One thing must be made clear from the outset: there is no cure for migraine - yet! Although we are finding out more and more about its mechanisms, we shall have to wait a while longer for a promising treatment based on its causes. However, the scientists are confident that there will soon be considerable therapeutic progress.

But you don't have to wait for this of course! Do not let your migraine control you, but do whatever you can and whatever is most useful to get the upper hand over this condition. There is a wide range of options open to you.

Your primary aim should be to identify and avoid your personal migraine risk factors on the basis that: the best migraine is the one that doesn't happen! Your headache and migraine diary is a valuable aid here.

If possible, keep to the same daily routine - even at weekends and on holiday. This means, for example, going to bed and getting up at the same time whenever possible and having your meals at the same time. Don't take on too much and always have breaks in which to relax. Say no to anything which threatens to disrupt your routine. But don't adhere slavishly to your daily plan, avoid the perfectionism trap and sometimes look the other way. Otherwise you put yourself under tension and stress - and the next attack will soon follow.

Regardless of whether or not stress and the pressure to perform are your migraine triggers, relaxation is always sensible for migraineurs. Do regular relaxation exercises, for example progressive muscle relaxation training, autogenic training or yoga. Ask your doctor for his advice and get the appropriate literature and audio and video cassettes.

Above all, you should engage in regular sporting activity - sport which you enjoy - and walk a lot as this relaxes you and your brain. Studies show that endurance sports such as jogging can even prevent migraine.

By heeding these tips, you can ensure that your migraine attacks become rarer and perhaps also even "milder". You will not be able to avoid them completely, however, but help is available. There is now a whole range of effective medications which can take the edge off an attack quickly, making it more bearable and also shorter-lived.

If you have a tendency towards nausea and vomiting during an attack, you should take medication, which is available on prescription, before the analgesic to prevent these unpleasant effects. An antiemetic of this type enhances the effect of the analgesic. The reason for this is that it restores the motility of the gastrointestinal muscles (which are "paralysed" by the migraine attack) so that the analgesic is transported more easily out of the stomach and can be absorbed from the gut so that it finds its way into the bloodstream and to its site of action as quickly as possible. Take the analgesic a quarter of an hour after the antiemetic to ensure optimum pain relief.

The German Migraine and Headache Society gives the following recommendations for drug treatment for mild to moderate migraine attacks:

1.Antiemetic to combat nausea and vomiting

• Metoclopramide (20 mg)
• Domperidone (20 mg)

2.Analgesic for pain relief

• Acetylsalicylic acid* (1000 mg)
• Paracetamol (1000 mg)
• Ibuprofen (400 mg)

If possible, you should retire to a quiet, darkened room during a migraine attack in order to avoid sensory stimuli such as glaring light and noise which make the pain worse.

Many people find it helps to focus on something else during an attack - for example by listening closely to music or visualising a pleasant situation, such as a holiday ...

It can also help to close your eyes and concentrate entirely on your pain. Imagine it as a large sphere. If you succeed, then you should not find it difficult to gradually reduce the size of this sphere to a tiny point until it disappears.