Migraines can be challenging but don’t have to be debilitating. There are treatments that can effectively alleviate your symptoms and improve your quality of life.
Learning about migraines is the first step to effective pain management.
What Is a Migraine?
A migraine isn’t just a bad headache. It’s a complex neurological disorder that may cause you to experience a host of symptoms, including:
- Severe headaches
- Sensitivity to light, smell, and sound
- Vision disturbances
- Neck pain and stiffness
- Nasal congestion
- Nausea and vomiting
- Loss of appetite
- Decreased concentration
- Difficulty speaking and reading
Migraines are very common: Roughly 12% of Americans suffer from migraine headaches. Yet, scientists don’t fully understand the root cause of this condition. One thing we know for sure is that you can experience a migraine headache when nerves within the wall of your brain’s blood vessels send pain signals to your brain, causing a release of inflammatory substances.
What Are the Types of Migraines?
There are many classifications of migraines. The simplest one I use in my practice divides migraines into two categories: chronic migraines and acute or episodic migraines, which are relatively infrequent. You have a chronic migraine if you experience headaches 15 days a month or more.
We also classify migraines as with or without aura. An aura is a group of symptoms that warns you of an impending headache.
Another important migraine subtype is status migrainosus, a rare and debilitating headache that exceeds 72 hours and doesn’t respond to medication. If you’re going through a status migrainosus episode, it’s best to seek medical assistance. You may even go to the ER to get what we call IV cocktails for migraine to break the cycle of headaches.
What Are the Four Stages or Phases of a Migraine?
There are four distinct phases associated with migraines, though not every person experiences each phase when they have a migraine:
Also known as the “pre-headache” or “premonitory” phase, a prodrome can last a few hours or a few days. Common symptoms include:
- Food cravings
- Sleep issues
- Light and sound sensitivity
- Increased urination
- Muscle stiffness
- Poor concentration
- Difficulty speaking and reading
Only about 15-20% of people with migraines have auras. When they occur, auras can last from ten minutes to an hour. Symptoms include:
- Vision disturbances, such as seeing floaters, sparkles, or zig-zag lines
- Tingling or numbness in your hands or fingers
- Speech disturbances, such as abnormal speech or difficulty finding words
- Ringing in your ears
- Changes in smell or taste
My patients usually describe migraine headaches as moderate to severe throbbing, pulsating, or drilling pain. The headache often begins on one side of your head before spreading to the other side, but some migraines primarily affect the back of your head. A migraine headache can last between a few hours and a few days if you don’t treat it properly.
Up to 80% of people with migraines experience postdrome after a migraine. Also known as a migraine hangover, the postdrome lasts a day or two. Fatigue is a common symptom, but you may also become euphoric because your headache is over.
Who Gets Migraines? What Are the Risk Factors?
Migraines can affect anyone, but females are four times more likely to experience migraines than males.
Genetic predisposition is another significant risk factor. 80% of patients with migraine have a first-degree relative who gets migraine headaches. If you have one parent with migraines, you have a 50% chance of getting it yourself. If both your parents have a history of migraines, your odds increase to 75%.
Other potential triggers include stress, anxiety, loud noises, and certain smells. For women, the monthly fluctuations of reproductive hormones can also trigger migraines. We call these menstrual-associated or estrogen-withdrawal headaches.
A migraine doesn’t have to decrease your quality of life. Several treatments are available to help manage symptoms.
Is There a Cure for Migraines?
I wish I could say there was a cure for migraine, but there’s currently none. However, there are treatments that can control and even prevent symptoms so that you only get headaches every few weeks or months.
What Are Common Treatments for Migraines?
The following treatments work for many of my patients:
- Lifestyle changes. If you know your migraine trigger or triggers, avoid them as much as possible.
- Over-the-counter (OTC) medications. If you only get a mild headache once a month or so, OTC painkillers might be a good solution.
- Prescription medications. If your migraines don’t respond to OTC medications, your doctor may prescribe something stronger. Take these at the first sign of a migraine to circumvent or decrease your symptoms.
- Preventive medications. If you get severe headaches that interfere with your normal activities more than four times a month, your physician may prescribe preventive medications to reduce the frequency and severity of your episodes.
What Medications Are Used to Relieve Migraine Pain?
- OTC medications that can help with migraines include:
- Ibuprofen (Advil)
- Acetaminophen (Tylenol)
- The group of acute, migraine-specific painkillers is called triptans. However, you shouldn’t take these more than 2-3 days a week, or 10 times a month , or you risk getting rebound headaches (medication overuse headache)
- Calcitonin gene-related peptide receptors (CGRPs) are a new class of migraine drugs that have been available for the last couple of years and are very effective at blocking migraine pain. If regular medications aren’t working, discuss CGRPs with your doctor.
Are There Interventions (Nerve Blocks or Surgical Procedures) That Relieve Migraines?
Sometimes, your migraine headaches may be due to pinched nerves in the neck, face, or another issue in your neck or cervical spine. If so, you may benefit from head and neck nerve blocks or (rarely) surgery to release the pressure on the nerves around your head and neck.
Is Acupuncture or Chiropractic Care Effective for Migraine Relief?
Acupuncture and chiropractic care can relieve migraine symptoms. Other beneficial complementary therapies include:
- Behavioral Health
- Relaxation techniques
- Coping skills
- Supplements like vitamin B12, magnesium, and coenzyme Q10 may also prevent migraines or make them less frequent.
How Not to Treat Your Migraine
Knowing what not to do is just as important as knowing what to do when dealing with migraines.
Are There Any Common Treatments That Should Be Avoided?
- Never take OTC painkillers daily. When you take painkillers every day, you risk turning your migraine from acute, episodic, and infrequent to chronic and daily, which is very difficult to treat.
- Some chiropractor maneuvers can do more harm than good. Gentle adjustments are generally fine, but I don’t recommend aggressive chiropractic adjustments.Never ignore a migraine. Don’t delay seeking migraine treatment. By getting on migraine-specific medications early, you can avoid
- developing more frequent and resistant headaches.
When to Seek Immediate Medical Care
Call your doctor or seek immediate medical care if you:
- Start experiencing double vision or other neurological symptoms
- Get a severe headache that feels different from your normal migraines
- Experience uncontrolled migraines after controlling your headaches for years
These symptoms may indicate a serious condition such as a stroke, meningitis, or a brain tumor.
Pain Medicine at Western Reserve Hospital — 100% Patient Centered Pain Treatment
You don’t have to suffer with unbearable migraines or headaches. At the Center for Pain Medicine at Western Reserve Hospital we provide the latest innovations in comprehensive pain treatment.
When chronic pain sets in, your life shrinks to fit your pain. Your health, work, and relationships suffer. You become less active. Often, you cannot sleep or suffer from depression. Living with chronic pain is hard, and the anxiety, stress, and anger that accompany it can make the pain even worse. The pain specialists at the Center for Pain Medicine at Western Reserve Hospital can help you conquer your pain with sophisticated new treatments and compassionate, professional care. Contact us at (330) 971-7246 to schedule an appointment and begin the journey to pain relief today.