Migraine: more than a bad headache

Anyone who gets migraines knows it is not “just a headache”. It means turning off the lights, cancelling the day and waiting for it to pass. The good news is that a lot can be done, both for the attack and to make attacks less frequent.

How to recognize it

According to MedlinePlus, from the U.S. National Library of Medicine:

• In most people it is a throbbing pain on one side of the head, often behind the eye or at the back of the head.
• It starts as a dull ache that gets worse over minutes or hours, and lasts 4 to 72 hours.
• Nausea, vomiting and sensitivity to light or sound are common. There can also be sweating, chills, fatigue or loss of appetite.

Migraines usually start between ages 10 and 45, can run in families and are more common in women than in men.

The aura

Some people get a warning before the pain, called an aura. It is most often visual: blind spots, zigzag lines or flashing lights. It usually comes 10 to 15 minutes before the headache, although it can be anywhere from a few minutes to 24 hours before.

What sets it off

Everyone has their own triggers. Common ones include:

• Poor sleep, or skipping meals.
• Stress.
• Hormone changes.
• Alcohol, or suddenly cutting out caffeine.
• Strong smells.
• Some foods, such as chocolate, aged cheeses, MSG, nitrate-containing meats and onions.

A headache diary helps you find yours: write down when it started, what you ate, how you slept and what you did beforehand. With that, you and your doctor can plan how to avoid them.

Treatment

Migraine has no specific cure. The goal is to treat the attack early and prevent the next ones:

• For the attack: when it is mild, over-the-counter pain relievers often help. If they are not enough, there are prescription medicines, such as triptans.
• To prevent it: if migraines are frequent, your doctor may consider a preventive medicine, which is taken every day to work.
• Day to day: a regular sleep schedule, not skipping meals, managing stress and, if needed, losing weight.

Careful with taking pain relievers too often

MedlinePlus warns that taking pain relievers more than 3 days a week can cause rebound headaches, which come back precisely because of the extra medicine. Also, too much acetaminophen can harm the liver, and too much ibuprofen, naproxen or aspirin can irritate the stomach or damage the kidneys. If you need them that often, it is time to talk to your doctor.

When it is an emergency

Call 911 if you have:

• The worst headache of your life.
• A headache that comes on suddenly.
• Trouble speaking, seeing or moving, or loss of balance, especially if you have never had these with your migraines.

And call your doctor if your headache pattern changes, if treatment stops working, if you take birth control pills and have migraines, or if the pain gets worse when you lie down.

How we handle it at the clinic

At our family medicine clinic we treat migraines and headaches: we review your history and your triggers, look for the treatment that works for you and follow up. In English or Spanish.

Sources

• MedlinePlus, U.S. National Library of Medicine. Migraine.

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This article is general information about our clinic and about migraine. It is not medical advice and does not replace a consultation with a professional. Do not change or stop your medications without talking to your doctor. If you have a medical emergency, call 911.