How to Stop a Migraine Before It Starts

A migraine does not begin with the pain. For most people it begins hours earlier, with yawning you cannot stop, a craving out of nowhere, or a neck that tightens for no reason. Medicine calls that stretch the prodrome. I call it an action window. Here is how to recognize yours, and two things to do at home while it is open.

Can you stop a migraine before it starts?

Often you can, because a migraine announces itself. An attack unfolds in phases, and the first one, the prodrome, begins hours to days before the headache.^[1]

The warning is reliable enough to act on. In a three-month study, 97 people who believed they could feel a migraine coming logged their symptoms in electronic diaries that could not be edited later. They correctly predicted a migraine from 72 percent of the entries that recorded warning symptoms.^[2]

And the window can be used. In a 2023 trial in The Lancet, 518 adults were randomized to treat one prodrome with a prescription migraine drug and another with a placebo, at the first warning sign and before any pain. No moderate or severe headache followed within 24 hours after 46 percent of the treated prodromes, against 29 percent with placebo.^[3] That trial tested a drug, but the principle is what matters: what you do in the prodrome changes what happens next.

Chinese medicine has always worked this way. We read the early signs and move while the body is still asking and not yet shouting. It is a large part of what I teach inside Gut Brain Synchrony, and it is the foundation of how I approach chronic pain.

What are the early warning signs of a migraine?

They are common, and they are not subtle once you know them. In a Finnish study of 2,223 people with migraine, 77 percent reported warning symptoms, three different ones on average. Yawning was the most common, reported by 34 percent.^[4]

In the diary study above, three symptoms were logged most often before an attack.^[2]

Repeated yawning, thirst and needing to urinate more often are on the recognized list as well,^[1] and so are food cravings and mood changes. Yawning and cravings are the two red flags people explain away, so I take those first.

Why do I yawn before a migraine?

Because the part of your brain that runs sleep, appetite and body temperature is already involved. Before the pain sets in, the hypothalamus, the brain's control tower, starts firing overtime.

Researchers at the University of California, San Francisco used PET to scan eight people during the warning phase of a triggered migraine, before any pain. Compared with their baseline scans, the hypothalamus was already active, along with parts of the midbrain and brainstem.^[5]

Yawning itself is tied to dopamine, one of the messengers the hypothalamus works with. In a study of 339 people with migraine, 45 percent reported repetitive yawning with their attacks, and the ones who yawned were also more likely to report sleepiness, irritability and changes in appetite beforehand.^[6]

A 2022 review links fatigue, mood changes, yawning and food craving to messengers made in hypothalamic neurons: orexins, neuropeptide Y and dopamine. Its authors also argue that the hypothalamus may be one of several regions involved and not the single driver, and that question is still open.^[7]

So when you yawn like you have not slept in three days, that is not tiredness. It is a signal.

Why do I crave chocolate before a migraine?

For the same reason you yawn. The hypothalamus governs appetite, and in the prodrome it can flood your body with cravings. Suddenly you want an entire chocolate bar, for no reason you can name.

This is also how chocolate got its reputation as a migraine trigger. You eat the chocolate, the migraine arrives hours later, and the chocolate takes the blame. A 2020 review in Nutrients gathered 25 studies on the question. In surveys, between 1.3 and 33 percent of people with migraine named chocolate as a trigger. In all three trials that tested chocolate against a placebo, chocolate set off no more attacks than the placebo did.^[8]

The reviewers raise the same possibility I am describing: the craving may be a symptom of an attack already under way, not its cause. In Chinese medicine, sweet is the flavor of the Spleen and Stomach, and a sudden pull toward it is read as the digestive center asking for support. Either way the craving is information.

Does soaking your feet in hot water help a migraine?

It is the first of the two home remedies I teach, and there is a clinical trial behind it. Heat up your feet and cool your head at the same time.

Researchers in Bengaluru, India randomized 40 people with chronic migraine to their usual medication alone, or to medication plus hydrotherapy: a hot arm and foot bath at 103 to 110°F (39 to 43°C) with ice massage to the head, 20 minutes a day for 45 days. Headache frequency and intensity dropped in both groups, and more with hydrotherapy. In that group heart rate came down and vagal tone, the rest-and-digest side of the nervous system, went up.^[9]

Why cold goes on the head

Cold has its own evidence. A meta-analysis pooled six studies of cold for migraine, among them gel headbands, gel caps and cold wraps. Cold lowered pain scores 30 minutes after it was applied. By 24 hours the difference was marginal.^[10] Cold buys you time, which is what the window calls for.

Why heat goes on the feet

Chinese medicine reads a migraine as too much above and too little below. Heat and pressure rise to the head while the feet go cold. The foot soak is the classical answer: warm the lowest point of the body, and what has collected above has somewhere to go. Doing this early, before the pain hits, can get blood out of the head and into the feet, so the episode passes quickly. That is the traditional explanation. The modern measurements so far are the ones above: fewer, lighter headaches and a calmer nervous system.

Is there a pressure point on the ring finger for migraines?

Yes. It is called Guanchong, and it sits at the corner of the ring fingernail, on the side facing your little finger. It is the first point on the channel Chinese medicine calls the San Jiao, or Triple Burner. From there the channel runs up the back of the hand and arm, over the shoulder, up the side of the neck and around the ear, and ends at the temple. That is the territory of a one-sided migraine.

Classically, the points at the tip of a channel clear what has built up at its far end, which here is the head. The next points on the same line, in the groove between the ring and little finger knuckles, are used for pain at the temple too. So I do not send you to a single dot. Work the whole edge of the finger, from the nail down to the space between the knuckles, and stay on the spot that is most tender.

