More than a billion people worldwide live with migraine, a neurological condition known for its severe pain and disruptive symptoms. While the causes of migraine are still not fully understood, new research is opening the door to a growing range of treatments that are helping many patients manage the condition more effectively.
Every morning, between brushing her teeth and applying skincare, Megan Daniels massages the side of her neck with a small handheld device. She places it just below her jaw until she feels a tingling sensation and the corner of her lip gently pulls downward. She repeats the process during lunch and again in the evening.
Getty ImagesWhile some people respond quickly to newer treatments for migraine, others can try several approaches without finding relief (Credit: Getty Images)
“It’s quite soothing,” says Daniels, a 35-year-old solicitor from Liverpool. “It feels like it’s sending waves through your brain.”
Daniels uses a neuromodulation device that delivers mild electrical pulses to stimulate nerves connected to the face and head. The goal is to prevent migraine attacks before they begin. Migraine affects more than a billion people globally and often presents as intense headaches accompanied by symptoms such as dizziness, nausea, and visual disturbances.
Despite its prevalence, migraine remains difficult to treat because it affects people in very different ways. Some experience throbbing pain on one side of the head, while others suffer from sensitivity to light, sound, smell, or movement. About a quarter of patients experience aura — visual disturbances that appear before or during an attack. Around three-quarters of migraine patients are women, and the condition can also affect children, sometimes presenting as severe abdominal pain rather than headache.
“There’s no single objective test for migraine,” says neurologists who specialise in the condition. “That’s one of the biggest challenges.”
Treatments can be unpredictable. Some patients find relief with over-the-counter painkillers, while others require prescription drugs designed to target migraine pathways. Even then, medications that work for many patients may not work at all for others. Frequent use of painkillers can also worsen migraine over time, leading to what doctors call medication-overuse headache.
For many people, preventing attacks is the priority. Over the years, doctors have discovered that drugs originally designed for heart disease, depression, or epilepsy can help reduce migraine frequency, although side effects can limit their usefulness.
A major breakthrough came in the 1990s, when researchers identified a group of proteins called calcitonin gene-related peptides (CGRPs). These proteins surge during migraine attacks and heighten pain sensitivity. Blocking CGRPs can reduce migraine frequency and severity, and several CGRP-targeting drugs are now available.
Studies show that some patients experience dramatic improvements with these treatments, while others see only modest benefits. For Daniels, CGRP blockers helped for several months before her migraines returned. She suffers from vestibular migraine, which affects balance as well as causing pain, leaving her unable to drive or leave the house during severe episodes.
New drugs are now being developed to target other molecules linked to migraine, including peptides involved in sleep and nerve signalling. These treatments aim not only to stop attacks once they start, but also to prevent them altogether.
Another unexpected option has come from Botox, more commonly associated with cosmetic procedures. Doctors noticed that patients receiving Botox injections often reported fewer migraines. Further research showed that Botox blocks pain-related nerve signals, including the release of CGRP. For some patients with chronic migraine, regular Botox injections can cut attack frequency by half or more.
For those who do not respond well to medication — including pregnant women — non-drug therapies are gaining attention. Neuromodulation devices like the one Daniels uses stimulate nerves using electrical or magnetic pulses. These devices come in many forms, including forehead pads, armbands, and crown-shaped headsets.
Some experimental treatments are even more unconventional. One device uses a vibrating balloon inserted into the nostril to stimulate nerves behind the nose, potentially reducing inflammation and calming migraine pain.
Experts say there is unlikely to be a single cure for migraine. Instead, treatment is becoming more personalised, combining medication, devices, lifestyle changes, and psychological therapies.
“Migraine is a chronic brain condition,” specialists say. “Managing it often means addressing sleep, diet, stress, physical activity, and mental health alongside medical treatment.”
For Daniels, improvement came from combining several approaches — physical therapy, regular exercise, meditation, hydration, and careful attention to mental wellbeing. No single treatment solved everything, she says.
“It’s all part of the puzzle,” she adds.
