This post may seem a bit out of place, but I have noticed an increasing amount of equestrians on my Twitter feed that seem to suffer from migraines. For those of you that don’t know, I have suffered from migraines for more than 20 years. For a long time, I suffered to no avail as OTC medications did and still do not work for me. This was because when I was younger most of the migraine medications contained addictive ingredients, and my mom was not comfortable allowing me to take them.

Once I turned 18, I was allowed to see a doctor for my migraines. I started by seeing my general physician who put me on a migraine-specific medication called Imitrex. This medication is prescribed to individuals who suffer from migraines and is considered an abortive medication. This means that one only takes it when they are suffering from a migraine attack. The medication generally works within 30 minutes, but in my experience, it can take up to two hours. Unfortunately, Imitrex stopped working for me, and I tried a number of other orally administered abortive medications, none of which helped. I was eventually prescribed a medication called Sumavel DosePro. Unlike Imitrex, Sumavel was administered through the skin. Essentially, it is a shot that you can administer in your thigh (like I did) or a number of other administration sites. While I would not recommend Sumavel (the pain of giving myself the shot outweighed the actual migraine), it did work fast (for the most part) and may be an option for those who can tolerate the pain of administration.

When my migraines got worse and started to affect my performance in law school, I decided to see a neurologist, which is a popular thing that migraineurs do. My neurologist put me on a preventative which I take every night. Because none of the migraine-specific abortives work for me, I also take something called Fiorinal Codeine, which is highly effective. Unfortunately, as of right now, there are no migraine-specific preventatives. That means that any medication prescribed to prevent migraines is actually being prescribed off-label. For example, the first medication I tried at the advice of my neurologist was a blood pressure medication. That medication, unfortunately, caused my migraines to become more intense and more frequent. I was switched to an anti-depressant which has been very effective in reducing my migraine attacks. Instead of getting 12-15 a month, I now get about 3 a month. If I do get a migraine, I am able to take the Fiorinal which usually works within half an hour.

Migraine attacks are very debilitating. I have found that those who have never suffered a migraine do not quite understand just how bad they can be. Along with severe pain, I often suffer nausea, sensitivity to light, smell, and noise, tingling, severe fatigue and weakness, and excessive thirst that continues no matter how much I drink. If my migraine is severe (or higher than a 5 on a scale of 1 – 10), I am often confined to my bed in pitch black until it goes away. In fact, the World Health Organization reported that migraine attacks are as debilitating as quadriplegia, and sometimes even more so.

Being an equestrian with migraines is difficult, and sometimes it severely affects my ability to ride and go to the barn. Although sometimes I can manage to survive a lesson while suffering from a migraine, there are times when I just cannot manage to get out of bed to ride or see my horses. I know that there are other equestrians out there who suffer from migraines, and many of the ones I’ve talked to do not know their options or the tricks to help relieve a migraine or at least dull the pain for some time.

I’ve put together some tips for those of you that suffer from migraines – whether you get them more than once a month or once a year – it helps to know what you can do to help yourself function.

Peppermint oil. Studies have shown that putting a dab of peppermint oil under your nose or on each of your temples seems to help migraines. If hypersensitivity to scents is a symptom of your migraines, this may not be the best thing for you to do. However, if not, it may be worth a try. You want to make sure that you purchase peppermint oil that can be applied to your skin. I have seen peppermint oils that are for olfactory therapy only – meaning they can only be placed in something that is meant to disperse the scent in the air, not on your skin.

Heat therapy. This is one of my all-time favorite methods of addressing migraine pain. Heat therapy can be done in a number of ways. One is to sit in the shower and let the hot water run on your face and head. Another is to run a washcloth under hot water (as hot as you can stand), wring it out, and apply it to your forehead or temples. Finally, there are special heat therapy masks you can buy that are heated simply by placing in the microwave. I have owned a few of these in the past. Some of the masks also have scents with them, so if you are sensitive to fragrances when you suffer a migraine attack, make sure the mask you purchase is unscented.

Cold therapy. This is another way of relieving migraine pain. Choosing between heat and cold therapy is a personal preference, so it’s best to experiment and see what works for you. In the summer, my migraines can be triggered by heat, so I prefer to use cold therapy. My mom actually purchased something for me called a “Chillow.” It is a rectangle shaped pad that creates a cooling sensation when you lay your head on it. You can also place it in the refrigerator for an extra cooling sensation. I have found this to be very effective when I am suffering from a migraine. It tends to up my comfort level and distract me from the migraine pain. I also sleep on a MyPillow which also creates a cooling sensation when you lay on it (Bonus: It is also designed to help you sleep better and help prevent migraines by aligning your neck and head correctly). You could also run a washcloth under cold water and lay it over your forehead, much like the heat therapy recommendation.

Pinch the layer of fat between your thumb and forefinger. I know this sounds weird, but my former college roommate’s sister, who also suffered from severe migraines, told me about this trick. I’m not sure how it works exactly, but I think it just has to do with distracting you from the pain by letting you focus on another form of pain. The pinching isn’t too painful, but it certainly is uncomfortable. I’ve found this is only temporary though, and the minute you stop pinching, you tend to become aware of the migraine pain again.

Lay down in a dark, cool room. Migraines are often accompanied by light sensitivity. Most migraineurs need to be in a dark room to recover from their migraine or find relief. Additionally, heat tends to make migraines worse (at least for me and most other migraine sufferers), so laying in a dark, cool room is a great way to find relief. If you are able to sleep with the migraine pain, this might also help you recover or find some relief.

