doctor
Even with a breadth of lifestyle behaviors in place and plenty of stress reduction techniques, you may still be suffering from migraines, and if that happens, it’s helpful to talk with your healthcare provider, advises Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif. “Especially if you’ve been taking medication and trying to reduce stress and your migraines are getting worse or more frequent, you should go in,” he says, adding that the situation could be considered more urgent if you begin to have signs of neurological issues like weakness in the arm or numbness in the face. “In cases like that, there could be more going on, so it’s good step to get checked out.”
But if your migraines are becoming more severe, more frequent, or involve numbness or weakness, you should get checked by your doctor.
