This study involved the analysis of publicly available data from online platforms and social media on the topic of migraines in English and Arabic. No personal or identifying information was collected or used, and no human participants were involved. All data were analyzed in aggregate form, and individual users were not identifiable. Therefore, ethics approval was not required for this study.

The results indicate a total of 53,000 mentions during the extraction period, averaging 4000 monthly conversations from 23,000 unique authors. About 33,920 (64%) of these discussions took place on X across both languages. Individuals with migraines primarily engaged with content related to migraine triggers and treatments. Men were slightly more likely than women to discuss migraines, with a 1.1-fold higher engagement rate.

The analysis of English language data (N=53,000) regarding migraine discussions among patients in the Gulf region revealed several concerns, including the potential impact of migraines on overall health. Patients discussed various aspects, including the impact of migraine during pregnancy, with this topic accounting for 1060 (2%) of the mentions. Discussions about vision loss made up 1325 (2.5%) of conversations, migraines in relation to influenza represented over 1060 (2%), concerns about connections to heart attacks accounted for 795 (1.5%), and seizures accounted for 1060 (2%). Sleep disruption due to migraines was a major issue, representing over 1590 (3%) of discussions as depicted in Multimedia Appendix 1. Many sufferers used paracetamol for pain relief and better sleep, showing the severe impact of migraines on daily life.

The analysis also shed light on patients’ self-management strategies for migraine relief, including alternative treatments such as cannabidiol (CB) softgels, cupping, acupuncture, and scalp massages. Patients in the Gulf region generally relied on self-treatment or other sources, underestimating the disease condition; hence, there is a need for greater awareness. Local hospitals actively shared information about treatment options and advancements. Throughout the analysis period, prominent news sites played a role in disseminating information and raising awareness about migraines within the Gulf community.

Among them, aspirin, ibuprofen, and paracetamol emerged as commonly mentioned options, each gaining attention in social media discussions. Ibuprofen stood out, accounting 1590 of 53,000 (3%), particularly on platforms like Tumblr. Mentions of triptans represented a smaller portion of the discourse, mainly because specific product names dominated the conversation. Metoclopramide, though less frequently discussed, was highlighted by HCPs for its potential benefits in migraine therapy. Nonmedication approaches, such as hot and cold therapy products, gained interest, with certain items like facial masks being mentioned in approximately 530 (1%) of discussions. Unconventional remedies, referred to as a “migraine stick,” were cited as alternative methods for soothing migraine symptoms. These findings showcase the diverse range of treatments explored by migraine sufferers and the insights shared within online communities.

In examining the customer journey for migraine treatment solutions, social media has emerged as a prominent method for discovering effective remedies. Platforms like TikTok (ByteDance) have become essential for users to share personal experiences and identify potential treatments, often leading them to purchase products on websites. In the Gulf region, nonpharmacological approaches to migraine management, including naturopathy, plant-based diets, and veganism, were present in the dataset and accounted for 2120 (4%) of discussions. Various sources, such as the Times of Oman and blogs, described naturopathy and plant-based diets in relation to migraine symptoms; these sources were referenced in patient discussions [13]. Closed groups like the UAE Migraine Facebook group offer a safe space for users, while platforms such as X, Tumblr, and blogs facilitate discussions between patients and health care providers (HCPs). These professionals play a crucial role, offering advice on medication, when to seek help, and strategies for managing migraines.

While webinars accounted for just 1% (530/53,000) of overall mentions, HCPs emerged as prominent participants, actively sharing event details and YouTube (Google) links. Discussions on migraine prevention and acute attack management highlighted the role of regional health care conferences in raising migraine awareness and elevating the Gulf’s visibility in neurology and migraine care [14]. These conferences featured local and international HCPs, amplifying the region’s expertise globally. With a robust online presence, including YouTube and X, conference organizers effectively disseminated migraine-related insights to a wide audience, including patients, HCPs, and the public.

Regional media interviews similarly emphasized that the UAE was preparing for a transformative shift in migraine management, with discussions of migraine prevalence, demographics, and the importance of local data collection [15]. Key trends included higher prevalence among women and a concentration of migraine sufferers within the fertile age range of 20 to 40 years. These insights highlighted the active involvement of HCPs and regional organizations in advancing migraine management practices and raising awareness in the Gulf region.

