Migraines & Medication: Why Some People Need Both Medical Care & Therapy

If you take medication for migraines, you're not alone. Millions of people rely on medication to manage their pain. And for many, medication helps. Sometimes a lot.

But what happens when your medication only takes the edge off? Or when you're still spending days in bed despite doing everything your doctor suggested?

You might wonder if there's something wrong with you. Or if you just need to try another medication.

Here's what many people don't know: medication and therapy for chronic pain can work together. You don't have to choose one or the other.

At Aspire Counseling, we help people with migraines find relief through counseling—often while they're still working with their doctor on the medical side. Because sometimes, the best approach includes both.

When medication helps—and when it's not enough

Migraine medication can be a lifesaver. Triptans, preventive medications, and even newer CGRP inhibitors can reduce how often migraines happen or how bad they feel.

For some people, medication is enough. They take their pills, and their migraines become manageable.

But for others, medication only helps so much. Maybe it takes the pain from an 8 to a 5. Or it works some days but not others. Or the side effects are almost as hard to live with as the migraines themselves.

And then there's the stress of it all. Worrying about when the next migraine will hit. Avoiding triggers. Feeling like your whole life revolves around preventing pain.

This is where therapy comes in. Not because medication isn't working. But because living with chronic pain affects more than just your body.

How therapy complements medical treatment

Therapy for migraines isn't about replacing your medication. It's about addressing the ways your brain has learned to respond to pain.

Here's the thing: your brain plays a huge role in migraines. When you have chronic migraines, your nervous system can get stuck in a pattern. It becomes more sensitive. It starts treating safe things as dangerous.

Stress, tension, even thinking about a migraine can trigger your brain's alarm system. And that can make migraines worse or happen more often.

Therapy helps you change that pattern. We use approaches like somatic tracking, mindfulness, and Internal Family Systems (IFS) to help your brain feel safer. When your nervous system isn't constantly on high alert, migraines often improve.

This doesn't mean your migraines are "all in your head." It means your brain and body are connected in powerful ways. And we can use that connection to help you feel better.

The best part? This works alongside medication. You're not giving anything up. You're adding a tool that targets a different part of the problem.

Medication rebound headaches: The surprising role of the brain

There's another reason therapy can help: medication overuse headaches.

If you're taking pain medication more than a couple times a week, you might be stuck in a cycle. The medication helps at first. But over time, your brain starts to expect it. When the medication wears off, your pain comes back—sometimes worse than before.

This is called a medication rebound headache. And it's more common than most people realize.

Therapy can help you break this cycle. We don't ask you to just stop taking your medication. Instead, we help your brain learn that pain doesn't always mean danger. We teach your nervous system that it can calm down without medication.

For many people, this means they can use less medication over time. Not because they're toughing it out. But because their brain has learned new ways to respond to pain signals.

Should I stop my migraine medication before starting therapy?

No. Please don't stop your medication without talking to your doctor first.

Therapy and medication work best when they work together. We're not here to tell you to give up something that helps. We want to add to what's already working.

Some people do eventually reduce their medication as therapy helps. But that's a decision you make with your doctor. Not something we push you toward.

Our job is to help your nervous system calm down. To help you feel less afraid of pain. To give you tools that work whether you're on medication or not.

We've seen people who keep taking their medication and still get huge benefits from therapy. They have fewer migraines. The migraines they do have are less intense. They feel less anxious about when the next one will hit.

And we've seen people who gradually need less medication as their brain learns new patterns. Both paths are okay. We follow your lead.

Coordinating care between your doctor and therapist

The best care happens when your medical provider and your therapist are on the same page.

We're happy to talk with your doctor if that's helpful. We can share what we're working on in therapy and how it fits with your medical treatment.

This doesn't happen automatically—we'll always ask your permission first. But when your healthcare team works together, you get better results.

Your doctor knows your medical history. They understand your medications and any physical factors in your migraines. We know how your brain is responding to pain and stress. Together, we can give you the most complete care possible.

Getting started with migraine therapy in Lee's Summit or online in Missouri

If you're taking medication for migraines but still struggling, therapy might help.

You don't have to choose between medical care and counseling. You can do both.

At Aspire Counseling, we work with people throughout Missouri—both in person at our Lee's Summit office and through telehealth. Our approach is grounded in research. We use methods that have been shown to help the brain change how it responds to pain.

And we get it. Living with migraines is exhausting. We're not going to tell you to just think positive or try harder. We're going to help you understand what's happening in your nervous system and give you real tools to change it.

If this sounds familiar, you're not alone. And you don't have to figure this out by yourself. Our chronic pain therapists in Lee's Summit would be glad to talk with you.

Ready to see if therapy might help? Start with a free consultation. We'll talk about what's going on and whether our approach might be a good fit. No pressure, no commitment required. You can reach us at (573) 328-2288 or reach out to us online.

About the Author

This post reflects the approach used by Adam White, LPC but was written by our founder, Jessica (Tappana) Oliver who also has training & experience treating chronic pain. . Adam specializes in helping people with migraines, chronic pain, and other persistent pain conditions find relief through evidence-based therapy. He practices at our Lee's Summit, Missouri location and also offers online therapy throughout Missouri.