Migraine triggers: Can acupuncture prevent migraine attacks? Can I take more painkillers for a migraine?

A record is not a test that can prove one trigger. It is a practical way to notice whether attacks repeatedly cluster around a change in routine. For example, an early meeting may coincide with less sleep, a delayed breakfast, extra coffee and a stressful commute. Writing down all of those factors is more useful than blaming the last thing eaten. The same record can show how long an attack lasts, whether it interrupted work or family plans, and whether a familiar treatment was taken early enough to help. The NHS also recommends a migraine diary to help people work out what may trigger attacks. [1]

Start each entry with the date, the time symptoms began and the time they settled. Describe the pain in your own words: one-sided or elsewhere, throbbing, pressing, mild, moderate or severe. Add nausea, vomiting, sensitivity to light or sound, dizziness, neck stiffness, tiredness, mood changes and any visual or sensory changes. Migraine often includes a throbbing headache, nausea and sensitivity to light or sound, but not every headache that is on one side is migraine. A local Hong Kong headache clinic likewise notes that one-sided pain can occur with migraine and may come with nausea, vomiting and light sensitivity. [4] If the label is uncertain, a record helps a clinician assess the whole pattern rather than the location alone.

Put the diary where it can be used during real life: on a phone, in a calendar, or in a small notebook beside regular medicines. Make a brief entry at the first sign, then update it after the episode. Include skipped or late meals, caffeine and alcohol changes, hydration, exercise, travel, screen-heavy work, sleep disruption and emotional strain as context. These are observations, not rules that require you to restrict everything at once. If you want a broader starting point for symptoms and questions, the migraine topic page can help you organise what to bring to an appointment.

A prevention plan aims to reduce the likelihood or burden of future attacks over time. Acute care addresses an attack that is happening now. Keeping those goals separate prevents a common misunderstanding: a treatment discussed for prevention should not be represented as a guaranteed way to stop pain immediately. The choice of approach depends on how often attacks occur, how disabling they are, other health conditions, pregnancy plans where relevant, medicines already used and what has or has not helped before. A diary gives the clinician the details needed to have that conversation.

For a current attack, follow the specific plan already agreed with your clinician or pharmacist. Resting in a dark, quiet room may be a comfort measure for some people, but it does not replace prescribed treatment or urgent assessment when warning signs are present. If nausea or vomiting makes oral medicine difficult, do not compensate by taking an extra unsupervised dose; ask a clinician or pharmacist how the plan should be reviewed. For an overview of questions to take into conventional care, see migraine treatment Hong Kong.

Migraine information is for a known or suspected pattern, not a way to self-manage every severe headache. Seek emergency help for a headache that comes on suddenly and is extremely painful, or for headache with new weakness or inability to move one side of the body, new speech or memory problems, loss of vision or new blurred or double vision, seizure, confusion, a very high temperature with symptoms of meningitis, or after a recent head injury. These are NHS emergency warning signs. [1] Do not drive yourself if emergency assessment is needed.

Urgent professional assessment is also appropriate if an attack lasts longer than usual, a visual or other aura symptom is prolonged or unlike your normal experience, you are pregnant or have recently given birth and develop a new severe headache, or your established pattern is becoming harder to control. A diary can be taken with you, but do not delay care in order to finish recording it. If neck symptoms are paired with difficulty breathing or swallowing, use the information in neck pain with difficulty swallowing or breathing and seek prompt medical help rather than assuming it is migraine.