It all depends on your server.
If you have SSH access, you can use migrations (and other perks of artisan, composer etc.) without problem (unless you are afraid of migrate:reset happening) as you do in local environment. If you are using shared hosting, it's not that comfortable. In that case, this entry illustrates what you are dealing with http://driesvints.com/blog/laravel-4-on-a-shared-host.
You can always export sql file from localhost and use it on host... Or you can make controller for running migrations...(I would go with these one for larger app's)
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