The wiki is still a work in progress, so as with the previous sticky, this highlights some resources that may be useful.

Edit - added the COVID-19 Vaccine and Migraines link since we're swapping that sticky for the Migraine World Summit announcement.

If this post looks familiar, most of it has been blatantly stolen from /u/ramma314's previous post. :)

Diagnostic Criteria

One of the most common questions that's posted is some variation of, 'Am I having migraines?'. The same is the case with 'what kind of migraine is this?'. These posts will most often be removed as they violate the rules regarding medical advice. You need to work with a medical professional to find a diagnosis. One of the better resources in the meantime (and in some cases, even at your doctor's office!) is the diagnostic criteria:

https://ichd-3.org/

It includes information about migraine, tension and cluster headaches, and the rarer types of migraine. It also includes information about the secondary headaches - those caused by another condition. One of the key things to note about migraine is that it's a primary condition - meaning that in most cases, migraine is the diagnosis (vs. the attacks being caused by something else). As a primary diagnosis, while you may be able to identify triggers, there isn't an underlying cause such as a structural issue - that would be secondary migraine, an example of which would be chiari malformation.

Not sure if your weird symptom is migraine related? Some resources:

• American Migraine Foundation

• Migraine Again

• Northwestern Medicine

• migraine.com blog

Website Resources

There are several websites with good information, especially if you're new to migraine. Here are a few:

National Headache Foundation

American Migraine Foundation - the patient-focused side of the American Headache Society

The Migraine Trust

UK Healthcare/Headache Center

Headache Australia

Migraine Australia

Added Feb 2025 - the American College of Physicians (ACP)'s treatment guidelines for prevention of episodic migraine: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01052

Migraine World Summit - Annual event, series of talks that are free for the first 24 hours and available for purchase (the year's event) thereafter.

They made a tools and resources list available, for both acute action and prevention, providing suggestions for some of the sub's most often asked non-med questions:

https://migraineworldsummit.com/tools/

Some key talks:

2024 - Beginner's Guide to Headache Types - If you're new and struggling with diagnosis, this talk alone may be well worth the cost of the 2024 package.

Reddit's built in search!

We get a lot of common questions, for which an FAQ on the wiki is being built to help with. For now though reddit's built in search is a great way to find common questions about almost anything. Just enter a medication, treatment, or really anything and it's likely to have a few dozen results. Don't be afraid to post or ask in our chat server (info below) if you can't find an answer with search, though you should familiarize yourself with the rules before hand. Some very commonly asked questions - those about specific meds (try searching for both the brand and generic names), the daith piercing, menstrual/hormonal migraine (there are treatments), what jobs can work with migraine, exercise induced attacks, triggers, and tips/non-drug options. Likewise, the various forms of migraine have a lot of threads.

Live chat!

^{An account with a verified email is required to chat. If you worry about spam and use gmail, using a +modifier is a good idea! There's no need to use the same username either.}

If you run into issues, feel free to send us a modmail or ping @mods on discord. The same rules here apply in the chat server.

Migraine/pain log template!

Exactly what it sounds like! A google docs spreadsheet for recording your attacks, treatments tried, and more. To use it without a Google account you can simply print a copy. Using it with a Google account means the graphs will auto-update as you use the log; just make a copy to your own drive by selecting File -> Make a copy while signed in to your Google account. There are also apps that can do this and generate some very useful reports from your logs (always read the fine print in your EULA to understand what you are granting permission for any app/company to do with your data!). Both Migraine Buddy and N-1 Headache have a solid statistical backbone to do reports.

Common treatments list

Yet another spreadsheet! This one is a list of common preventatives (prophylactics), abortives (triptans/ergots/gepants), natural remedies, and procedures. It's a good way to track what treatments you and your doctor have tried. Plus, it's formatted to be easily printable in landscape or portrait to bring to appointments (checklist & long list respectively). Like above, the best way to use it is to make a copy to your Google drive with File -> Make a copy.

This sheet is also built by the community. The sheet called Working Sheet is where you can add anything you see missing, and then it will be neatly implemented into the two main sheets periodically. A huge thanks from all of us to everyone who has contributed!

Finding Treatment

Most often the best place to start is your family doc - they can prescribe any of the migraine meds available, including abortives (meds that stop the migraine attack) and preventives. Some people have amazing success working with a family doc, others little or none - it's often down to their experience with it themselves and/or the number of other migraine patients they see combined with what additional research they've done. Given that a referral is often needed to see a specialist and that they tend to be expensive, unless it's been determined that secondary causes of migraine should be ruled out, it can be advantageous to work with a family doc trying some of the more common interventions. A neurologist referral may be provided to rule out secondary causes or as a next step in treatment.

Doc not sure what to do? Dr. Messoud Ashina did a MWS talk this year about the 10 step treatment plan that was developed for GPs and other practitioners to use, primarily geared for migraine with and without aura and chronic migraine. Printing and sharing this with your doc might be a good place to start: https://pubmed.ncbi.nlm.nih.gov/34145431/

Likely in response to this, the NHS published the following:

https://headaches.org/2022/01/19/national-headache-foundation-position-statement-on-the-treatment-of-migraine/ (link is broken)

/mod hat off

My personal take on this is that hopefully your doctor is well-versed. The 10-step treatment plan is, I think, a good place to start for clinicians unfamiliar, but it's not a substitute for doing the learning to be able to move away from an algorithm and treat the patient in front of them.