Across 5 Gulf countries, the migraine treatment discourse included contributions from both HCPs and patients. Discussions focused on publication announcements, regulatory updates, and other developments in the field. The conversations extended beyond general discussions about migraines to specific medications and treatments. Gulf-based patients shared and discussed international news, including updates related to US Food and Drug Administration (FDA) approvals and announcements from pharmaceutical companies. These discussions indicate that treatment-related announcements and migraine therapy updates were present in the regional online discourse. A study on oral calcitonin gene–related peptide (CGRP) receptor antagonists for migraines gained attention among Gulf authors and contributed to related discussions [16]. These observations suggest that some social media users in the region discussed such announcements and findings in the study dataset.

Arabic-speaking patients in the Gulf region gather information about migraines primarily from social media, news, and television. Social media platforms serve as channels for sharing experiences and seeking advice, including viral tweets that invite audience participation in TV discussions featuring medical experts. Other information sources include hospital-led webinar announcements about updates in migraine management [17]. There were also discussions suggesting that migraine symptoms were caused by subvariants of the coronavirus. FDA-approved options for migraine prevention, including medical devices, mobile apps, and innovations in the field, have been acknowledged by patients with migraines in the Gulf [18].

Government involvement and public health concerns are also prevalent in the discourse, with patients in Kuwait advocating for improved access to migraine medication and patients in Bahrain calling for measures to address environmental triggers such as noise pollution. Discussions surrounding the effectiveness and side effects of painkillers, particularly paracetamol and stronger medications like sumatriptan and diclofenac, also shed light on the challenges faced by patients with migraines in managing their symptoms.

To provide a principal structure for interpreting discourse patterns, the findings were organized into 3 conceptual stages of the migraine journey: prediagnosis, diagnosis, and postdiagnosis, as shown in Figure 1.

The study analyzed migraine conversations from January 1, 2018, to June 30, 2022, focusing on the 5 Gulf countries: Kuwait, Bahrain, the UAE, Oman, and Qatar. Out of 53,000 mentions, 33,920 (64%) were on X, and men were 1.1 times more likely to discuss migraines than women. Although migraines affect both sexes, it is often stereotyped as a condition that primarily impacts women due to its higher prevalence among women and the increased health care resources used by women for migraine management [22].

Conversations among patients in the Gulf region, conducted in English, discussed the impact of migraines on overall health. Patients discussed various aspects, including the impact of migraines during pregnancy, with this topic accounting for 1060 (2%) of the mentions. During pregnancy, migraine episodes can impact a woman’s well-being and raise important considerations for the health of both the mother and baby [23,24]. Conversations related to migraines in relation to influenza represented over 1060 (2%) of mentions; the effect on vision, 1325 (2.5%); concerns about connections to heart attacks accounted for 795 (1.5%); seizures, 1060 (2%); and disruption of sleep caused by migraines, 1590 (3%). Migraines are linked to a broad spectrum of comorbidities, spanning from stress and sleep disturbances to suicide [25].

Therapies mentioned in social media discourse ranged from evidence-based pharmacological treatments to complementary or self-management remedies. Medications such as paracetamol, aspirin, ibuprofen, and triptans were frequently mentioned, along with self-management treatments like CBD softgels, cupping, and aromatherapy oils. Evidence-based therapies for migraines also include newer CGRP-targeting agents in social media discourse. For example, an oral CGRP receptor antagonist has demonstrated efficacy in relieving migraine symptoms compared with a placebo in the acute treatment of migraine attacks in randomized controlled trials [16]. In contrast, social media discussions frequently referenced nonpharmacological or complementary approaches such as acupuncture, cupping therapy, aromatherapy products, and topical remedies. Some nonpharmacological approaches, including behavioral therapies, lifestyle modifications, and certain complementary practices, have supportive but variable levels of evidence. However, other interventions discussed online, such as CBD products or topical remedies, currently have limited or uncertain clinical evidence for migraine management. The widespread discussion of these therapies in online communities may reflect interest in alternative symptom relief. While pharmacological treatments remain the primary approach for managing migraines, concerns over adverse effects and inefficacy have led patients to explore Complementary and Alternative Medicine therapies. More people are looking for these therapies to treat and prevent migraine attacks because they are seen as safe and possibly effective [26].

