But what are the real causes they never tell you about? The head pain is related to dilation of extracranial blood vessels. So, what can cause that?

* An allergic reaction, usually to a ‘C’ food (J Allergy, 1952; 23: 429), such as chocolate, cheese, cauliflower, citrus, coffee, cow’s milk, crustaceans, cane sugar, caramel, candied fruits, corn (or maize products), cantaloupe, casein, cassava, caper, cashew nut, chicken, chestnut, cabbage and carrots (Lancet, 1979; i: 966-9; Lancet, 1980; ii: 1-4; Ann Allergy, 1985; 55: 28-32). Other common triggers include red wine and foods containing nitrates (such as bacon and smoked salmon).

* Musculoskeletal triggers, such as trauma to the head, neck or muscles. Recurrent throbbing migraine attacks on one side of the head often follow such injury (J Am Osteop Assoc, 1975; 74: 400-10).

* Hormones, such as the Pill or similar treatments for the menopause (see box).

* Stress, altered sleep patterns, unaccustomed exercise, irregular eating or alcohol consumption.

If eliminating these triggers doesn’t work, what can you do instead of drugs?

* Try homoeopathy. Several excellent studies demonstrate its effectiveness in migraine (Brigo B, ‘Homoeopathic treatment of migraine: A sixty-case, double-blind, controlled study (homoeopathic remedy versus placebo)’, Proceedings of the Congress of the Liga Medicorum Homoeopathicorum Internationalis, Arlington, VA, 1987).

* Use osteopathy for post-traumatic migraine. This is best between migraine attacks, when manipulation is less uncomfortable (Ward RC. Foundations for Osteopathic Medicine, Philadelphia, PA: Lippincott, Williams & Wilkins, 1997: 404-6). The osteopath may try manipulation, applications of local heat or cold, massage, trigger-point therapy, traction or neural therapy (local anaesthetic blockade).

* Herbs may help. Feverfew (Tanacetum parthenium) at 50-140 mg/day of granulated or powdered extract in divided doses (Cephalalgia, 1998; 18: 704-8) can successfully treat migraine. Don’t use it for more than five months, or if you are taking anticoagulant (blood-thinning) medications, if you are pregnant or breastfeeding, or hypersensitive to the Asteraceae plant family.

In Oriental medicine, fang feng (Radix Ledebouriella divaricatae, or Siler root) can significantly raise a migraine sufferer’s pain threshold (Bensky D, Gamble A, Chinese Herbal Medicine: Materia Medica, Seattle, WA: Eastland Press, 1993: 32-3).

During an attack, try taking the powdered root of Securidaca longipedunculata, successfully used in traditional African medicine (Chem Abstr, 1959; 53: 1065).

* Learn biofeedback and relaxation techniques. Both offer substantial benefits for adults and children suffering from migraine (Pain, 1990; 42: 1-13; Pain, 1995; 60: 239-56).

Harald Gaier Harald Gaier is a registered naturopath, osteopath, homoeopath and herbalist. He can be contacted at The Diagnostic Clinic, London, tel: 020 7009 4650