The most helpful thing you can do for someone mid-migraine is reduce what their body has to process: less light, less sound, less conversation, less decision-making. A migraine attack involves far more than head pain. It floods the nervous system with hypersensitivity, making ordinary stimuli feel genuinely painful. Your role is to shrink the world down to something manageable while handling the practical tasks they can’t.
Understand What They’re Going Through
A migraine can last anywhere from 4 to 72 hours untreated, and it often includes throbbing pain on one or both sides of the head, nausea, vomiting, and intense sensitivity to light, sound, smell, and even touch. But the attack itself is only one phase. Many people experience warning signs one to two days beforehand: neck stiffness, food cravings, mood shifts, excessive yawning, or increased thirst. Recognizing these early signs can help you both prepare before the worst hits.
After the pain finally fades, there’s a recovery phase sometimes called a “migraine hangover” that can last up to a full day. During this period, the person may feel drained, confused, dizzy, or sore throughout their body. They may still be sensitive to light and sound. Sudden head movements can briefly bring the pain back. This phase is real and debilitating, not a sign that someone is being dramatic or milking it.
Control the Environment First
Light is one of the biggest aggravators. Research from Harvard Medical School found that at office-level brightness, nearly 80 percent of migraine patients reported worsened pain from exposure to most colors of light. The exception was a narrow band of green light, which at low intensity actually reduced headache pain by about 20 percent. In practical terms, this means dimming or turning off overhead lights, closing blinds, and keeping screens off or at their lowest brightness. If the person needs some light, a dim green-toned bulb is the least likely to make things worse.
Sound sensitivity is equally common. Turn off the TV, lower your voice, silence phone notifications in the room, and close windows if there’s traffic noise. White noise machines can help some people, but ask first. Every migraine is different.
Smell sensitivity, called osmophobia, affects a large number of people during attacks. The most common offenders are body perfumes, scented candles, air fresheners, cigarette smoke, food odors, and cleaning products. Skip the cologne. Don’t cook anything with a strong smell nearby. If the person finds certain scents soothing (peppermint and lavender are the most commonly cited), you can offer those, but never assume a scent will help without asking.
Offer Specific Help, Not Open Questions
Asking “How can I help?” seems thoughtful, but for someone in severe pain, it can feel overwhelming. The American Migraine Foundation recommends offering small, specific options instead: “Can I get you a blanket?” or “Do you want me to close the blinds?” Yes-or-no questions are far easier to answer when thinking clearly is already a struggle.
Beyond that, believe them. If they say they need to rest, they do. If they cancel plans, don’t take it personally. If they leave an event early, let them go without guilt. One of the most damaging things for someone with chronic migraine is the feeling that people around them doubt how bad it really is. Listening before offering advice, and not comparing their experience to a headache you once had, goes a long way.
Temperature Therapy and Physical Comfort
Ice packs and heating pads are two of the simplest tools available, and many migraine sufferers rely on one or both. There’s no universal rule about which works better. Some people find a cold pack on the forehead or temples numbs the pain, while others prefer heat on the back of the neck to ease muscle tension. The Association of Migraine Disorders advises letting the person guide what feels right, since individual responses vary significantly. You can offer both options and let them choose, or try a combination: cold on the head, warmth on the neck.
Help them get physically settled in a comfortable position, ideally lying down in a cool, dark room. Bring a glass of water within arm’s reach. If they’re nauseated, a basin nearby is a small but meaningful kindness.
Keep Them Hydrated and Fed
Dehydration is a well-documented migraine trigger, and nausea during an attack can make it hard to drink anything. Encourage small, frequent sips rather than a full glass at once. Plain water works, but beverages with some electrolytes (coconut water, a drink with a pinch of salt and lemon, or a commercial electrolyte mix) help the body retain fluid more effectively. The body needs a balance of salt and water to maintain blood pressure and fluid levels, so plain water alone isn’t always enough.
A general target for daily hydration is about 2 liters, roughly one cup every two hours during waking hours, but during an attack, even getting a fraction of that in is better than nothing. If they can tolerate food, offer something bland and easy. Avoid anything with a strong aroma.
Help With Medication Timing
If the person has a prescription medication for migraines, the most useful thing you can do is bring it to them quickly. Most acute migraine medications work best when taken early in an attack, so speed matters. Know where they keep their medication, or ask them to tell you in advance during a pain-free period.
For over-the-counter options, ibuprofen and acetaminophen are the most commonly used. The FDA’s recommended maximum for acetaminophen is 3 grams per day, which means no more than 650 mg every six hours. Products marketed specifically for migraine, like Excedrin Migraine, combine aspirin, acetaminophen, and caffeine. The key thing to track is that the person isn’t doubling up on acetaminophen from multiple products without realizing it, since it appears in many combination medications.
One important caution: using any pain reliever more than two or three days a week on a regular basis can lead to rebound headaches, where the medication itself starts triggering new attacks. If you notice the person you’re caring for reaching for painkillers this frequently, it’s worth a gentle conversation when they’re feeling well.
Support the Recovery Phase
Once the pain subsides, the migraine isn’t necessarily over. The postdrome phase can leave someone feeling exhausted, mentally foggy, and physically sore for up to a day. Difficulty concentrating and making decisions is common. They may feel like the room is spinning.
During this window, the best things you can do are practical: handle meals, take over childcare or pet duties, field phone calls, and give them permission to rest without guilt. Light stretching or gentle movement can help some people recover, but pushing through strenuous activity too quickly can actually trigger another attack. Let them set the pace. Keep the environment relatively quiet and dim until they feel fully back to normal.
Heating pads, ice packs, and meditation can all provide comfort during recovery, just as they do during the attack itself. Well-balanced meals and continued hydration help the body reset.
Know When It’s an Emergency
Most migraines, even severe ones, are not medical emergencies. But certain symptoms during a headache signal something potentially dangerous. Call emergency services or go to the ER if the person experiences a sudden, explosive headache that reaches maximum intensity within seconds (sometimes called a thunderclap headache), which can indicate a blood vessel problem like an aneurysm. Other red flags include new weakness or numbness on one side of the body, difficulty speaking, vision changes that don’t resolve, a high fever alongside the headache, or a headache that is clearly and rapidly getting worse in a pattern unlike anything they’ve experienced before.
A new, severe headache in someone over 50 who has never had migraines, or a new headache in someone who is pregnant or has a compromised immune system, also warrants prompt medical evaluation. When in doubt, err on the side of getting help. The person in pain may not be in a position to advocate for themselves.