What the research says

The strongest evidence is for acupuncture. In a Cochrane review of 22 trials and 4,985 participants, headache frequency at least halved in 41 percent of people who added acupuncture to usual care, against 17 percent without it. Against sham needling the gap was smaller, 50 percent against 41 percent, and still significant.^[11]

Finger pressure has been studied far less than needles. In one trial, 76 people with migraine pressed acupuncture points on themselves three times a week for four weeks, and their fatigue fell significantly more than in the group pressing sham points.^[12] In another trial, of 98 people with chronic migraine with aura, adding acupressure to medication eased nausea but did not lower pain scores.^[13] That fits how I use it: early, alongside the foot soak, while the window is open.

If your headaches sit in the forehead more than at the temple, the point between the thumb and index finger is the next one to learn.

How do you make migraines happen less often?

The two remedies above are for the window. The longer project is making it open less often, and that work starts in the gut.

One of my patients went from three migraines a week to one light aura a month. What changed along the way was her tongue. In Chinese medicine the tongue is a picture of the digestive terrain, which I explain in my post on iced matcha. She took the right medicine to heal her gut-brain axis, and she learned this routine to keep that aura from turning into a full migraine episode.

The gut-brain axis is the two-way line between your digestive system and your central nervous system. A 2020 review in The Journal of Headache and Pain lays out the connections: migraine is associated with irritable bowel syndrome, celiac disease and H. pylori infection, and the proposed pathways run through inflammatory messengers, the gut microbiota, serotonin and stress hormones.^[14]

There is trial evidence too. In a randomized, double-blind study, 40 people with episodic migraine and 39 with chronic migraine took a 14-strain probiotic or a placebo. After ten weeks, attack frequency in the episodic group had fallen by a mean of 2.64 on the probiotic and had not moved on placebo. The chronic group showed the same pattern after eight weeks.^[15]

A probiotic is not the point. The point is that when the gut changes, the head can change with it. Terrain, not symptom.

How to stop a migraine when you feel it coming on

Do it early. The value of the routine is in the timing.

Migraine warning signs, answered

What is the difference between migraine prodrome and aura?

They are two different phases. The prodrome is the long, quiet build: hours to days of fatigue, yawning, cravings and neck tension, with no pain. Aura, which only some people with migraine get, comes later, closer to the headache. It is a short neurological event, most often visual: zigzag lines, blind spots, sometimes tingling in a hand or the face. The prodrome comes first, and that makes it the better window.

Does soaking feet in cold water help migraines?

Not the way I teach it. The cold goes on the head and the heat goes on the feet. Chilling the feet works against what you are trying to do.

Can a migraine prodrome cause anxiety?

Yes. Irritability and anxiety are among the recognized warning symptoms, along with sleepiness and changes in appetite, and they are more common in people who also get the repetitive yawning.^[6]

Your body has been sending these signals your whole life. Now you know what to do with them.

— Brehan Crawford, L.Ac.

References

1. Karsan N, Bose P, Goadsby PJ. The Migraine Premonitory Phase. Continuum (Minneap Minn). 2018;24(4):996-1008. doi:10.1212/CON.0000000000000624
2. Giffin NJ, Ruggiero L, Lipton RB, et al. Premonitory symptoms in migraine: an electronic diary study. Neurology. 2003;60(6):935-940. doi:10.1212/01.wnl.0000052998.58526.a9
3. Dodick DW, Goadsby PJ, Schwedt TJ, et al. Ubrogepant for the treatment of migraine attacks during the prodrome: a phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023;402(10419):2307-2316. doi:10.1016/S0140-6736(23)01683-5
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8. Nowaczewska M, Wiciński M, Kaźmierczak W, Kaźmierczak H. To Eat or Not to Eat: A Review of the Relationship between Chocolate and Migraines. Nutrients. 2020;12(3):608. doi:10.3390/nu12030608
9. Sujan MU, Rao MR, Kisan R, et al. Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients. J Neurosci Rural Pract. 2016;7(1):109-113. doi:10.4103/0976-3147.165389
10. Hsu YY, Chen CJ, Wu SH, Chen KH. Cold intervention for relieving migraine symptoms: A systematic review and meta-analysis. J Clin Nurs. 2023;32(11-12):2455-2465. doi:10.1111/jocn.16368
11. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;2016(6):CD001218. doi:10.1002/14651858.CD001218.pub3
12. Vagharseyyedin SA, Salmabadi M, BahramiTaghanaki H, Riyasi H. The impact of self-administered acupressure on sleep quality and fatigue among patients with migraine: A randomized controlled trial. Complement Ther Clin Pract. 2019;35:374-380. doi:10.1016/j.ctcp.2018.10.011
13. Xu JH, Mi HY. A randomized controlled trial of acupressure as an adjunctive therapy to sodium valproate on the prevention of chronic migraine with aura. Medicine (Baltimore). 2017;96(27):e7477. doi:10.1097/MD.0000000000007477
14. Arzani M, Jahromi SR, Ghorbani Z, et al. Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain. 2020;21(1):15. doi:10.1186/s10194-020-1078-9
15. Martami F, Togha M, Seifishahpar M, et al. The effects of a multispecies probiotic supplement on inflammatory markers and episodic and chronic migraine characteristics: A randomized double-blind controlled trial. Cephalalgia. 2019;39(7):841-853. doi:10.1177/0333102418820102