A Comprehensive Guide to Migraines

Migraines are a type of headache that causes intense aching or throbbing, often in a specific region. They may be accompanied by other symptoms, such as nausea leading to potentially vomiting, aswell as extreme sensitivity to input. Most commonly this will be to light and/or sound

Sometimes, migraines can be so painful that all you want to do is find a dark place to lie down. For 20-30% of migraine sufferers, they are preceded by aura, a group of nervous system symptoms which include blind spots appearing in your field of vision, sudden flashes of light, and tingling in the limbs.

Medication is usually effective in making migraine headaches bearable, while also reducing their frequency. Home remedies and lifestyle changes can also help to ease the severity of migraine headaches.

Who Gets Migraines?

According to the National Headache Foundation, an estimated 28 million people suffer from migraines in the United States. Women are more likely to experience migraines than men, with 25% of women experiencing four or more migraine headaches in a single month. An additional 35% of women experience between one and four attacks in a month, while two-fifths of all women experience one attack or less per month. Migraines can last anywhere from four hours to several days. Occasionally, they last even longer.

Symptoms

Migraines tend to start appearing between childhood and late adolescence. They may progress through four distinct stages—prodrome, aura, headache, and postdrome—though not everyone experiences every stage.

1. Prodome

A couple of days prior to a migraine coming on, you might be able to notice some subtle indicators of an oncoming attack. These can include:

• Depression
• Hyperactivity
• Irritability
• Constipation
• Cravings
• Stiffness in the neck
• Excessive yawning

2. Aura

Auras can occur both prior to and during migraines. They involve disturbances in your visual field, such as seeing black spots or flashes of light. But they can also affect your senses, movement, and speech. They may cause a tingling sensation in the arms and legs or leave you feeling like you’re having trouble forming words.

3. Attack

Symptoms of migraines can greatly vary from person to person and from attack to attack. They may include:

• A dull ache that progresses to a pulsing pain. The pain may shift between either side of the head. It may affect the front of the head, or the whole head, and in general, the pain feels worse with physical activity.  
• Sensitivity to light, noise, and smell
• Nausea and vomiting, an upset stomach, or pain in the abdominal region
• Loss of appetite
• Feeling too hot or too cold
• Paleness
• Dizziness, sometimes followed by fainting
• Fatigue
• Blurred vision, or visual disturbances
• Diarrhea
• In rare cases, fever

If left untreated, migraines can last up to one week. On average, they last about four hours.

4. Postdrome

During the postdrome phase, which occurs after a migraine, you might feel unusually tired or exhausted. Some people have reported mild feelings of euphoria.

Seeing a Doctor

Many people suffer from undiagnosed and untreated migraine headaches. If you regularly experience symptoms, you should keep track of the frequency and severity of your migraines, as well as how you treated them. Make an appointment to discuss your symptoms with your doctor.

What Causes Migraines?

Doctors don’t know what causes migraines, but genetic and environmental factors do play a role. One theory suggests that migraines are caused by changes in the way that the brainstem interacts with a pain pathway called the trigeminal nerve.

Other research points to the role of neurotransmitters such as serotonin, which helps regulate pain. Research has indicated that serotonin levels decrease during migraines. This action may trigger the release of neuropeptides, which travel to the brain’s outer layers, causing the sensation of pain.

How Are Migraines Triggered?

A wide variety of environmental factors and stimuli can trigger migraines. These vary from person to person. If you suffer from migraines, it’s important to keep a record of what you were doing when you felt a migraine coming on. Triggers may include: 

• Stress - Emotional or work-related stress can stimulate chemical changes in the brain which may trigger migraine headaches.
• Food sensitivities - Certain foods may trigger migraines. These include aged cheese, salty and processed foods, as well as food additives such as MSG and nitrates. Skipping meals or eating irregularly can also trigger attacks.
• Alcohol - Alcoholic beverages, especially wine, may prompt migraines.
• Caffeine - Found in coffee, tea, and soda, caffeine consumption can have an effect on headaches. If you consume excessive amounts of caffeine, a migraine may occur when your caffeine level drops. Or, if you regularly consume caffeine, for instance by drinking coffee every morning, you might experience a migraine if you try to go without caffeine.
• Weather - Changes in air pressure or altitude, high winds, and storms can trigger migraines.
• Menstrual periods - Normal changes in estrogen levels trigger headaches in many women, including women who regularly experience migraines. Women commonly report experiencing migraines right before or during menstruation, when estrogen levels are low. Others may develop migraines during pregnancy or menopause. Hormonal contraceptives can worsen migraines, though some women find that migraines occur less frequently when they are taking hormonal contraceptives.  
• Changes in sleeping patterns or intense fatigue - Missing sleep or changing your regular sleep schedule may spur migraine headaches, as can jet lag.
• Sensory stimuli - Unusually bright lights, sun glare, strong smells, and loud noises may trigger migraines in some individuals.
• Physical activity - Overexerting yourself physically or sexually may initiate a migraine headache.
• Medications - Oral contraceptives and vasodilators are two types of medications that are known to activate migraines.

Risk Factors

Migraines appear to run in families. Eight percent of migraine sufferers have a family history of migraines. When one parent has a history of migraines, the likelihood of a child developing migraines is 50-50. When both parents suffer from migraines, the risk of the child experiencing migraines jumps to 75%.   

Common disorders, including asthma, chronic fatigue syndrome, high blood pressure, stroke, or sleep disorders are also related to migraines.

Medication

Though migraines cannot be cured, symptoms can usually be managed through medication. There are two categories of medication commonly used to treat migraines:

• Migraine relief medication - Migraine relief drugs are taken when a migraine begins. They are designed to get rid of symptoms that are already in progress.
• Preventative medication - This kind of medication is taken on a daily basis and helps to both prevent the onset of migraine headaches and reduce their severity.

Treatments vary from individual-to-individual according to the frequency and severity of headaches, other medical conditions you may have, and the debilitation caused by your headaches. Consulting a doctor is the only way to find out which medications suit your symptoms.  

Practicing Self-Care

Many people find that certain techniques and habits can help to ease the pain of migraines and reduce their frequency.

• Muscle relaxation, yoga, or meditation
• Sticking to a regular sleep schedule without oversleeping.
• Keeping a journal of headache-related symptoms