More than a headache. A neurological storm — light becomes hostile, sound unbearable, thinking impossible. Hours or days lost to a brain that won't quiet down.
Acute treatment relies on triptans, NSAIDs, and for severe episodes, ergotamines or anti-emetics. Preventive options include beta-blockers, anticonvulsants like topiramate, antidepressants, and the newer CGRP monoclonal antibodies (Aimovig, Ajovy). CGRP drugs have been a step forward but cost $600-700/month, don't work for everyone, and require ongoing injections. Botox injections every 12 weeks are FDA-approved for chronic migraine. Most patients cycle through multiple preventives before finding partial relief.
Bennett et al. (2008) conducted a Cochrane systematic review of HBOT for migraine and cluster headache. The review found that hyperbaric oxygen therapy was effective for aborting acute migraine attacks, with a number needed to treat of 2.0 — meaning every second patient benefited. The evidence was strongest for treatment of acute episodes.1
Wilson et al. (1998) published a double-blind, placebo-controlled trial in Cephalalgia showing that HBOT at 1.5 ATA produced complete or near-complete headache relief in 82% of migraine patients during acute attacks, compared to 17% with sham air. Pain scores dropped within 40 minutes of treatment.2
Eftedal et al. (2004) demonstrated in the European Journal of Neurology that repeated mild HBOT sessions reduced migraine frequency in chronic sufferers over a three-month follow-up period. The proposed mechanism involves normalization of cerebrovascular reactivity and reduction of cortical spreading depression.3
Loeb et al. (2018) published a randomized controlled trial in Photomedicine and Laser Surgery showing that transcranial PBM at 810 nm significantly reduced migraine frequency and intensity. Patients receiving active treatment experienced a 55% reduction in monthly headache days compared to 20% in the sham group over eight weeks.4
Hamblin (2019) reviewed evidence for photobiomodulation in headache disorders in Photobiomodulation, Photomedicine, and Laser Surgery, noting that NIR light reduces neuroinflammation, calms overactive trigeminal nerve signaling, and improves mitochondrial function in cortical neurons — addressing multiple migraine mechanisms simultaneously.5
Bussadori et al. (2015) demonstrated in a controlled trial published in Cranio that PBM applied to the temporal and frontal regions produced significant reductions in migraine-associated pain, with effects lasting beyond the treatment period.6