Take a break. We are busy. We have full-time jobs, go to school, ride often, show, work at a barn, etc., but sometimes you need to take a break to rest and recover. Please do not be ashamed of this. I know that sometimes supervisors do not understand migraines and think you should be able to take an Advil and continue to work, attend class, ride, etc., but do not allow yourself to be pressured like this. If you need to, get a doctor’s note or provide the doubtful party with some materials that show just how debilitating a migraine is. I still suffer from judgment about my migraines – even from people who have had family members that were migraineurs. It is tough, but you need to do what is right for you. I hate having to skip a lesson or going to the barn due to a really severe migraine, but having a helmet on my head really isn’t the best thing to do when my head already feels like it’s going to explode. If you need help on how to explain your issue to a teacher, parent, supervisor, trainer, or other loved one, please feel free to reach out to me. I know how tough it can be to have someone that doesn’t understand or believe how severe a migraine can be. I can’t say how many times I’ve had someone I know – that previously judged me and doubted my migraines – get a migraine and say, “Oh my God, I never realized how bad these are. I don’t know how you do it!”

See a doctor. I am lucky that my general practitioner doctor suffers from debilitating migraines herself, so she was able to help me initially when it came to treating my migraines. However, I decided to seek out a specialist when they got worse as I figured the specialist would be more up-to-date on new medications and treatments. A migraine specialist is usually also a neurologist, but don’t let that scare you. If you are just suffering from migraines and have no other signs of a neurological problem, you don’t have to worry about undergoing any scary tests (usually). The biggest issue is finding a doctor that specializes in migraine treatment. There is actually a shortage on migraine specialists. However, if you are unable to find a reputable migraine specialist in your area, usually seeing a general neurologist can help too.

You may be wondering if preventing migraine attacks is possible. It is, but it can be tricky. Unfortunately, researchers aren’t quite sure why migraines occur. This is because there are so many migraine triggers. However, if you track your migraines, you can probably figure out what causes them. This will allow you to avoid those things (unless you’re like me and have migraines that are triggered by barometric pressure changes, temperature changes, and heat – among other things). Here are some tips to help you prevent your migraines.

Track what causes them & avoid those triggers. You can track your migraines in a variety of different ways. I prefer to use an app on my phone; however, some people prefer to keep a migraine journal in which they write down what caused their migraine. I like my apps because they asks me a variety of different things including when the migraine started, how long it lasted, how painful they were (on a scale of 1 – 10 or on a scale of mild – severe), what I had to eat that day, any other stressors I experienced that day, and my symptoms. While one app I only use when I have a migraine, another app I use regardless of if I have a migraine. Every day it asks me whether I had a migraine. It tracks various factors and compiles data that will eventually identify things that happened 24 – 48 hours before I experienced a migraine to show me what my triggers are, the percentage of my migraines that are mild, moderate, and severe, and where the pain tends to be. Tracking and identifying your triggers can help you avoid what causes a migraine. For example, if you get migraines after eating salty foods or foods with artificial sweeteners, you can cut those out of your diet – or eat them sparingly. To me, being proactive about what causes your migraines is probably the number one thing you can do in starting to reduce their frequency and even prevent them altogether.

Drink a lot of water, especially on hot days. Dehydration is a big cause of migraines. If your migraines are triggered by heat, drinking a lot of water and taking frequent breaks in cool areas can also help in preventing yourself from suffering a migraine attack. A good rule of thumb is to drink 8 glasses of water a day, but on hot days, or days where you ride a lot of horses or even just one horse, it’s good to drink even more.

Consider taking a preventative medication. Some people prefer not to take medication every day; however, if your migraines severely inhibit your life, or if you get them more than half the month, you should seriously consider going on a preventative. You do not have to live in pain most of the time, and there are many different medications to try. You are bound to find something that works for you. Taking a pill everyday is definitely worth it and outweighs the fear of getting a migraine for more days a month than you are migraine free – at least to me.

Go on the migraine diet. I choose not to do this because it is actually extremely restrictive. It seems as if everything can cause a migraine. However, if you don’t mind restricting what you eat, looking up the migraine diet may be a good thing. You can cut out any and all foods that cause migraines. If you continue to get them after being on the migraine diet for a satisfactory period, then you know that your migraines are most likely due to another cause.

Look into seeing a chiropractor or acupuncturist. This has been recommended to me a million times, but I’ve never actually gone. This is because I have identified what triggers my migraines. However, I have known quite a few people that suffered from migraines and invested in some chiropractic or acupuncture work and never suffered one again! It is entirely possible you are misaligned or something in your Chi needs to be unblocked. Make sure you go to a reputable chiropractor or a licensed acupuncturist so you are getting the best service possible.

I cannot possibly cover every single way to address a migraine in this post, but I hope this provided a good starter guide for those of you who have been suffering and don’t know what to do. There are many resources on the internet, including my go-to, Migraine.com, and I highly encourage you do your own research and experiment to find what works for you. I also am always here to help with questions you have about migraines and how to treat and/or prevent them. I am obviously not a doctor, but I can give you a starting point or some “tricks of the trade” since I’ve tried so many over the year. I can be reached on any of my social sites (Twitter, Facebook, Instagram, Ask.fm), or you can email me at thelegalequestrian@gmail.com.

If you are severely affected by migraines, and you are finding yourself unable to function the majority of the time in your career, academic career, and riding career, I highly recommend seeing a doctor. There is hope, and there is help. Don’t give up or think that you’ll never find relief. I know it is hard and frustrating – I can’t tell you how many times I’ve wanted to give up or just accept that I will always be miserable and have chronic migraines. While some of that is partially true – there is no cure for migraines, unless it’s caused by a curable medical condition – they can be managed, and the frequency can be reduced. It may take some tweaking of medication and some experimentation, but there is something out there for everyone.