Pushing Through Migraine Attacks… More Harm Than Good?

What would happen if, as soon as I noticed a migraine coming on, I took meds and rested instead of pushing until I absolutely can’t do another thing and I’m beyond exhausted before sitting or lying down? “I’d never get anything done,” is my immediate response, and I’m guessing most chronic migraineurs would think the same thing. But what if the behavior I see as helping me cope with chronic migraine — pushing myself — is actually making my health worse?

What if resting at the first warning of a migraine would reduce the severity of that migraine attack? What if pushing myself to the brink actually makes the migraine attack worse? And beyond individual migraine attacks, what if my habit of constantly pushing myself to severe fatigue compromises my body and health in such a way that makes me have more frequent migraine attacks?

These are some of the thoughts floating in my head thanks to therapy and the article about validating pain that I wrote about last week. I have no answers, but asking these hard questions feels like a step in the right direction.

11 thoughts on “Pushing Through Migraine Attacks… More Harm Than Good?”

  1. I can understand not being able to stop and relax when you see the first warning signs. I work in a warehouse and have had more migraines in the last year than I have had the last 5 years before. I just learned to watch for the ‘traveling spots’ (black spots that start on one side of an eye and go to the other eye), and take an Advil or something. I have done this so many times, I actually get surprised when I hear someone say they had to take the whole day off. I just think ‘Wait…you can do that?’

    1. Lindsay, it’s great that your migraine attacks are relatively mild and respond to over-the-counter medications. Not everyone has obvious warning signs of a migraine attack. You have what’s called a visual aura, which only happens for about a quarter of people with migraine. Also, many people get no migraine relief from OTC medications and some don’t get relief from prescription medications either.

      Take care,

  2. I used to be like you Chris trying to hold down a full time job while struggling with 10 migraines a month. The worst ones being around my period. Or some were triggered by chocolate or alcohol of which i had to give up both.
    I would muddle through most of them my productivity went down the tube. And i had to take time off for the bad ones. It just made it look bad in the eyea of my employer. When i started getting panic attacks as well i had to call time on my 28 year job. 2 years later things seem to be a bit better as far as the migraines go i’m not getting the ones where i would vomit everytime i moved. But i still get them as often as 10 a month so i take a imigran tablet as soon as i feel one coming on. this seems to stop them getting worse most of the time 😉 So i think im ready work again..heres hoping things stay good….

  3. I’m 34 and have a 5 year old and have had migraines that have progressively gotten worse since I was a teenager. Some days I can and want to push through it, other times I know or have a feeling that its going to be bad, and I give in and rest, and I’m usually right that it was bad. Other times since I have a small one I have to push through it because my daughter needs me, I hate her seeing me not my best, but if anything I think she is kinder and more empathetic. She often asks if I’m ok. Bottom line seems to be that you can’t go back and second guess yourself, you can only do what you can do in the moment.

  4. macattack, it’s definitely a balancing act. One that has me teetering just about every day!

    Nilofer, taking meds can be such a difficult decision, especially because we’re limited to how many we get in a month. I’m glad you’ve figured out a good balance for you. I do “intraoral massage” as well — it feel great!

    Kate, I love your words: “Truth is: if I can go, I GO. If I can do something, I DO it. – When the migraine gives me a break, I never just sit around for the heck of it.” I’m learning the same thing about myself. I know what you mean about second-guessing yourself during a migraine. Does it help to remind yourself that you have a strong track record of always taking good care of yourself?

    Chris, thanks for sharing your struggles. I, too, wish I had a solution for everyone who must work through their migraine attacks. It is so draining, both physically and emotionally. Not sure if it would help, but have your read Keep Working, Girlfriend? It’s obviously directed toward women, but it’s guidance on working with chronic illness might be helpful.

    Diana, I *believe* in pacing, I’m just not so good at putting it into practice! Any tips?

    Robert, I’m sorry you’re having a rough time right now? Have you checked with your doctor? It’s always good to check in when there’s a change in your migraines, and you’re getting them frequently enough that a preventive medication might be helpful. Best of luck.


  5. Im reading your email and at the same time feeling my left eye doing its thing,pressure building and so on.Yep its coming but still waiting for it to get worse…..why I ask…why.Oh Oh getting worse but cant stop typing.My first time on any migraine website.Ive had migraines since I was 16 and now 43.Not too many males out there but I guess im one of the unlucky ones.Im getting really worried lately because ive been getting one to two migraines a day for the past 3 months. normally they only last two weeks once a year.

  6. This post hits home for me this week.

    As a Chronic Migraineur who holds down a full time job I find myself, almost daily, in a position where I must choose between “toughing it out” or “throwing in the towel”. I most often choose to continue though my day.

