By Magdalena Shemayev, LMBT, CPT

Too much sleep, not enough sleep. Extra cup of coffee, or you skipped your second cup today. You could be in the middle of finals at school, or maybe you just finally got a break after a long week at work. Yet, no matter what, it seems like it’s time for a migraine. The neck pain starts to creep in, maybe you yawn, and maybe you start craving sugar. You get nauseous, the pain creeps behind one eye, and all you can think about is crawling to a dark room and trying to sleep it off.

Unfortunately, it’s much harder to stop pain once it begins than it is to prevent it. A better approach lies in identifying as many migraine triggers as possible, and controlling the ones you can.

Migraine triggers are highly individual, but there are common themes. According to a large study, the most common trigger is weather, followed closely by stress and not enough sleep. For those who have dealt with migraines — many of us for our whole lives — some triggers are obvious and predictable (no, thanks, I’ll pass on the white wine!), while others are elusive and fickle. Maybe some days you can handle that extra cup of coffee, and other days, a few sips and you can feel the throbbing start. What gives?

This is where the concept of a trigger threshold is useful. A tool used to describe how and why certain combinations lead to that telltale pain, being able to identify and whittle away at your own trigger threshold is an invaluable tool for the migraineur.

Imagine a cup that, when filled, means you get a migraine. Some things add a few drops, like spending too many hours at your computer or forgetting your sunglasses on a long walk. Some things fill the cup halfway, like a glass of white wine or sleeping on your neck wrong.

What matters most is how full the cup already is. Say you skipped a meal — that’s a third of your glass. Unfortunately, you skipped that meal because you slept badly (another quarter, let’s say), and you tossed and turned so much you wrenched your neck (another quarter). Now your glass is five sixths full, so while your coworker wearing cologne isn’t usually an issue, BAM, the glass is full and now it’s migraine time.

Some triggers are controllable. Avoiding certain foods, for example, is a relatively easy solution, or sticking to two cups of coffee a day. Other triggers are completely outside our control, like the weather or whether a coworker piles on the cologne for a hot date. A lot of triggers can be controlled to an extent with regular massage to reduce stress, eating regularly and not skipping meals, stretching for muscle tension, etc. In particular, stress and physical tension reduction can go a long way toward preventing a migraine, or if one has already started, making the pain and symptoms more bearable.

One of the most common symptoms of migraines — more common even than nausea or the migraine aura itself in some studies — is neck pain. For many, neck pain is the final drop in their migraine cup, or perhaps the first symptom of the migraine itself. Many common prescription migraine medications, such as the triptans (Imitrex, Amerge, etc.) can cause muscle cramps and tension, which don’t feel great even if your head starts to feel better. Massage can help relieve the tension before and during a migraine, and regular bodywork can help reduce your overall stress levels and prevent the physical tension patterns from taking hold as easily.

Most importantly, find what combination works for you. The key is to control as many triggers and symptoms as possible so that when the uncontrollable happens, your cup isn’t already full. Many find it hard to tell what facets of their migraines are triggers and precede the migraine, or make up the migraine itself. By regularly emptying your migraine cup, or keeping the amount in it low, you can reduce your levels of pain and help prevent a migraine before it starts.

Magdalena Shemayev is a licensed massage therapist and certified personal trainer at Renu Massage, Energy & Bodywork. She specializes in working with clients with chronic pain conditions, such as migraines or TMJ. Her goal in any session is to give the body and mind a safe space to find itself again, in order to facilitate relaxation and healing. You can contact her through her business Facebook (http://www.facebook.com/mshemayevLMT) or schedule an appointment with her through Renu Massage, Energy & Bodywork www.renumadison.com

References: “Common Triggers.” Migraine.com. www.migraine.com/mia2012/common-triggers/.

“Neck Pain.” Migraine.com. www.migraine.com/migraine-symptoms/neck-pain/.