Complementary therapies are add-on therapies meant to be used along with traditional treatment, according to the National Center for Complementary and Integrative Health (NCCIH). Massage, spinal manipulation, and acupuncture are examples of complementary therapies that may be beneficial for people with migraines. “Migraines can be a sign of underlying imbalance,” says Starr Ramson, ND, a naturopathic doctor with the Nourish Medical Center in San Diego. “Often, this is due to subtle changes in hormones, inflammatory mediators, and nutritional deficiencies — all of which can be addressed by complementary therapies. In other cases, there may be an underlying disease state that must be diagnosed and treated appropriately.” However, this latter point underlines the importance of talking with your doctor before trying any of these therapies, Ramson adds. In addition, there are some considerations such as cost — they’re not always covered by insurance — and the immediacy of your pain, she notes. And, complementary therapies also may take a few months to provide relief. Still, when performed safely by licensed practitioners and under the supervision of your doctor, these complementary therapies may offer safe ways to help tame your migraine pain: Acupuncture This ancient Chinese therapy involves a trained acupuncturist inserting very fine needles in specific points in your skin, according to the NCCIH. Many studies have examined the impact of acupuncture on migraines, and some research suggests that acupuncture modulates the central nervous system’s interpretation of pain, Ramson explains. According to a review of research, published in 2016 by Cochrane, six sessions of acupuncture can be effective for treating migraine. In general, it’s a safe option with long-lasting results, but needles aren’t for everyone and, overall, studies assessing the effectiveness of acupuncture across all pain conditions have yielded mixed results. Biofeedback Stress is a common migraine trigger, and biofeedback can be especially powerful in managing migraines brought on by stress, Ramson says. In biofeedback, electrodes are placed on your skin to measure your heart rate, brain waves, and muscle tone, feeding the results to a monitor. The findings can help you better understand your physiological response to stress; working with your doctor and your care team, you can then learn ways to self-regulate, Ramson explains. Tension in the muscles of the face, neck, or scalp can put pressure on your nerves and affect blood flow, Ramson says. Massage can help reduce that tension and stimulate blood flow. Though a relaxing massage from a loved one can ease tension, Ramson suggests visiting a professional who can target specific muscle groups. Relaxation techniques Deep breathing and progressive relaxation activate the parasympathetic nervous system, which counters the effects of stress on blood circulation, Ramson explains. “Even five minutes per day of deep abdominal breathing can make a difference,” she says. To practice progressive relaxation, contract and then relax all the muscles from your feet up to your face. Tai chi and yoga The slow, mindful movements of tai chi and yoga ease muscle tension and stress, which are major migraine triggers, Ramson says. Both of these mind-body practices are also effective for improving sleep, which can lead to a decrease in headaches, says Timothy A. Collins, MD, an associate professor of neurology and division chief of the department of headache and pain at Duke University Medical Center in Durham, North Carolina. Research published in a 2014 issue of the International Journal of Yoga found that yoga therapy, in combination with conventional migraine therapy, led to less frequent and less painful migraines than conventional therapy alone. Spinal manipulation Chiropractic care, also known as spinal manipulation, can help relieve compressed nerves and improve blood circulation, Ramson says. “This is valuable in classic migraine since the pain is related to abnormal blood flow in the cranial structures,” she says. Be sure to see a licensed chiropractor if you want to try it for relief; it may be especially helpful if your migraines are a result of whiplash. Dietary supplements There are a few dietary supplements with good evidence supporting their effectiveness at reducing migraine symptoms, Dr. Collins says. For instance, taking supplements with melatonin, a hormone that helps promote sleep, was as effective in preventing migraines as the antidepressant amitriptyline without the side effects, according to research published in the October 2016 issue of the Journal of Neurology, Neurosurgery, & Psychiatry. Riboflavin, or vitamin B2, is a safe option that also may help provide relief, according to a review of research published in the February 2015 issue of BioMed Research International, which noted one study in which more than half of participants saw a 50 percent reduction in migraine symptoms with very few side effects. Finally, butterbur was among the recommended dietary supplements to help prevent migraines in guidelines published in the March 2012 issue of the Canadian Journal of Neurological Sciences. Remember that managing migraine pain — naturally or otherwise — involves working closely with your doctor. “It is important that patients seek the care of a trusted doctor who will take the time to listen and to assess the unique history of their migraines,” Ramson says.