Migraine can disrupt everyday life, with symptoms extending beyond head pain. Roman Samborskyi/ShutterstockWhen you have a migraine, anything that might ease the pain can become very appealing. On social media, that might mean ordering chips and a Coke or pressing a cold spoon against your forehead. As someone who experiences migraine, I understand the willingness to try something that promises relief.As a neuroscientist and author of Splitting, a book about headaches including migraine, I want to know what supports that promise. An explanation that sounds plausible needs testing before it becomes reliable treatment advice.Understanding what happens during an attack helps explain why some remedies might offer comfort, while others promise more than the evidence can support.ProdromeMigraine can affect how you feel and function long before your head starts hurting. For me, repeated yawning is a warning sign. Researchers have documented symptoms before the headache, including tiredness and difficulty concentrating. This early phase, called the “prodrome”, can begin hours or even days beforehand.Food cravings can also occur. That creates a problem when trying to identify triggers: something you eat because an attack has already begun may subsequently get blamed for causing it.Chocolate is a good example. A review of research found insufficient evidence to recommend that everyone with migraine avoid it. The authors noted that eating chocolate before a headache might reflect a craving during the early phase of an attack, rather than chocolate triggering it. Of course, that does not establish chocolate as a treatment, either. AuraSome people also experience aura: temporary changes in vision or other sensations. Around a third of people with migraine experience it. Visual symptoms can include flashing lights or missing patches in the visual field.I once experienced a striking visual disturbance while visiting Saltburn beach. Part of my visual field disappeared, and I expected a headache to follow. It never arrived, and it never does for some people who experience these ocular migraines. Aura is associated with a slowly spreading wave of altered electrical activity across the brain’s outer surface. Depending on the area affected, people may experience flashing lights, tingling or other symptoms. Migraine aura can occur without a headache, although unfamiliar visual disturbances should be medically assessed because they can have other causes.When headache develops, it can be accompanied by nausea and sensitivity to light and sound. Untreated or unsuccessfully treated attacks typically last four to 72 hours. Symptoms vary, so being able to carry on with some activities does not rule out migraine.PostdromeThe end of the pain may not mean the end of the attack. During the recovery phase, called the “postdrome”, people can feel exhausted or struggle to concentrate. An electronic diary study documented these lingering symptoms. The comparison with a hangover is understandable, although there has been no night out to account for it.This complexity is one reason to be cautious about simple explanations for headache hacks. Migraine has sometimes been explained as a problem of blood vessels widening. But it also involves networks that process pain and sensory information, including signalling between nerves and blood vessels around the brain.Consider the chips-and-Coke suggestion. Caffeine has a legitimate place in some headache medicines. A Cochrane review, which systematically assessed results from clinical studies, found that adding caffeine to common painkillers modestly improved pain relief across several conditions, including headache.Caffeine affects chemical signalling in the nervous system as well as blood vessels, but its pain-relieving effects are more complicated than simply narrowing widened vessels. And studies of caffeine added to medicines cannot establish that a fast-food meal treats migraine, or that its salt and sugar “rebalance” the brain.Caffeine also complicates the picture because suddenly stopping regular consumption can trigger headache. A small randomised trial involving ten people with migraine who regularly consumed substantial amounts of caffeine found that abrupt withdrawal triggered migraine attacks in several participants.Cooling treatments have some supporting research. A systematic review found evidence of short-term pain relief from cooling interventions, although the six studies used different methods and the certainty of evidence varied. That offers some support for cooling as a comfort measure; it does not establish that holding a cold spoon against your forehead will relieve migraine.Established treatments deserve attention, too. Triptans, such as sumatriptan, are medicines designed to treat migraine attacks. They act on receptors for serotonin, a chemical messenger involved in nerve signalling, and generally work best when taken early in the headache phase, while pain is still mild.If attacks are frequent or disabling, discuss preventive treatment with a clinician. Options include medicines targeting CGRP, a chemical messenger involved in migraine.Between attacks, a headache diary can help you and your clinician understand the pattern. Record symptoms and medication use, alongside possible influences such as changes in sleep and diet. Look for repeated associations before deciding that a particular food must go.A sudden, extremely painful headache, new weakness, difficulty speaking or sudden loss of vision needs emergency assessment. Do not assume an unfamiliar symptom is migraine.Understanding your own migraine patterns can help you recognise early warning signs and make informed decisions about care. It will not make every attack preventable, but it may help you act sooner when symptoms begin.Strange Health is hosted by Katie Edwards and Dan Baumgardt. The executive producer is Gemma Ware, with video and sound editing for this episode by Anouk Millet. Artwork by Alice Mason.If you’ve got a question about a viral trend or video you’ve seen and you’d like us to delve into the science behind it in a future episode, please email us at strangehealth@theconversation.com.Listen to Strange Health via any of the apps listed above, download it directly via our RSS feed or find out how else to listen here. A transcript is available via the Apple Podcasts or Spotify apps.Amanda Ellison does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.