Migraine 101: The Basics
What is migraine?
Migraine is a common, painful headache disorder. Migraine headaches can last between 4 and 72 hours. Symptoms such as sensitivity to light or sound, nausea, vomiting, and others often accompany the headaches.
Migraine attacks are not the same for everyone. They vary in how often they occur, how long they last, how severe the pain is, and what symptoms are felt before or during the headache.
Most people may not realize how challenging migraine can be. In fact, it is among the top 20 disabling health conditions. Less than 10% of people with migraine can work or function normally when they have headaches.
Quick facts about migraine:
- More than 29.5 million Americans suffer from migraine, with women 3 times more likely than men to be affected.
- Migraine is most common between the ages of 25 and 55.
- 70% to 80% of sufferers have a family history of migraine.
- Nearly half of people with migraine are never diagnosed.
- Migraine is often misdiagnosed as sinus headache or tension-type headache.
What causes migraine?
Medical researchers are still studying the exact cause of migraine. In the past, it has been explained as a problem in the blood vessels, a reaction to stress, or the result of bad dietary choices.
In fact, more current research shows that migraine is a disorder that affects the nervous system. People who suffer from migraine may have nervous systems that are sensitive to certain things in the environment—called triggers. Exposure to triggers can start a chain reaction of chemical changes in the brain. In turn, this affects pain-sensitive areas of the brain and eventually leads to a migraine attack.
Migraine also is connected to family history. If 1 parent has the condition, there is a 40% chance a child also will have migraine. If both parents have migraine, the chance increases to 90%.
Phases of migraine
Migraine is more than just a bad headache. It is a complex process that begins in the brain and sets off many other symptoms. There are different phases, or parts, to a migraine attack. To help reduce the pain and disruption of migraine, your health care professional may suggest specific ways to treat migraines at each phase:
The preheadache phase is an early warning sign. Preheadache symptoms, such as those described under Migraine symptoms, can be felt hours or days before a migraine.
During this early phase, experts suggest that a migraine may be prevented from occurring by removing yourself from a stressful environment or situation, or by doing relaxation exercises. Understanding your symptoms may help you recognize when a migraine is going to occur.
The headache phase is usually the most painful and disabling part of a migraine attack. It usually starts with mild or dull pain on 1 side of the head that builds to moderate or severe intensity.
Migraine pain can be so severe that it affects a person's ability to function and do normal activities. For many migraine sufferers, symptoms such as sensitivity to light or sound can be so bad, they often need to lie down in a dark room until the attack ends.
For migraine pain relief, people may use over-the-counter or prescription medicines. But with daily use, some of these medicines—such as analgesics—can result in medication-overuse headache (also called rebound headache). The medicines may help relieve the pain for a few hours. But taking them over and over again may result in long-term (or chronic) headaches. And other medicines to help prevent or treat the headaches may not be effective. It's important to speak with your health care professional about the most appropriate way to treat your migraine.
Knowing when to treat migraine is as important as knowing which medicines to use. Research shows that a medicine's effectiveness greatly improves when it is taken while the headache pain is still mild—instead of waiting until the headache pain is moderate or severe. It may reduce how long the migraine lasts.
Your health care professional can help you find the appropriate medicines. Be sure to ask how often and how early in the migraine attack they should be taken.
The postheadache phase (or recovery phase) begins after the pain peaks in intensity. The pain gradually lessens and disappears. This phase can last up to 48 hours. But it can have lingering symptoms such as:
- Stomach problems—feeling sick, queasy, or unable to tolerate food
- Difficulty concentrating
- Sore muscles
- Overall fatigue
These symptoms can affect normal activities so much, it has been called "migraine hangover." There are also some people who experience the exact opposite—feelings of well-being and euphoria.
Your health care professional also may recommend medicines or other treatments to help you through the postheadache phase.
Migraine symptoms
Migraine symptoms can vary from person to person, and from attack to attack. Knowing the symptoms that signal a migraine may help you treat it early, before it becomes a full-blown attack.
Before headaches start, some people may experience:
- Mood changes
- Fatigue
- Muscle pain
- Food cravings
- Difficulty concentrating
About 10% of people with migraine also experience aura—temporary visual problems that may come in the form of flashing lights, zigzag lines, blind spots, or blurred vision. In some cases, aura can have more physical signs, too. This may include difficulty speaking, sensations of tingling, dizziness, or numbness.
Other common migraine symptoms include:
- Moderate to severe throbbing pain on 1 side of the head
- Sensitivity to light and sound
- Nausea
- Vomiting
Potential migraine triggers
For some, migraine may seem to be related to particular events, foods, or changes in the body. These are called triggers. Recent research shows that triggers do not actually cause migraine, but they can interact with the pain centers in your brain, making you more vulnerable to headaches. Some potential triggers are:
- Food and drink—for example, chocolate, cheese, alcohol, or citrus fruit
- Stress or strong emotions—feelings of anxiety, tension, excitement, depression, shock, or frustration
- Strong smells—perfumes, gasoline, or paint
- The environment—changes in weather, extreme heat, light, or noise
- Hormonal changes—puberty, menstruation, menopause, pregnancy; or the use of birth control pills.
- Irregular meals
- Too much or too little sleep
If you have a migraine journal or tracker, it's a good idea to write down your potential triggers. Share the information with your health care professional. He or she may offer advice on ways to avoid triggers as part of your treatment plan.
Taking steps to manage migraine
Just about everyone can get headaches—but migraine is different. It's not just a bad headache. The symptoms can be frightening, but they're less frightening when you understand them.
Everyone's experience of migraine is different: keeping a migraine journal or tracker, you can provide your health care professional with valuable information about how migraine affects you.
Your journal notes also may help you and your health care professional recognize which symptoms warn you that a migraine is going to occur. You may be able to prevent an attack with steps such as relaxation techniques before the pain begins. Or, taking medicine while the pain is still mild during the headache phase may help. Treating a migraine early provides a better chance of effective relief.