We all get the occasional headache from time to time. But migraine headaches are a totally different animal. They are intense, painful and throbbing headaches that can last between 4 to 72 hours and can prevent you from doing your usual activities. It affects more than 12% of the population (or 38 million people), including children. They can begin at any age. It is also more common in people with a family history of migraine headaches: 4 out of 5 migraine sufferers have a family history of migraines. And it is 3 times more common in women than in men.
Signs and Symptoms
People with migraines may experience symptoms differently from one another. Symptoms may include:
- Throbbing pain that affects the entire head, or on one side of the head
- Extreme sensitivity to light and sound
- Nausea or vomiting
- Blurred vision
Up to 30% of migraine sufferers experience migraine with “aura.” This is a warning sign that tells you a headache is coming. It usually occurs one hour before the onset of a migraine. Auras usually happen as visual disturbances (e.g., flashing lights, streaks of light or temporary loss of vision) but can also cause changes in smell, taste or touch. Some report having speech problems or tingling in the arms, while others report that they “feel strange”. Some people may feel fatigue or irritability for up to 24 hours before an attack occurs (also called pro-dromal phase), and then subsequently feel fatigued (post-dromal period) after the headache resolves.
Some people have chronic migraine headaches, which is when their headaches last 15 days or more per month. Chronic migraine sufferers are at higher risk for depression and anxiety.
What Causes Them?
It is a neurological disorder with no known cause; however, it is believed that it is caused by an imbalance in brain chemistry or by physical changes in the brain. Many things can trigger a migraine headache, including:
- Lack of food or sleep (or too much sleep!)
- Exposure to bright lights, loud sounds or unusual odors
- Hormonal changes in women, such as during menstruation, pregnancy and menopause
- Eating certain foods or drinks, such as aged cheese, cured meats, wine and drinks with high caffeine content (or withdrawal from caffeine)
How is it Diagnosed?
There is no one specific test to prove that your headache is a migraine. If you suffer from migraines or suspect that you do, be sure to see a doctor trained in treating headaches (neurologist). In order to rule out other conditions, your doctor may conduct a physical exam, ask you questions about your symptoms and family history, and conduct series of tests, such as bloodwork, CT scan or MRI.
How is it Treated?
Though there is no cure, migraines can often be managed with proper diagnosis and treatment. Talk to your doctor about the right treatment plan for you.
Keep in mind that the use of over-the-counter or prescription medications too often or at too high of a dose can actually cause headaches—this is called medication-overuse headaches.
What You Can Do
Managing migraines is like managing any chronic illness. That means you need to create and sometimes update your treatment plan. Work with your healthcare team to design an updated, proactive treatment plan that’s focused on both preventing and treating your migraines.
Here are a few other tips to help you manage migraine headaches:
- Turn down the lights. If you are experiencing a migraine, rest in a dark room and place an ice pack wrapped in a cloth on the back of your neck and apply gentle pressure to painful areas on your scalp
- Keep a headache diary. Track when you get headaches and what triggers might be linked to your episode. Over time, you may see patterns developing. Speak with your doctor about your trigger diary
- Get adequate sleep each night, without oversleeping or disrupting your sleep schedule
- Eat regularly. Skipping too many meals can increase your risk for a migraine
- Exercise. Try to get 30 minutes of physical activity every day
- Quit smoking. Avoiding nicotine may help manage symptoms
- Relax. Take a moment to breathe deeply, clear your mind and relieve stress
Reviewed by Margaret Frazer, MD, FAAN, Pfizer Medical Director.
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