What You Need to Know About Migraine Headaches and Their Treatment
Migraines are one of the most prevalent and incapacitating conditions in the world. It is also one of the least understood. Although 38 million Americans have been diagnosed, there are only around 500 specialists in the country with the training and experience to care for them. Chronic migraine cases often go untreated.
Almost 90 percent of patients have a family history of migraine. That same 90 percent report that they cannot work, drive, study, or perform ordinary tasks during migraines, which can last up to 72 hours. It’s estimated that migraine-related costs in the U.S. total $36 billion in health care and lost productivity. Families with at least one migraine-affected member pay 70 percent more for insurance and healthcare than nonaffected families.
What Is Migraine?
Migraine is a complex illness in which severe headaches are accompanied by sensory disturbances. Attacks are marked by a diverse collection of neurological symptoms. Throbbing pain is usually concentrated on one side of the head, but both sides are affected in roughly one-third of cases.
Scientists believe that an inherited instability in the brain results in poor processing of incoming sensory information. Ordinary physiological factors like hunger, sleep or heavy exercise can further impact brain response.
Many migraines have four distinct phases: prodrome, aura, headache and postdrome. The prodrome phase may precede a migraine by hours or even a couple of days. Some common symptoms of the prodrome phase include fatigue, neck stiffness, mood swings, and bowel distress.
The aura phase typically begins shortly before the onset of the headache. Aura can be frightening, but it usually passes in less than an hour. Blurred vision, flashes of light, and blind spots are some of the visual disturbances that may follow the aura phase.
You might also experience numbness or tingling in your face or extremities. Some people report muscle weakness or difficulty with speech and language during this phase.
Symptoms of the headache itself may include the following:
- Intense, pulsating pain on one or both sides of the head
- Dizziness or fainting
- Nausea or vomiting
- Heightened sensitivity to of the senses
- Blurred vision
The postdrome phase is much easier to manage. As your pain subsides, you will probably have low energy and slight dizziness. Your thinking may be confused or weak while you recover.
What Causes Migraine?
The factors that cause migraines aren’t fully understood, but most scientists agree that there’s breakdown in the brainstem that impairs its interaction with pain pathways. An imbalance of brain chemicals, chiefly serotonin, could also be involved.
Migraines are a neurological problem, but researchers have identified several things that can trigger headaches or make them worse:
- Estrogen fluctuations in women caused by menstrual periods, hormone replacement therapy, or oral contraceptives
- Alcohol, caffeine, salty foods, food additives, and fasting
- Bright lights, sun glare, loud noises, and strong smells
- Oversleeping or undersleeping
- Sudden changes in barometric pressure
- Blood pressure medication, stimulants, analgesics or asthma medication
- High altitudes
Different Types of Migraines
The two major categories of migraine used to be called common migraine and classic, or complicated, migraine. Now they’re simply labelled migraine without aura, and migraine with aura. Migraines without aura occur more frequently, without warning, and the pain is typically confined to one sign of the head.
You may be affected by just one types or both types, but there are also less severe forms of migraine that can accompany either. These subsets include the following:
- Typical aura without headache
- Migraine with brainstem aura – Partial or total loss of vision, vertigo, dizziness, fainting, poor coordination, slurred speech or ringing in the ears
- Hemiplegic migraine – Temporary paralysis, vertigo, prickling sensation or difficulty seeing, speaking or swallowing
- Retinal migraine – Loss of vision or visual disturbances in only one eye
- Chronic migraine – Disabling migraines, with or without aura, that occur on at least 15 days during a three-month period
How to Treat Migraines
Many specialists recommend keeping a migraine journal to chronicle symptoms, frequency, pain levels, and other characteristics. This helps doctors pinpoint the type of migraine and design the best treatment plan.
Pain medications can be taken when you feel a migraine coming on, but taking a pill during the migraine may prove ineffectual. What works well for one patient may not work as well for you, so you may have to try several products. Aspirin, ibuprofen and acetaminophen can potentially help. Some over-the-counter drugs are made with a combination of ingredients designed to relieve pain, and will be labeled specifically for migraines.
These medications can be harmful if you take them for long periods of time, so consult your doctor about long-term treatment plans. Be sure to tell the physician or pharmacist if you’re pregnant or nursing.
Stronger medications that may be effective are triptans, ergots, glucocorticoids and opioids. However, most have serious side effects, and opioids are dangerously habit-forming.
If you’re interested in one of these remedies, inform your doctor of all the drugs and nutritional supplements that you take. Take no more than the prescribed dose, and discuss a time frame for tapering off slowly. Additionally, some migraine sufferers swear by home remedies such as peppermint, cayenne, chamomile and ginger.
Prevention and Avoidance
If you have prolonged attacks with serious symptoms more than four times a month, you may be a good candidate for preventative therapy. The medications below may reduce the frequency and severity of your headaches, but talk to your doctor about side effects:
- Some cardiovascular drugs
- Anti-seizure drugs
- Nonsteroidal anti-inflammatory drugs
Some natural approaches have proven effective in prevention:
- Regular exercise, especially yoga
- Good hydration
- Magnesium-rich foods like dark greens, avocados, tofu, seeds, nuts, and whole grains
- Riboflavin-rich foods like lamb, chicken, fish, cheese, almonds, natural yogurt, and sun-dried tomatoes
If you have severe headaches that you suspect could be migraines, call your doctor right away. Migraine could increase your risk of developing other physical problems. It is often accompanied by mental issues like anxiety, depression or insomnia. Don’t let migraine stand in the way of a happy, fulfilling life.