Migraine Treatments Ranked: What REALLY Works
Below is a ranking of wide range of drug-free migraine treatments (supplements included) based on an extensive evaluation of the available evidence for their effectiveness, and their associated risks or burdens. Ultimately, the goal is to help identify that interventions with the highest “bang for the buck,” meaning a strong possibility of benefit with minimal downsides. A single emoji next to the intervention provides a quick summary of its benefit to burden ratio as follows:
π€© = top-tier, best benefit to burden ratio
π = Very good with a favorable tradeoff
π = So-so
π = Poor – weak benefit or high burden
π€’ = weak or nonexistent evidence, or potential for net harm
You can click on any of the treatments for a more detailed breakdown.
| Treatment | SCORE | Benefit | Burden | Evidence | Effect Size | Risk | Cost |
|---|---|---|---|---|---|---|---|
| π€© Strength Training | 3.0 | 6 | 2 | Strong | High | Low | $β$$ |
| π€© Regular Aerobic Exercise | 2.5 | 5 | 2 | Moderate | Moderate | Low | $ |
| π€© Sleep Hygiene | 2.0 | 2 | 1 | Moderate | Moderate | None | $ |
| π€© Ketogenic Diet | 2.0 | 4 | 2 | Moderate | Moderate | Moderate | $ |
| π€© Cognitive Behavioral Therapy (CBT) | 1.67 | 5 | 3 | Moderate | Moderate | Minimal | $$$ |
| π€© Riboflavin (Vitamin B2) | 1.5 | 3 | 2 | Moderate | Moderate | Minimal | $ |
| π€© Melatonin | 1.5 | 3 | 2 | Moderate | Moderate | Minimal | $ |
| π HRV / Neurofeedback | 1.0 | 4 | 4 | Moderate | Moderate | Minimal | $$$ |
| π Magnesium | 1.0 | 2 | 2 | Moderate | Moderate | Low | $ |
| π Whole-food Gluten-free Diet | 1.0 | 2 | 2 | Moderate | Moderate | Minimal | $ |
| π CoQ10 | 1.0 | 3 | 3 | Moderate | Moderate | Minimal | $$ |
| π Hydration & Meal Regularity | 1.0 | 1 | 1 | Moderate | Moderate | None. | $ |
| π Box Breathing | 1.0 | 1 | 1 | Weak | Low | None | $ |
| π Buteyko Breathing | 1.0 | 1 | 1 | Weak | None | Minimal | $ |
| π Green-light Lamp | 1 | 3 | 3 | Weak | Low | Minimal | $$ |
| π High Omega-3 / Low Omega-6 Diet | 1.0 | 3 | 3 | Moderate | Moderate | Low | $$ |
| π Nerivio | 0.8 | 4 | 5 | Moderate | Moderate | Low | $$$ |
| π Cefaly | 0.8 | 4 | 5 | Moderate | Moderate | Low | $$$ |
| π gammaCore | 0.8 | 4 | 5 | Moderate | Moderate | Low | $$$ |
| π Hypnosis | 0.67 | 2 | 3 | Weak | Unknown | Minimal | $$ |
| π Yoga / Tai Chi | 0.67 | 2 | 3 | Moderate | Low | Low | $ |
| π Acupuncture | 0.5 | 2 | 4 | Moderate | Low | Low | $$ |
| π ONS Implant | 0.5 | 4 | 8 | Moderate | Moderate | High | $$$$ |
| π McDonaldβs Migraine Hack (Coke + Fries) | 0.5 | 1 | 2 | Anecdotal | Unknown | Low | $ |
| π Cooling Cap | 0.5 | 1 | 2 | None | None | Minimal | $$ |
| π NTI Splint | 0.5 | 1 | 2 | Weak | None | Low | $$ |
| π sTMS / Relivion | 0.4 | 2 | 5 | Moderate | Low | Low | $$$ |
| π Ear-pressure Device (ZΕk) | 0.33 | 1 | 3 | Weak | Low | Minimal | $$ |
| π Essential Oils | 0.33 | 1 | 3 | Weak | Low | Low | $ |
| π Tinted Glasses | 0.33 | 1 | 3 | Weak | Low | Minimal | $$ |
| π Butterbur / Feverfew | 0.25 | 1 | 4 | Weak | Low | Moderate | $ |
| π CBD / Cannabis | 0.25 | 1 | 4 | Weak | None | Moderate | $$$ |
| π SPG Block | 0.17 | 1 | 6 | Weak | Low | Moderate | $$$ |
| π€’ Ear Seeds | 0.0 | 0 | 1 | Weak | None | Low | $ |
| π€’ Daith Piercing | 0.0 | 0 | 4 | None | None | Moderate | $ |