Migraine headache is a recurrent neurological disorder with symptoms like throbbing pain, nausea, aura, and sensitivity to light or sound. Nurses assess triggers, monitor symptoms, and support pain relief—essential for improving quality of life and reducing attacks.
A migraine is a severe headache, often associated with other symptoms including nausea, vomiting, light sensitivity (photophobia) and noise sensitivity (phonophobia). An aura may occur before the migraine headache starts. An aura is a collection of symptoms which can include visual disturbances, sensory problems or speech problems.
Signs & Symptoms
- Intense, throbbing or pulsating head pain
- Nausea and/or vomiting
- Sensitivity to light and sound
- Visual disturbances or aura before headache onset
When to Seek Medical Help
- First-ever or sudden “thunderclap” headache
- Neurological signs (confusion, weakness, vision loss)
- Headache following head injury
- Fever or stiff neck with headache
- Inability to tolerate any movement or worsening symptoms
First Aid for a Migraine Headache
1. Create a Calm Environment
- Dim the Lights: Migraines frequently trigger photophobia (sensitivity to light). Encourage the person to move to a quiet, darkened room. Dimming or turning off bright lights, closing curtains, or using an eye mask can significantly help reduce discomfort.
- Reduce Noise: Sensitivity to sound (phonophobia) is common during a migraine. Turn off televisions and radios, and if possible, ask others to keep noise to a minimum.
2. Encourage Rest and a Comfortable Position
- Lie Down or Sit Quietly: A quiet, cool, and comfortable space is ideal. Have the person lie down on a soft surface or a supportive chair, keeping the head elevated if that feels more comfortable. Limiting movement can help prevent the pain from worsening.
- Minimize Activity: Since physical exertion can aggravate migraine pain, advise them to avoid any strenuous activities until the headache subsides.
3. Apply Temperature Therapy
- Cold or Cool Compress: Many individuals find relief by applying a cold or cool compress to their forehead, temples, or the back of the neck. Wrap an ice pack or a bag of frozen vegetables in a thin cloth before applying it; direct contact with the skin can cause irritation.
- Experiment with Temperature: Although cold therapy is common, some patients may benefit from a warm compress on tense neck muscles. It’s worthwhile to experiment gently, depending on what the person finds more soothing.
4. Manage Hydration and Nutrition
- Water Intake: Dehydration can trigger or worsen migraine attacks. Encourage sipping water slowly, or if nausea is a factor, small, frequent sips may help settle the stomach.
- Light, Bland Foods: If the person is hungry and not too nauseous, a light snack like toast or a banana might be beneficial. Avoid heavy or greasy foods, which can exacerbate nausea.
5. Provide or Administer Medication (If Appropriate)
- Over-the-Counter Pain Relievers: Medications such as acetaminophen (paracetamol), ibuprofen, or aspirin can sometimes help if taken at the onset of migraine symptoms. Always check the person’s medical history and any contraindications, and follow dosage instructions carefully.
- Prescribed Migraine Medication: If the person has been prescribed specific migraine medications (like triptans) or anti-nausea drugs, help them take it at the first sign of migraine if they feel well enough to do so.
6. Offer Additional Comfort Measures
- Scalp or Neck Massage: A gentle massage at the temples, neck, or scalp can help some individuals relax and reduce tension that may be contributing to the migraine.
- Encourage Relaxation Techniques: Deep breathing, meditation, or guided imagery can help reduce stress, which is a common trigger for migraines. A quiet moment with focused, slow breathing may help ease anxiety and pain.
7. Monitor and Reassure
- Stay With the Person: Let them know you’re there to help and monitor how they’re doing. Sometimes, knowing that support is available can help reduce the overall stress level.
- Watch for Alarm Signs: Although most migraines aren’t dangerous, if the person experiences unusual symptoms (such as sudden altered vision, confusion, severe or rapidly worsening pain, or signs of a stroke), seek emergency medical assistance immediately.
Additional Considerations
- Identify Triggers: When the migraine improves, it might be helpful for the person to note what may have triggered the attack (e.g., certain foods, stress, lack of sleep, dehydration). Keeping a headache diary is a useful long-term strategy.
- Professional Guidance: Remind them to follow up with their healthcare provider or neurologist for an ongoing management plan, especially if migraine attacks are frequent or particularly debilitating.
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Create a calm, dark environment | Expose the person to bright lights or loud sounds |
| Encourage rest and minimal movement | Force the person to remain active or socialize |
| Apply cool compresses for short periods | Rub or massage the head vigorously |
| Provide clear fluids and monitor hydration | Give caffeinated drinks in large amounts |
| Assist with appropriate OTC pain or antiemetic medication |
Prevention
Lifestyle Strategies
| Strategy | Benefit |
|---|---|
| Regular sleep schedule | Stabilizes brain chemistry and reduces attacks |
| Hydration & nutrition | Prevents blood sugar dips and dehydration triggers |
| Moderate exercise | Boosts endorphins and reduces stress |
| Relaxation techniques | Yoga, meditation, and biofeedback lower tension |
| Screen breaks | Reduces eye strain and light sensitivity |
REFERENCES
- John Furst, First Aid for a Migraine Headache, Updated May 30, 2020, https://www.firstaidforfree.com/first-aid-for-a-migraine-headache/
- Brunilda Nazario, Fast Remedies for Migraine, December 16, 2024, https://www.webmd.com/migraines-headaches/migraine-avoid-mayhem
- Rachael Zimlich, —Top Strategies to Try for Migraine Relief, Updated on October 17, 2023, https://www.healthline.com/health/migraine/treating-migraines/how-to-get-rid-of-a-migraine
- Chen L, et al. (2021). The efficacy of ginger for the treatment of migraine: A meta-analysis of randomized controlled studies.
https://www.sciencedirect.com/science/article/abs/pii/S0735675720310391 - Nowaczewska M, et al. (2020). The ambiguous role of caffeine in migraine headache: From trigger to treatment.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468766/ - Jahromi SR, et al. Association of diet and headache. Journal of Headache and Pain. 2019; doi:10.1186/s10194-019-1057-1.
- Martin P. Behavioral management of the triggers of recurrent headache: A randomized control trial. Behaviour Research and Therapy. 2014; doi:10.1016/j.brat.2014.07.002.
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