Some people with migraines find that migraine pain is much more intense than the discomfort from a tension headache. Often, migraine headaches typically follow a four-stage pattern:
- Some migraine sufferers report noticing small changes in their body 1-2 days before the migraine begins including constipation, diarrhea, depression, irritability, food cravings, or a stiff neck. This is called the Prodrome Stage.
- Sometimes migraine sufferers will receive a warning symptom such as a flash of light, visual disturbance, blind spot, bright spot, speech problem, or tingling in an arm or leg. This warning is called the Aura Stage. At other times, there is no pre-warning.
- The Attack Stage comes next with the a painful, pulsing, and throbbing head along with nausea, vomiting, blurred vision, diarrhea, and the feelings of dizziness, light-headedness and fainting.
- The final phase, Postdrome, often leaves one feeling drained and washed out. However, others report a feeling of mild euphoria after a migraine has passed.
What Causes Migraines?
Experts don’t know exactly what causes migraines or why some people have them while others don’t. For most people with migraines, a combination of genetic and environmental causes is likely to blame. According to the Mayo Clinic, 90 percent of people who have migraines have a family history of them.
For people prone to migraines, certain foods and medications, along with stress, irregular sleep patterns, exercise and even changes in the weather may trigger these throbbing, often one-sided headaches. Some women report that their migraines occur more often at or around the start of their menstrual cycle. Additional factors associated with migraines include
- Hormonal changes in women related to birth control medication and hormone replacement therapies, menstrual cycle, pregnancy or menopause
- High levels of anxiety, worry, shock, depression, mental fatigue, grief, life changes, vacations, work projects, and repressed emotions
- Environmental sensory stimuli, such as loud noises, bright lights, glaring sunlight, computer screen usage, temperature and weather changes, smog, certain scents like perfume, paint thinner, and secondhand smoke
Ending Migraine Pain
Unfortunately, there’s no cure for migraines, but many people find relief with a combination of prevention strategies and medications. Keeping a "headache diary" that details when and how your migraines start, how often you experience them and any changes to your day-to-day habits (especially what you’ve eaten and how much you’ve slept) that precede them, can help you identify and avoid your triggers. You can take this diary with you to any appointments you have with your primary healthcare provider or neurologist to help create the ideal treatment plan.
Common migraine triggers can include skipping meals, changes in estrogen levels (think starting or stopping birth control pills or hormone replacement therapy, as well as menopause or ovulation), stress, monosodium glutamate (MSG) and alcohol—particularly beer and red wine.
Sticking to a sleep schedule, eating healthfully, exercising regularly, managing stress and limiting your alcohol and caffeine consumption may help, too.
If you end up with a migraine despite your best efforts, try these self-care tips:
- Rest in a quiet, dark room.
- Drink water and stay hydrated, especially if you’re vomiting
- Take pain medication as prescribed by your healthcare provider (or as soon as symptoms occur if you use over-the-counter painkillers)
- Stay calm; try progressive relaxation or breathing exercises
Medications for Migraines
Over-the-counter analgesics, such as ibuprofen and aspirin, can help you tackle mild migraine pain. Your healthcare provider can also prescribe medication for more severe pain, including prescription-strength painkillers designed for migraine pain, anti-nausea medications and, less frequently, opiates and corticosteroids (which are often paired with other medications to relieve pain).
For people with frequent migraines, preventive medications that are taken regularly to decrease the severity of aura symptoms and the frequency of attacks are also available with a prescription.
To help your physician find the most effective treatment for you, arm yourself with details of your migraines (including your headache diary) before you arrive for your appointment. How often do you experience them? How severe is the pain? What symptoms, other than pain, do you have? What makes your pain better or worse?
Migraine Treatments to Avoid
It can hurt to cut out foods you love most (wine and chocolate, anyone?) to curb migraines, but once you identify your food triggers, try not to tempt fate. Stick to what works.
When taking medications, especially over-the-counter options, it can be tempting to take too much, especially when pain is severe or continues despite already taking medication. Stay safe by following the dosing instructions on the bottle and let your healthcare provider know if the pain becomes unmanageable with OTC drugs alone.
With a little time spent analyzing your triggers, organizing a headache diary and working with your healthcare provider, you may find that migraines soon lose their painful punch.
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