One of my patients used to keep a pair of sunglasses in every room of her house. Not for the LA sunshine — for the days a migraine turned ordinary daylight into something unbearable. She'd lie down, cancel her plans, and wait it out. She assumed that was just her lot in life. It wasn't.
If headaches are shaping your week around them, I want you to know that effective migraine treatment exists, and it's more than reaching for another over-the-counter pill. In my practice, I look at the whole pattern — how often the headaches come, what sets them off, and what they're costing you. That's where real relief usually starts.
How do I know if it's a migraine or just a headache?
A migraine is typically more than head pain — it tends to come with light or sound sensitivity, nausea, and a throbbing quality, often on one side. Some people get an "aura" beforehand: flickering lights, blind spots, or tingling.
A run-of-the-mill tension headache feels more like a tight band and usually lets you carry on with your day. Migraines tend to stop you in your tracks. If yours are disabling, recurring, or changing in character, that's worth a real conversation.
What are the most common migraine triggers?
Triggers are deeply personal, but a handful show up again and again. I often tell patients to watch for these:
- Skipped meals, dehydration, or too much caffeine
- Poor or irregular sleep
- Stress — and, oddly, the "let-down" period right after stress
- Hormonal shifts around the menstrual cycle
- Bright light, strong smells, weather changes, and certain foods
This is why I'm a fan of a simple headache diary. A couple of weeks of notes often reveals a pattern that surprises both of us, and patterns are something we can actually work with.
What does migraine treatment actually involve?
Migraine treatment comes in two flavors: stopping an attack that's already underway, and preventing the next ones from starting. Most of my patients with migraines and headache disorders benefit from a plan that does both.
For an active attack, acute treatment might include prescription options like triptans alongside well-timed NSAIDs. The key word there is timed — these tend to work best when you take them early, not after hours of toughing it out.
If you're getting frequent or severe attacks, preventive therapy aims to lower how often they hit and how hard. There are several daily medication options, and the right choice depends on your other health conditions, which is one reason I like managing this within a primary care relationship rather than in isolation.
Can lifestyle changes really reduce migraines?
Yes — and I'd never want a patient to skip this part, because it often does the heavy lifting. Steady sleep, regular meals, hydration, and movement aren't glamorous, but they genuinely move the needle.
The mind-body connection here is real. Poorly controlled anxiety and insomnia can both feed a migraine cycle, and treating them often quiets the headaches too. I'll also keep an eye on your blood pressure, since some medications overlap and uncontrolled hypertension deserves attention in its own right.
When should I worry about a headache?
Some headaches need prompt attention, not a diary. Seek prompt care for a sudden, severe "worst headache of my life," a headache with fever and a stiff neck, or one accompanied by weakness, confusion, vision loss, or trouble speaking.
New headaches after age 50, or a clear change in your usual pattern, also warrant a closer look. When in doubt, ask. I'd rather reassure you than have you wait at home wondering.
You don't have to organize your life around the next migraine. If headaches are stealing your days here in Los Angeles, let's sit down, look at the pattern together, and build a plan that fits you. I'd genuinely like to help — reach out anytime and we'll take it from there.