/mod hat back on!

At this point it's probably good to note that neurologists are not, by definition, migraine specialists. In fact, neurologists often only receive a handful of ours on the entire 200+ headache disorders. As with family doctors, some will be amazing resources for your migraine treatment and others not so much. But they can do the neuro exam and ruling out of secondary causes. Exhausted both? There are still options!

Migraine Specialists

A migraine specialist is just that - a doc, most often a neurologist, who has sought out additional training specific to migraine. There are organizations that offer exams to demonstrate that additional knowledge. Some places to find them:

Migraine Research Foundation

MRF is no longer. UCNS is it!

United Council for Neurologic Subspecialties

National Headache Foundation

Migraine Trust (UK)

Migraine & Headache Australia - Headaches and Pain Clinics

Telehealth

There's a serious shortage of specialists, and one of the good things to come of the pandemic is the wider availability of specialized telemedicine. As resources for other countries are brought to our attention they'll be added.

US:

Cove

Neura

Canada:

Maple

Crisis support.

Past the live chat we don't have subreddit specific crisis support, for now at least. There are a lot of resources on and off reddit though.

One of the biggest resource on reddit is the crisis hotlines list. It's maintained by the /r/suicidewatch community and has a world wide list of crisis lines. Virtually all of which are open 24/7 and completely anonymous. They also have an FAQ which discusses what using one of the hotlines is like.

For medical related help most insurance companies offer a nurse help line. These are great for questions about medication interactions or to determine the best course of action if nothing is helping. If your symptoms or pain is different than normal, they will always suggest immediate medical attention such as an ER trip.

edit - the new bit is a... ranty. To those here just to check in, my apologies.

Y'all.

Seriously.

The sheer number of app devs who have continued to waste mod time and continue spamming in comments after being warned is mind-boggling.

I believe that this community deserves good tools. HOWEVER, this community is not here to be sold to, and just like the post that preceded this, the people who can't stop spamming are rarely community members first, and devs second. They're here because you are the market. Since last week's post I had given a lot of thought to a periodic 'promote your stuff!' post to strike a balance, but after spending far too much of my holiday cleaning up spam-droppings... I'm feeling less than charitable. o.O

Spammers. If we warn you and you keep spamming, it won't just be you that's banned. It will be any mention of your product regardless of who posts it.

Astroturfing? Instant permaban - you and your product. Why?

You should not spam in any way, especially through private message. You should not hide your affiliation to your project or site, or lie about who you are or why you like something.

Here's a copypasta of the previous post, all of which still applies:

(If you were looking for the Summit pinned post, it's here.)

We're currently seeing multiple posts - or people that know promotion isn't permitted and trying to sneak it in via comments - promoting apps and/or doing market research daily. Most of the people hoping to benefit from this community have never made any effort to participate in it.

Promotion has always been in the the rules, and surveys/research have always required pre-approval from the mod team (though we recently had to update to not approving any because I'm the only active mod and simply don't have time to review in addition to everything else).

With all of the above in mind and all of the attempts to circumvent or flat-out argue about removals, it's time to formalize things:

Promoting your new app and/or doing market research (what don't you like/what works for you/what is missing in other <whatever>) is not permitted in this subreddit. The same goes for asking for feedback. Yes, this includes the ever popular 'hey I did a thing but it's against the rules to promote here, so if you're interested, send me a pm!'. If you're thinking about sending a modmail to ask to be an exception with less than 6 months of active participation in this subreddit, don't (even then it may not be approved).

I will be updating rules, sidebar, and filters over the course of the weekend.

Because of the lack of participation for most of these users and the number of users that have attempted to get around this, this will be one of the rare times when suspensions will be issued on first strike, rather than warnings first.

Also, you've probably noticed I'm the primary one handling approvals/removals, and that there are updates the sub could use that have not been done. In addition to chronic migraine and adulting in general I have what totals up to nearly 2 full time jobs and am usually also taking college classes, so there is a lot going on, and running this sub in a way that rules are enforced and the sub itself is enhanced and we're able to provide space for the community to be active in helping with research opportunities takes a lot more time than the above workload allows. To that end, I'd love to add 2 or 3 new mods to the team that can consistently (meaning most weeks) offer a couple of hours to running/maintaining the subreddit. That can be:

• Working on the FAQ: at one point there was an effort to build something of an 'intro to migraine' resource

• Fielding research/survey reviews: even better if you are or have been part of the research community (someone did offer this before; if you're still interested please reach out!)

• Post / comment reviews: If you're a regular/semi-regular visitor and don't mind doing some cleanup while you browse, this is one of the easiest ways to ensure that community standards are upheld

I've held off on posting this because I had big plans to set up an awesome form to fill out, but for all of the above reasons that has not happened. SO! If you're interested, please send us a modmail with answers to the following questions:

• Why you're interested

• What you think mods do

• Previous modding experience

• What you're interested in helping with

• Your time zone / location

• How much time you can reasonably and consistently pitch in to help

• Optional: Anything else we should know about you? Any ideas for the sub you'd like to implement?

As long as the above isn't struck through feel free to send a message if you're interested. It may take a bit to hear back because busy, but unless we get hundreds of apps we'll follow up to set up a chat with u/ramma314 and myself so we can get to know you a bit. If we do get hundreds of apps we'll update here that we either can't get back to everyone or that we'll be copypasta-ing replies specifically for that reason.