Online communities on social media serve as hubs for sharing insights, seeking advice, and exchanging experiences related to migraine management [10]. Patients use TikTok to share their experiences and seek advice. Many individuals also join closed groups, such as the UAE Migraine Facebook group, to connect with other migraine sufferers for support and to share their experiences. HCPs and patients are actively engaged in discussions about migraines. A key limitation of social media–derived insights is the influence of the digital divide and related health equity issues. For example, younger individuals generally engage more with social media than older adults, which may result in findings that disproportionately reflect the perspectives of more digitally active users rather than the broader patient population [27].

Migraines impose significant personal and social burdens, affecting not just the individual but also their family. It can disrupt interpersonal relationships and psychological health, jeopardizing the financial stability of the entire family unit [28]. Key themes in English language discourse included concerns about migraines’ impact on health, correlations with other illnesses, and self-management strategies. Patients expressed interest in alternative treatments, while hospitals and news sources disseminated information on treatment options and health care advancements.

Arabic language discourse mirrored similar themes, with a focus on social media as a source of information. Discussions encompassed a wide range of topics, including concerns about migraines’ impact on health, correlations with other illnesses, self-management strategies, medications used by patients to treat migraines, alternative therapies, and the journey of patients with migraines. Patients advocated for improved access to medication and government intervention to address environmental triggers. Various platforms, including scientific journals, news media, and specialized medical websites, played a role in disseminating treatment advancements. The study offers valuable insights into the varied landscape of migraine discussions across the 5 Gulf countries, emphasizing the complex nature of patient experiences, treatment options, and engagement with HCPs.

Social media listening studies, combined with structured surveys, patient interviews, or registry data, may help strengthen findings in future in migraine research. Evaluating how themes evolve over time, particularly following guideline updates, therapeutic approvals, or public awareness campaigns, can be beneficial. Future research should account for differences in social media penetration and usage across countries and subgroups (age, sex, and urbanicity) to improve representativeness. Researchers should examine geographic variation in discourse to identify region-specific educational needs or systemic barriers related to migraines. Researchers should design and prospectively assess digital education campaigns to determine whether addressing identified myths or gaps measurably alters knowledge or adherence in migraine management.

One notable limitation of our study is the absence of data from Facebook and Instagram (Meta Platforms, Inc), as these platforms do not permit data crawling. This restriction significantly affects the overall thoroughness of our analysis, especially given the importance of these platforms, where data collection is constrained. This may introduce substantial selection bias due to differing user demographics, privacy settings, and communication norms across platforms. The dataset may overrepresent publicly visible discussions on platforms such as X and the open web while underrepresenting conversations on private platforms.

Therefore, the observed finding that men were 1.1 times more likely to discuss migraines should be interpreted cautiously. Established epidemiological evidence demonstrates a higher migraine burden among women [4,22], suggesting that the gender pattern observed in our dataset may reflect platform-specific engagement behaviors rather than true disease prevalence. Public platforms such as X may overrepresent certain demographic groups, while migraine-related discussions among women may occur more frequently within private or closed communities that were not captured in this analysis. Social media mentions should not be equated with prevalence, and the gender distribution reported here should be interpreted as discussion behavior within a particular platform rather than epidemiological representation. Future research should triangulate social media listening findings with regional survey or epidemiological data to better assess the extent of platform-driven bias.

Formal sensitivity analyses comparing broader versus narrower keyword configurations were not conducted during the original analysis window. As a result, the robustness of keyword expansion strategies could not be quantitatively evaluated retrospectively, introducing the possibility of keyword-driven capture bias; therefore, findings should be interpreted with this limitation in mind. The full bilingual search strategy, including Arabic dialects, spelling variants, and transliterations such as Arabizi, was not systematically retained, nor was code-switching (English and Arabic in the same post) formally addressed, which may limit reproducibility. The complete proprietary query library developed by Rila Global Consulting was not retained in a publishable format, further limiting transparency and reproducibility.

