Migraine and Pregnancy

Migraine is especially common in women of reproductive age. There are many treatments available for migraine that are highly effective but common questions I get from patients who fall into this population include:
What am I going to do when I am trying to get pregnant, am pregnant, or breast feeding?
Will I have to stop my current treatment that has been working so well?
What are the fertility risks associated with migraine treatment during this time?

Don’t worry, we will find an individualized treatment plan for you! Another reason not to worry is the fact that for most women, pregnancy and breast feeding after pregnancy is protective against migraine. Approximately 47% of women have improvement in their migraines during their 1st trimester, 83% during their 2nd trimester and 87% during their 3rd trimester. Essentially for most women, the rate of remission from migraines increases as the pregnancy progresses.

Even if your migraines don’t improve during your pregnancy there are still options for you, such as:
Non-pharmacological behavioral changes and approaches can help decrease the frequency and severity of migraines. For example: rest and relaxation techniques, biofeedback, behavioral sleep modification, prenatal yoga.
Supplements and minerals are safe during pregnancy and are shown to improve migraine. Supplements include: Riboflavin, Vit B2, CoQ10, and Magnesium.
Acetaminophen (Tylenol) is safe to use in all trimesters as an abortive while pregnant
Metoclopramide (also known as Reglan) is an ant-nausea medication that is safe during all trimesters, can help with the nausea associated with migraines and the nausea associated with pregnancy (hyperemesis gravidarum)
Occipital and trigeminal peripheral nerve blocks (preferably done with just lidocaine) can be given when pregnant
Neuromodulation devices

By: Caroline Pruski, NP


Caffeine is a stimulant substance found in items such as coffee, tea, and chocolate.
It is a known trigger for migraine sufferers. Some people are more sensitive than others to the effects of caffeine consumption and this can be very different from individual to individual.
In addition to triggering migraines, caffeine can cause dehydration. It is important to replace any water lost from caffeine consumption. For instance, if you drink 1 cup of coffee, then drink two 8 ounce glasses of water.
Keep in mind that in some people, headaches are triggered by caffeine withdrawal. For example, if you drink coffee during the weekdays, you may experience a withdrawal headache on the weekend.
For more information about lifestyle changes that may help you to decrease migraines and headaches, call The Manhattan Center for Headache & Neurology to speak with one of our caring providers. We look forward to seeing you!

By: Brooke Steiger, NP


Sleep is vital to help you maintain overall health. Many people who get migraines notice that they may experience more migraines when they are fatigued or haven’t slept well.
Make sleep a priority! It is recommended that you get 7-8 hours of sleep per night. Keeping a consistent bedtime and wake time is also an important part of a healthy sleep routine.
Creating a bedtime routine is another self-care habit that is part of setting yourself up for a good night’s sleep. You may consider taking a bath with essential oils, practicing meditation, or reading a good book as part of this routine.
It is also vital to maintain good sleep hygiene. This means turning off electronics for 1 hour prior to going to bed, not eating and drinking close to your bedtime, and avoiding alcohol near bedtime.
For more information about how sleep and other lifestyle changes can help your migraines, call The Manhattan Center for Headache & Neurology and speak to one of our caring providers!

By: Brooke Steiger, NP

Riboflavin for Headaches

Riboflavin is also known as vitamin B2 and is a B vitamin normally found in foods such as eggs, milk, poultry, green vegetables, and liver. It is involved in many cellular processes in the body, including the conversion of food into energy. It is sold as a natural supplement and is a safe and inexpensive option to be used for the prevention of migraines. It is common to see riboflavin included as part of a multi-component supplement that is specifically labeled for migraine prevention.

It has been shown to reduce the frequency of migraines. In one study, riboflavin supplementation helped reduce the frequency of migraines. Other studies have found a decrease in the use of migraine medications after several months of daily riboflavin supplementation. It is important to take this supplement at the correct dosage for it to be beneficial.

Call The Manhattan Center for Headache & Neurology to speak to one of our providers about adding riboflavin to your daily regimen!