    I have a wonderful wife and four sons (9 through 17 years of age). Both my wife and I work. Neither of our incomes alone would sustain our family. So, for me, working is a necessity and not something I can choose to stop. So, in all but the most severe cases, I work through my migraines. I have, over two decades of pain, developed the ability to muddle through all but the most severe of these migraines. This is not to say that my productivity and performance are not impacted. They most definitely take varying hits from small to large. I have the benefit of being employed in a role that allows some flexibilty. In other words, if I miss a mark today I can catch up tomorrow. If I am struggling today with a migraine I can accelerate my productivity the next morning. Of course, when I have consecutive days with significant migraines I do have some serious struggles.

    This week I was reminded that not all migraines can be “struggled through”. On Tuesday I had one of the worst migraines I have experienced in the last three months. It was completely off the chart! There was no choice with this one. I was down. I spent the day in a dark room. I pumped in all the abortives I could safely use and still the migraine had me in its firm and painful grip.

    Stopping for the day allowed me to journey through the pain without worrying about trying to focus on work (or anything). It also reminds me of how taxing and draining it is to continually work through the migraines. There are many days, weeks, months where I really feel like my soul is being eaten. Between the migraines themselves and the constant “act” of being upright at my desk working on some project I sometimes wonder how I can keep doing this. My wife will comment, “I don’t know how you do it.” Lately when she says that I think to myself, “I cannot do this anymore.”

    I am not sure what choices I have. If I stopped every time I had a migraine I would lose my job. I simply cannot afford that. So I continue with the act of being at work. I continue to muddle through the migraines. I continue to use the abortives that do not completely knock me off my feet (and obliterate my consciousness).

    What would it be like to not fight this fight on top of weathering the migraine? I don’t know. Still unpleasant, but maybe I would not always feel completely wiped out. Maybe, when I do manage some time free of migraine I might be more inclinced to live a more engaged, a more active life.

    Long term, I suspect that the continual fighting contributes to feelings of depression, of low energy, of frustration, of feeling trapped in a bad situation.

    For those of us who simply must work I am not sure what, if any, solution(s) is available.

  7. I go through all the same mental flip-flops: should I rest? Take meds? Both? Neither? Am i being lazy? Etc., etc., etc…. But why do I do that to myself? – So far, in 12 years of daily headache/migraine, I’ve never found any of those kinds of plans, (from now on I’ll do this or that), have any long term effect on this situation whatsoever.
    It’s just what I do when I get a migraine. (the thinking)

    Truth is: if I can go, I GO. If I can do something, I DO it. – When the migraine gives me a break, I never just sit around for the heck of it. I wish I could stop second-guessing myself DURING an attack, because every time I look back on a migraine, and the decisions I made to manage it, I know I did everything in my power to function and/or care for myself.

  8. For way too many years I had the “push until you have to take a triptan” approach, thinking that I was somehow fighting the “demon”. Before being diagnosed with migraine I just suffered through them for 2-3 days without and pain killers.

    Now I do the opposite and I think it helps not only reduce the severity of the migraine, but help me get fewer overall. Generally speaking, I believe that we shouldn’t automatically use the “go for the pill” approach and that is why I spend so much time eating foods without gluten, aspartame, MSG, onions and other strong trigger foods. I eat lots of foods rich in magnesium and avoid dairy. That being said, my day 10 migraine is almost guaranteed and so are some of the PMS/MS ones and instead of waiting until the pain cements its way into my body, I nip it in the bud. I don’t punish myself for getting migraines by waiting to relieve the pain. I realize that it isn’t a weakness to take a pain med. but a strength as long as I use a preventive approach as much as possible with good diet and few key supplements. Even with the best intentions and the best possible diet I can muster, I will still get them and I definitely think taking the triptan early is the way to go. I have sore muscles, very tight twisted fascia, possibly muscles pulling on my vertebrae from over two decades of migraines. These physical conditions are triggers too.

    I spend a lot of time self-massaging parts of my neck that are hard as bone. I also have been squeezing the skin around these areas and doing my own “Rolfing” which I find to also be helpful. I was diagnosed with TMJ as a teenager (which seems to be a right of passage for a lot of migraineurs) and so I also self massage my cheeks by putting my thumb inside my mouth and squeezing/massaging the cheek muscles from inside and outside. I do this in private:)

  9. The validating pain post is still running through my mind… it was a good one.
    The questions you pose here remind me of conversations with my acupuncturist who reminds me weekly to remember to take time to rebuild. I have the classic-dog-off-a-leash syndrome when I have a few hours, outside of work, of feeling well. Inevitably, after how many years of this, I end up wearing myself right out again. Sometimes I decide it was worth it. Other times, I’ve wished I would learn. It’s becoming a coping mechanism to push through the pain and continue to function as best we can. Like you say, without that, nothing would get done. I know I DO need to be better at the balancing act. Thank you for the reminder!!

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