Key statistical elements, including confidence intervals, subgroup comparisons, effect sizes, and corrections for multiple testing, were not performed. Confidence intervals for key proportions and for comparisons by country, language, platform, time period, and audience segment were not included in this analysis. Adjustments for multiple comparisons, such as Bonferroni or false discovery rate corrections, were not performed. Safeguards to ensure analytic independence (eg, a prespecified protocol, independent validation, and data transparency) were not implemented. These factors may affect the robustness of findings and introduce potential bias, particularly in the interpretation of medication-related discourse.

The dataset was collected through extensive web crawling and aggregation of online discussions based on specific queries, rather than through a structured sampling design. As a result, no hypothesis testing, confidence intervals, subgroup comparisons, or effect size calculations were performed. Consequently, the quantitative outputs reflect the proportions of online mentions and engagement in the dataset and should not be interpreted as epidemiological estimates or population-level measures. The findings are descriptive and intended to generate hypotheses rather than provide comprehensive or population-based estimates. The lack of standardized annotation protocols, interrater reliability assessment, and formal classification validation may introduce variability in categorization. This variability should be taken into account when interpreting the results.

Another limitation of this study is that the findings are presented as cumulative data, without temporal trend analysis. The study period (2018 to mid-2022) spans substantial shifts in social media platform usage and online health information–seeking behaviors, particularly during the COVID-19 pandemic. The absence of time-stratified analyses limits the study’s ability to evaluate how discourse patterns, engagement levels, and content characteristics may have evolved over the pandemic period.

The journey of patients with migraines in the “Results” section is a conceptual structure created by the authors to organize themes in the data. It was not derived from a temporal analysis of posts. It should not be interpreted as a validated or strictly linear patient journey, as migraine management is often cyclical, and posts may reflect overlapping or repeated stages of experience.

A 2024 study focused on the unmet needs of patients living with migraines in the Gulf Cooperation Council countries. The findings suggest that the burden of migraines and its impact on patients in these countries are often underestimated and that both diagnosis and treatment are suboptimal [33].

Another study reported that the prevalence of migraines in the general Arab population ranges from 2.6% to 32%. Among medical university students, the estimated prevalence ranges between 12.2% and 27.9%, while among schoolchildren aged 6 to 18 years, it ranges between 7.1% and 13.7%. The study also found that women were more likely to experience migraines than men [6]. In contrast, our findings indicated that men were 1.1 times more likely to discuss migraines on social media than women. This discrepancy may reflect the limitations of social media–derived interpretations, including aspects of the digital divide and health equity wherein participation patterns differ across genders. For instance, women may be more likely to engage in private or closed online groups, which were not captured in our study.

In 2023, a study found that X was the most-used social media platform in Japan, Germany, and France [12]. Our study also revealed that 64% (33,920/53,000) of the discussions took place on X, in both English and Arabic.

On the other hand, a 2019 study found that Facebook emerged as the preferred social media platform for discussions related to migraines, especially within closed, migraine-specific groups [10]. These groups played a crucial role in providing individuals with valuable information and social support, helping them understand and manage their condition effectively. Our study found that closed groups, such as the UAE Migraine Facebook group, offer safe spaces, while X, Tumblr, and blogs facilitate discussions between patients and HCPs. Patients engaged in discussions concerning migraine triggers, treatment options, alternative therapies, and self-management strategies, while HCPs shared insights on medications and medical advancements.

In conclusion, the analysis of migraine discourse among the 5 Gulf countries highlights the engagement of patients and HCPs in discussions concerning migraines on different social media channels. It is evident that patients in the Gulf region use social media as a primary channel for sharing experiences, seeking advice, and raising awareness about migraines. The involvement of HCPs enriches these discussions by providing expert guidance and participating in educational initiatives. The discourse explores concerns about migraines’ impact on health, correlations with other illnesses, self-management strategies, medications used by patients to treat migraine, and alternative therapies. This helps us understand the diverse perspectives and preferences within the Gulf migraine community.

Many patients turn to self-management and alternative medicine, which can lead to less effective outcomes. This choice to avoid professional medical help may result in inadequate symptom management, highlighting the need for expert health care. To improve migraine care practices in the region, it is essential to bridge this gap by increasing awareness and providing education. These insights will also help raise awareness of available treatment options and dispel misconceptions. Therefore, social media listening may help identify gaps in migraine management and better understand migraine-related concerns, although further validation is required through additional research.