There’s an App for That

We are all so connected these days. Migraine specialists at NYU have taken advantage of that fact to develop an app for smartphones to help patients suffering from migraines. The app is called RELAXahead and it uses behavioral and relaxation techniques to help patients manage their headaches. The study of migraine patients using the app found that after 2 months of use, those who used it 2 days per weeks had 4 fewer headache days per month. The app is especially helpful for patient’s to manage their headaches who have fewer choices of pharmacologic therapy such as pregnant and nursing mothers.

You can download the app from the Apple App Store or Google Play App Store.

By: Brooke Steiger

Magnesium and Headaches

Magnesium is one of the most abundant minerals found in the body that controls many important processes within our cells. It plays a vital role in the proper functioning of our nerves and muscles.

Some studies have shown a connection between low blood magnesium levels and chronic migraines and headaches. Other studies have found a significant decrease in symptoms associated with migraines including sensitivity to light and sound.

For this reason, your provider may recommend magnesium supplementation in pill form or via IV infusion to help control your migraines.

For more information please call our office to schedule an appointment with one of our caring providers. We look forward to meeting you!

By: Brooke Steiger, NP

Procedure spotlight: SPG block

SPG stands for sphenopalatine ganglion. It describes a group of nerve cells connected to the trigeminal nerve that is located behind the bony structures of the nose that is associated with headache and migraine. This in office procedure takes less than 5 minutes and uses a small plastic tube inserted in the nose to deliver local anesthesia to the SPG to help stop the pain signaling that causes the headache or migraine. Risks and side effects are minimal and temporary but may include mild discomfort, bitter taste in mouth, and lightheadedness.

Please call the office to schedule your consultation and discuss this procedure with your provider.

By: Brooke Steiger, NP

Headaches and Massage

Massage therapy has been used successfully to treat chronic pain and tension.
But did you know that it helps relieve and prevent the pain associated with migraines and tension headaches?
Therapeutic massage offers a noninvasive and medication-free approach to help manage your chronic headaches.
Research has shown that massage may reduce the frequency and severity of headaches.
Massage for migraines targets specific muscle groups that may be contributing to your headache.
We have a wonderful massage therapist here at The Manhattan Center For Headache & Neurology who is licensed and trained in technique for chronic headache.

By: Brooke Steiger, FNP

Dehydration Headaches

It’s hot and humid outside! During these summer months, it’s very important to stay hydrated. Not drinking enough fluids and not eating fluid rich foods can result in your body not getting enough of the fluids that it needs. This may cause a dehydration headache, a secondary headache caused by not having enough fluids. This is especially common during the summer months when you are more active than usual and enjoying the beautiful weather outside. Be aware of becoming dehydrated. Common signs of dehydration include extreme thirst, reduced urination, dark colored urine, confusion, dizziness, fatigue, dry, sticky mouth, loss of skin elasticity, low blood pressure and increased heart rate. People at higher risk of dehydration include: people who live in higher altitudes, infants and young children, elderly people, people with chronic illnesses (diabetes and kidney disease), endurance athletes and people who live in hot climates. But remember, anyone can become dehydrated if it’s hot outside and you are active! Severe dehydration may result in seeking medical attention to restore fluids. During this 4th of July holiday increase your fluid intake and replace lost electrolytes with a sports drink! Try to temporarily decrease physical activity in extreme heat. The Manhattan Center for Headache & Neurology wishes you a very happy and festive Independence Day Celebration. Stay cool and hydrated! Have fun and celebrate!

Top 10 Natural Headache/Migraine Remedies

Prevention is the key to managing migraines and headaches. Here are some non pharmacological methods of migraine and headache reduction. In our practice we recommend below preventatives which minimize headache frequency.

Magnesium 200-600 mg
Gluten free Diet
Peppermint and Lavender Essential Oil
Herbs: Feverfew and Butterbur
B complex Units (Vitamin B20
Stay Hydrated
Chiropractic Care

Call us to discuss these options! We look forward to helping you!