Migraine relief at home: what helps, what is unproven, and when painkillers backfire

When a migraine begins, the first thought is usually, 'How do I make this stop?' You may reach for a tablet, close the curtains, or lie down with a cloth over your eyes. Some things help. Some help a little. Some are popular but have little proof behind them.

This article shares what guidelines and research say, and how strong the evidence is. It talks about types of medicine only in general terms. It gives no doses and does not tell you which medicine to take. A doctor or pharmacist who knows your health can do that.

During an attack: what many people find helps

The NHS advises trying to sleep or lie down in a darkened room during a migraine attack. It also lists staying well hydrated and eating meals at regular times as part of managing migraine. These are sensible, widely given advice, but they are not proven treatments. Think of them as comfort and support.

• Rest in a dark, quiet room, if you can. Light and sound sensitivity is a main feature of attacks.
• Sip water. The NHS lists staying well hydrated as a self-help step.
• Try a cool cloth on your forehead or neck. Evidence here is limited. A small 2025 trial of 26 people with migraine without aura compared a relaxation programme alone with the same programme plus cold packs, given in regular sessions rather than during attacks. Both groups improved, adding cold did not clearly change pain intensity, and attacks per month fell more with cold. With so few people and short follow-up, see cold as a comfort measure.
• Eat something light if you can manage it. The NHS says skipping meals can trigger migraine.

Medicines: types, in general terms

Guidelines describe several types of medicine for migraine attacks. This is a map of the types, not advice for you.

• Simple painkillers. The NHS lists over-the-counter painkillers. NICE says a simple painkiller or an NSAID (non-steroidal anti-inflammatory drug) can be an option on its own.
• Triptans. These are prescription medicines made for migraine. NICE says doctors may offer a triptan together with an NSAID, or with a simple painkiller. The NHS also mentions newer prescription medicines called gepants (not covered here).
• Anti-sickness medicines. The NHS lists medicines that stop you feeling or being sick. NICE says a doctor may consider adding one to the other treatment, even if you do not feel sick.
• What guidelines advise against. NICE says not to offer opioids or ergots for acute migraine treatment. The American Headache Society's Dr Todd Schwedt calls opioid and butalbital-containing medicines 'the worst offenders' for medication overuse.

Take it early, not late

The NHS says that if you take painkillers, take them as soon as your headache starts. The WHO says analgesics work best at the first sign of symptoms, such as visual aura, and the American Migraine Foundation describes acute medicines as taken at the first sign of an attack. Ask your doctor what 'early' means for you, especially if you get aura. Early treatment still counts toward your limit, described next.

When painkillers backfire: medication-overuse headache

This is one of the most important things to know. Taking painkillers or migraine medicines too often can cause more headaches, which can then lead to taking even more. The NHS says to try not to take painkillers for more than 2 days a week, because it can cause more headaches and make migraine harder to treat.

Doctors use specific thresholds. The International Headache Society (ICHD-3) says medication-overuse headache means headache on 15 or more days a month in someone with a pre-existing headache disorder, along with regular overuse for more than 3 months of acute treatment. 'Overuse' means:

• 15 or more days a month for simple analgesics (simple painkillers, including NSAID-type ones).
• 10 or more days a month for triptans, ergotamine, opioids, or combination painkillers.

NICE (CG150) uses the same figures: it says to be alert to this problem in people whose headache developed or worsened after taking triptans, opioids, ergots or combination painkillers on 10 or more days a month, or simple painkillers or NSAIDs (alone or in any combination) on 15 or more days a month, for 3 months or more.

The weekly advice is stricter. The American Headache Society's Dr Schwedt gives a rule of thumb of using acute medicine on average no more than two or three days a week, and the American Migraine Foundation calls more than two or three days a week 'the first red flag'. The ICHD-3 notes its day counts are based on expert opinion rather than formal evidence.

The ICHD-3 notes that more than half of people with headache on 15 or more days a month have medication-overuse headache, and that most improve after the overused medicine is stopped. It also says simple information about the problem can often help.

A small note on caffeine

The American Migraine Foundation says small doses of caffeine may give mild relief of head pain. But people who use a lot regularly can get withdrawal symptoms if they stop suddenly, and withdrawal can itself trigger migraine. It says that for episodic migraine, doctors recommend limiting caffeine to one or two drinks a day, and that people with daily headaches should consider avoiding it. The NHS also lists too much caffeine as a possible trigger.

Between attacks: prevention

When to ask a doctor about preventive treatment

The American Headache Society says preventive treatment should be considered if you have four or more headache days a month, especially with frequent, disabling or long-lasting attacks. A 2026 AHS update on the AAN-AHS guideline says preventive treatment can be advised for four or more migraine days a month, four or more moderate to severe headache days a month, or migraine that affects work and daily tasks. The NHS says preventive options include medicines such as beta blockers, certain antidepressants and epilepsy medicines, along with acupuncture, relaxation techniques and CBT, and vitamin B2. A doctor will discuss risks and benefits. For example, NICE notes that one preventive epilepsy medicine should not be used in pregnancy or by women who could become pregnant unless a pregnancy prevention programme's conditions are met.

Habits and non-drug approaches, graded honestly

• Regular sleep, regular meals, exercise, managing stress. The NHS lists these as self-help steps. They are sensible and widely advised, but they have not been proven in the way medicines have. Many people find that a steady routine helps.
• Exercise. A 2024 review of 28 studies with 1,501 people suggested that yoga and aerobic exercise may reduce migraine frequency compared with medicine alone, but the authors rated the evidence as very low quality and said there is no clear evidence on which type is best.
• Relaxation training and CBT. The NHS lists both as preventive options. A 2019 Cochrane review of 21 trials (2,482 people) rated the evidence as very low quality. It found more people had at least a 50% drop in migraine frequency with psychological therapy (54% against 24% in controls), but no clear effect on average migraine days or on mood. Relaxation is low risk, so many people try it.
• Biofeedback. A 2025 meta-analysis found it reduced headache frequency and severity compared with a waiting list, but not compared with other active treatments.
• Riboflavin (vitamin B2). NICE says it may be effective in reducing migraine frequency and intensity for some people. Ask a doctor before starting any supplement.
• Acupuncture. The NHS lists it as an option. NICE says a course can be considered if the first-choice preventive medicines have not worked, are not tolerated or are unsuitable.

Weak or unclear evidence

A 2012 guideline from the American Academy of Neurology and American Headache Society found conflicting or inadequate data on omega-3 supplements for migraine prevention. The guideline is over a decade old, so ask a doctor what current advice is.

A quick checklist for an attack

1. Check the warning signs. If any fit, call 112.
2. If your doctor or pharmacist has told you which medicine to use, take it early, as they advised. Note the time.
3. Move to a dark, quiet place if you can and lie down.
4. Sip water. Try a few bites of something light.
5. Use a cool cloth or slow breathing if you find it comforting.
6. Write down the date, length, and what you took.

When to see a doctor

The NHS says to see a GP if attacks are severe or getting worse, last longer than usual, happen more than once a week, are hard to control, or regularly come before or during your period. It says to seek urgent advice if an attack lasts more than 72 hours, if aura lasts more than an hour, or if you are pregnant or have just had a baby.