Guide · Headache
Migraine without medication: what is proven and where the jaw system comes in.
Tablets dampen an attack but rarely affect how often it comes. Here you can read which drug-free approaches are proven, what role the jaw system can play and where the limits lie.
Dr. med. dent. Bodo S. von GadomskiDentist · Founder of the CMD-Klinik
Contents · 8 questions
Many people with migraine would like to take fewer tablets. That is a good goal, as long as it is approached realistically: according to current knowledge, migraine cannot be treated away, but the number and severity of attacks can often be reduced. Several complementary building blocks help.
Can you get rid of migraine without medication?
In shortUsually not completely, because migraine is a neurological predisposition. But for many people, attacks become less frequent and less severe, even without additional medication.
The aim of treatment is therefore not a cure but fewer headache days, shorter attacks and fewer days on painkillers. Drug-free methods are not a replacement for neurological treatment but its foundation.
People with very frequent or severe attacks often benefit from preventive medication. Whether this makes sense for you is something you decide with your neurologist.
Why are painkillers alone often not enough?
In shortAcute medication works on the individual attack, not on the tendency to have them. Taken very often, it can even sustain the headaches.
The limits are triptans or combination products on 10 or more days a month and simple painkillers on 15 or more days a month. Going above this risks medication-overuse headache. A headache diary shows where you stand.
Which drug-free approaches are proven?
In shortRegular endurance exercise, relaxation techniques, biofeedback, a stable daily rhythm and behavioural therapy. They are recommended in headache guidelines.
- Endurance exerciseAbout three times a week for 30 to 40 minutes at a moderate pace, for example cycling, walking or swimming. The effect shows after a few weeks.
- Progressive muscle relaxationMuscle groups are tensed and released one after another. Practised daily, it lowers baseline tension. Many health insurers offer courses.
- BiofeedbackBody signals such as muscle tension are made visible so that you learn to influence them consciously.
- A stable rhythmThe same bedtimes at weekends too, regular meals, enough to drink. The migraine brain reacts sensitively to fluctuations.
- Behavioural therapyIt helps you manage stress and triggers better and change how you deal with the fear of the next attack.
These building blocks work best together and over months. Exercising for just one week will not make a noticeable difference.
What role does the jaw system play in migraine?
In shortThere is a well-documented link between CMD and migraine: people who have one are much more likely to have the other. This does not prove a cause.
Reviews find that people with CMD have a roughly fourfold higher risk of also having migraine. The reason probably lies in shared pain processing: the trigeminal nerve, jaw muscles and upper neck send their signals to the same relay in the brainstem. Overloaded jaw muscles can thus lower the threshold for attacks.
In practice, this means: with migraine and jaw signs, it can be worth checking the jaw system as one of several amplifiers. Typical signs are morning headache, clenching or grinding, jaw clicking and tender temples. More on this in the article Recognising headaches from the jaw.
Does a splint help with migraine?
In shortA splint can relieve overloaded jaw muscles. It is not proven that it ends migraine, and nobody should promise you that.
If clenching and grinding help trigger attacks, relieving the jaw system can remove an amplifier. How much this affects the migraine varies from person to person and cannot be predicted. That is why we first measure whether the jaw system is working abnormally at all.
A splint from the chemist protects the teeth from wear but is not adapted to your bite position. What an individually planned splint achieves is explained in the article Teeth grinding.
What can I do myself today?
In shortDuring an attack: rest, darkness, cold and the medication your doctor recommended, taken early. Between attacks: rhythm, exercise, relaxation and a diary.
During the attack
- A darkened, quiet room
- Cold on forehead or neck
- Drink slowly, if nausea allows
- Take the acute medication early, not at the peak
Between attacks
- Fixed bedtimes, at weekends too
- Endurance exercise three times a week
- 15 minutes of relaxation a day
- Keep your teeth slightly apart during the day
You will find gentle exercises for jaw and neck in the article CMD exercises at home.
May I stop taking my migraine medication?
In shortNot on your own. Please always discuss changes to acute or preventive medication with your doctor.
A CMD assessment does not replace neurological treatment; it complements it. If your headache days decrease, it is up to your neurologist to adjust the medication.
When must I see a doctor immediately?
In shortIf a headache is different from your familiar migraine: sudden and extremely severe, with fever and a stiff neck, with new paralysis, speech or visual disturbances, or after a fall.
An aura that lasts longer than an hour or occurs for the first time should also be checked by a doctor. If in doubt: emergency number 144.
More questions, already answered
Sources
- International Classification of Headache Disorders, 3rd edition (ICHD-3)
- Guidelines on migraine therapy: drug-free methods (endurance exercise, relaxation, biofeedback, behavioural therapy)
- Systematic reviews with meta-analysis on TMD and migraine (odds ratio about 3.79)
- Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)
This article is for general information and does not replace medical treatment. A cure for migraine cannot be promised. Only change your medication after consulting your doctor.
Is your jaw system an amplifier?
The self-test gives you an initial assessment. Or call us: +41 44 888 99 44