Oh, my aching head!

Q: I'm a 30-year-old office worker who tries to exercise regularly. But I do have regular and serious migraines that I need to take medication for every once in a while. However, in addition to my headache I usually get stomach ache after taking the painkillers. What should I do? - Amara P.

A: Migraine sufferers often only get attacks once in a while, with long periods during which they are free of headaches. But more frequent attacks can be a sign of underlying contributing factors like tension or stress that the patient is unaware of. When examined, frequent sufferers often have neck stiffness, shoulder pain and muscle tension at the back of the neck, all of which can be reduced by massage. The stress can be treated with drugs, but the type of medication used needs to be matched to each patient's needs. After the treatment there should be a noticeable reduction in the tension of the neck muscles.

For the abdominal pain, there are several migraine-relieving medicines that shouldn't cause stomach irritation, among them the Tryptan group of drugs.

Seeing a specialist is the best way to figure out the underlying cause of your migraine attacks and the medication that will best treat them. You still need to do the basic things such as getting enough good-quality sleep, eating properly, cutting your sources of anxiety and taking your medication at the right time.

Migraine patients should remember to always take their medication at the first sign of an attack, which should reduce the severity and duration of the headache. My advice is to make an appointment with a doctor who specialises in headaches. We also need to check for neurological abnormalities, which an examination will show.

Kaseansom Viranuvatti, MD, is a neurologist at Samitivej Srinakarin Hospital

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