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Migraines: What You Need To Know

Migraines are a chronic neurological disorder that can cause debilitating recurring headaches that can last for hours or days. They are characterized by throbbing or pulsing pain on one side of the head, and can also cause nausea, vomiting and can worsen with physical activity, bright lights, loud noises and strong odors.

Migraines can impact daily life and leave people in bed for days. They are caused by changes in brain chemistry and body, and genetics account for about half of all cases.

Migraines are common. Studies show that an estimated 12% of people in the United States experience them. Women are three times more likely to experience migraines than men, and they are more common in women between the ages of 15 and 55.  Other risk factors include family history of migraines, smoking, high stress levels and hormonal changes.


What are the types of migraines?

There are several types of migraines. The most common migraine categories are:

  • Migraine with aura (classic migraine)
  • Migraine without aura (common migraine). (An aura is a phase of the migraine before head pain begins.)

Other types of migraines include:

 

Common triggers for migraines

Loud noises, bright lights, strong smells, physical activity (exercise or sex) and changes in sleep – sleeping too much or not enough can trigger migraines.

Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack, and post-drome. Not everyone who has migraines goes through all stages.

Prodrome Stage
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

  • Constipation
  • Mood changes, from depression to euphoria
  • Food cravings
  • Neck stiffness
  • Increased urination
  • Fluid retention
  • Frequent yawning

Aura
For some people, an aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and can last up to 60 minutes. Examples of migraine auras include:

  • Visual phenomena, such as seeing various shapes, bright spots, or flashes of light
  • Vision loss
  • Pins and needles sensations in an arm or leg
  • Weakness or numbness in the face or one side of the body
  • Difficulty speaking

Attack
A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

  • Pain is usually on one side of your head but often on both sides
  • Pain that throbs or pulses
  • Sensitivity to light, sound, and sometimes smell and touch
  • Nausea and vomiting

Post-drome
After a migraine attack, you might feel drained, confused, and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.


Steps you can take to ease migraine symptoms

Temperature therapy: Apply hot or cold compresses to your head or neck. Ice packs can numb the pain, while hot packs and heating pads can relax tense muscles.

Caffeine: Small amounts of caffeine can help relieve migraine pain in the early stages.  Caffeine can also enhance the pain-reducing effects of acetaminophen (Tylenol) and aspiring. However, drinking too much caffeine too often can lead to withdrawal headaches, and having caffeine too late in the day can interfere with sleep.

Take a break: Lie down in a quiet, dark room to avoid environmental triggers.

 

When to see a doctor

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then, make an appointment with your health care provider to discuss your headaches.

Even if you have a history of headaches, see your health care provider if the pattern changes or your headaches suddenly feel different.

See your health care provider immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, confusion, seizures, double vision, numbness, or weakness in any part of the body, which could be a sign of a stroke
  • Headache after a head injury
  • A chronic headache that is worse after coughing, exertion, straining or sudden movement
  • New headache pain after age 50


Migraine treatment options

Consider Osteopathic Manipulative Treatment (OMT), a hands-on therapy used by osteopathic physicians, shows promise as a complementary approach to managing migraines, potentially reducing frequency, intensity, and duration, and improving quality of life. Other migraine treatments include:

  • Acupuncture
  • Biofeedback
  • Cognitive behavioral therapy
  • Meditation and yoga
  • Herbs, vitamins, and minerals

 

References

Mayo Clinic
Clevland Clinic