
The Traffic Light System
As migraineurs we use a lot of pain scales and mark our pain from 1-10 based on severity. We use the diaries to notes symptoms, medications, pain, etc. However, if we’re episodic, and only use acute medication such as painkillers and anti-inflammatories, this can make us more susceptible to Medication Overuse, and eventually lead to Medication Overuse Headache.
Some of the most difficult things to decide sometimes are:
- When do I use those few precious triptans that are in the pack?
- Does this attack warrant the full treatment or can I manage without the Triptans?
- How do I treat this type or this level of attack?
- Do I wait until the full-blown headache to develop?
Well two Doctors with Migraine Canada, – Ana Marissa Lagman-Bartolome, MD, and Christine Lay, MD from the Centre for Headache, Women’s College Hospital, University of Toronto, devised a system a couple of years ago that may help both you and your GP simplify this decision-making process, called the ‘Traffic Light system’[1].
The traffic light system is based on the associated disability of the migraine attack:
Green: “I can still go” headache
Yellow: “I have to slow down” headache
Red: “I have to stop” headache
You can work with your doctor to choose what the appropriate first‐line medication choice is for your migraines based on the severity of the attack, i.e., what colour on the ‘Ttraffic Light of headache’ you’re experiencing. For more information click this link https://migrainecanada.org/posts/mgc_archived/the-traffic-light-system/
Your migraine diary can be used with this system, with the aim of gradually reducing the amount of red and yellow days and eventually having mostly green days, because you’re managing your medication and migraine better.
Doctors should be able to advise you on the best course of treatment for each level on the scale depending on pain, other symptoms and how disabling the attack is.
Done well, this system can restore your control over your migraine and prevent more debilitating attacks from becoming the norm.
[1] Marissa Lagman-Bartolome A, Lay C. The Traffic Light of Headache: Simplifying Acute Migraine Management for Physicians and Patients Using the Canadian Headache Society Guidelines.