For many people experiencing recurring headaches, the first instinct is to reach for an over-the-counter medication such as Panadol or ibuprofen. These medications can be very helpful in relieving occasional headaches. However, if your headache becomes frequent, severe, or disrupts your daily life, a more comprehensive treatment approach is needed.
Migraines are a complex form of headache. Unlike typical headaches, patients experience a range of associated symptoms such as auras, including visual distortions or abnormal sensory perceptions, sensitivity to light and sound, nausea, vomiting, and tiredness. If these symptoms are severe or occur frequently, more than four times a month, you should consider starting a preventive medication.
Why Is My Migraine Not Responding to Panadol?
While many migraine sufferers rely on over-the-counter medications for relief, excessive use can lead to medication-overuse headaches. This refers to headaches caused by the very drugs meant to relieve them, resulting in more frequent and severe episodes. For patients who experience frequent migraines, starting preventive medications is strongly recommended.
Preventive Migraine Medications
Preventive medications include beta-blockers, anticonvulsants, and antidepressants. While not originally developed to treat migraines, these medications help regulate nerve activity along migraine pathways and reduce the number of episodes. Unlike Panadol or ibuprofen, these should be taken regularly, even on headache-free days.
Over the past decade, a newer group called Anti-CGRP medications has been introduced. These include Ajovy, Aimovig, Emgality, and Vyepti, all of which act on the CGRP pathway implicated in migraine development. While highly effective, they are typically considered after traditional preventives have not worked, largely due to cost.
Interventional Pain Management for Migraine
For patients with an inadequate response to medications, interventional pain treatments should be considered. These include botulinum toxin injections, nerve blocks, infusions, and peripheral nerve stimulation.
There is strong evidence supporting the use of BTX injections for chronic migraine management. This involves injecting BTX into multiple small muscles of the face, neck, and shoulders. While its exact mechanism is not fully understood, it is believed to reduce CGRP neurotransmitter release, contributing to its effectiveness against migraines.
Lifestyle Factors and Migraine Triggers
Beyond medications and interventions, it is important to be aware that migraines can be triggered by environmental and lifestyle factors. Common triggers include stress, irregular sleep patterns, dehydration, and hormonal changes.
Keeping a headache diary can be valuable in helping you and your doctor identify patterns that lead to migraine attacks. If you have frequent migraines, maintaining a regular sleep schedule, managing stress levels, and avoiding known food triggers can all make a meaningful difference.
Find Real Migraine Relief at Alleviate Pain Clinic
If your headaches are becoming more frequent, severe, or resistant to over-the-counter medications, it may be time to consult a specialist. For those seeking chronic migraine treatment in Singapore, getting the right diagnosis and personalised care early can make a significant difference in the long run.
Dr Christopher Liu is a migraine specialist in Singapore at Alleviate Pain Clinic, with two decades of experience treating headaches and facial pain, including complex cases requiring interventional procedures.
You do not have to keep pushing through the pain. Book a consultation with Dr Christopher Liu and take the first step towards lasting relief.
