What are the other (alternative) treatments for migraine?

  (Migraine belongs to the category of “head wind” and “brain wind” in Chinese medicine, and Chinese medicine has been used to treat migraine for thousands of years and has accumulated a lot of clinical experience. The safety of Chinese medicine in the treatment of migraine has been widely recognized, and randomized controlled studies on the efficacy have been conducted [289]. Wang Yong of the Pain Medicine Center of the Aviation General Hospital of China Medical University uses acupuncture and moxibustion in accordance with the principles of evidence-based treatment and identification of meridians, and according to the severity and urgency of the headache, either acupuncture, moxibustion, or local acupuncture, or distant acupuncture, or both, and auricular acupuncture, wrist and ankle acupuncture, and electroacupuncture are used flexibly, which may have certain efficacy. In general, acupuncture treatment for migraine should be given at the beginning of the pain attack and before the pain is too severe, and the effect is often better. For patients with recurrent attacks, a treatment plan should be formulated according to the condition and treated according to the course of treatment. Tui na is effective for migraine. Massage at different acupuncture points on the head, face and neck can often relieve pain.  (ii) Psychotherapy and physical therapy: The psychotherapy of migraine is mainly based on behavioral therapy, including relaxation, biofeedback and cognitive therapy. The main purpose of relaxation therapy is to reduce the activation of various body systems and to promote physical relaxation. Biofeedback is to enable patients to feel clearly awake and thus awake to control and change their body functions. Relaxation facilitated by biofeedback is achieved through the use of instruments that measure sensory muscle tone (EMG biofeedback), skin resistance (electrodermal biofeedback), or peripheral body temperature (temperature biofeedback) to measure, amplify, and feed back somatic information to the patient. Cognitive therapy treats recurrent headaches by guiding the patient to better manage the stress response associated with the headache and other concomitant psychological disorders.  Behavioral therapy is usually considered when (1) the patient desires non-pharmacologic treatment; (2) the patient cannot tolerate medication or has a contraindication to medication; (3) medication is ineffective or less effective; (4) pregnancy, preparation for pregnancy, or lactation; (5) frequent or larger doses of analgesics or other acute-phase treatment medications; (6) there is a significant life stressful event or the patient lacks appropriate stress management skills.  Some studies suggest that behavioral therapy is effective for migraine prophylaxis [292] as an alternative or complement to pharmacotherapy, but evidence from well-designed controlled studies is lacking. It is also unclear which behavioral therapy is indicated for which migraine patients and may be used on an individual patient basis. Studies comparing behavioral therapy with pharmacotherapy have found that pharmacotherapy has a faster onset of action, but overall they are comparable; behavioral therapy in combination with pharmacotherapy is most effective, and Meta-analyses have shown that the overall effect of different behavioral therapies is similar to that of propranolol or flunarizine. Physiotherapy alone was not as effective, but it improved the patient’s response to behavioral therapy. The efficacy of aerobic exercise such as swimming, jogging and cycling has been demonstrated. Randomized double-blind studies of homeopathy in adult patients have failed to show its effectiveness. Transcranial magnetic stimulation (TMS) for acute phase migraine has shown good efficacy in controlled studies with no significant adverse effects.  (iii) Surgical treatment: Some studies suggest an association between patent foramen ovale (PFO) and migraine with aura, and the most likely explanation for this association is the genetic arrangement. Sealing surgery in patients with PFO has not been proven to prevent migraine attacks.