What is a Migraine?
is a type of headache that's often severe. Although any head pain
can be miserable, migraines are often disabling. In about 15 percent of
cases, these painful headaches are preceded by a sensory warning sign
(aura), such as flashes of light, blind spots or tingling in your arm or
leg. Migraines are also often accompanied by other symptoms, such as
nausea, vomiting and extreme sensitivity to light and sound. Migraine pain
can be excruciating and may incapacitate you for hours or even days.
Fortunately, migraine pain management has improved dramatically in
the last decade. If you've seen a doctor in the past and had no success,
it's time to make another appointment. Although there's still no cure,
medications can help reduce the frequency of migraines and stop the pain
once it has started. The right medicines combined with self-help remedies
and changes in lifestyle may make a tremendous difference for you.
What are the
signs and symptoms of a migraine?
A typical migraine attack produces some or all of
these signs and symptoms:
- Moderate to severe pain — 60 percent of
migraine sufferers feel pain on only one side of their head, while 40
percent experience pain on both sides
- Head pain with a pulsating or throbbing quality
- Pain that worsens with physical activity
- Pain that hinders your regular daily activities
- Nausea with or without vomiting
- Sensitivity to light and sound
When left untreated, migraines typically last from
four to 72 hours, but the frequency with which they occur can vary from
person to person. You may have migraine headaches several times a month or
just once or twice a year.
Not all migraines are the same. Eighty-five
percent of people suffer from migraines without auras, which were
previously called common migraines. About 15 percent of adults have
migraine headaches with auras, which were previously called classic
migraines. If you're in the second group, you'll likely have auras about
15 to 30 minutes before your headache begins. They may continue after your
headache starts or even occur after your headache begins. These may
- Sparkling flashes of light
- Dazzling zigzag lines in your field of vision
- Slowly spreading blind spots in your vision
- Tingling, pins-and-needles sensations in one
arm or leg
- Rarely, weakness or language and speech
What are the causes of
Although much about headaches still isn't
understood, some researchers think migraines may be caused by functional
changes in the trigeminal nerve system, a major pain pathway in your
brain, and by imbalances in brain chemicals, including serotonin, which
regulates pain messages going through this pathway.
During a headache, serotonin levels drop.
Researchers believe this causes the trigeminal nerve to release substances
called neuropeptides, which travel to your brain's outer covering. There
they cause blood vessels to become dilated and inflamed. The result is
Because levels of magnesium, a mineral involved in
nerve cell function, also drop right before or during migraines, it's
possible that low amounts of magnesium may cause nerve cells in the brain
Whatever the exact mechanism of headaches, a number of things may
trigger them. Common migraine triggers reported by some people include:
- Hormonal changes.
Although the exact relationship between hormones and headaches isn't
clear, fluctuations in oestrogen and progesterone seem to trigger
headaches in many women with migraines. About 60 percent of women with a
history of migraines report headaches immediately before or during their
periods. Others report more migraines during pregnancy or menopause.
Hormonal medications such as contraceptives and hormone replacement
therapy also may worsen migraine headaches.
Certain foods appear to trigger headaches in some people. Common
offenders include alcohol, especially beer and red wine; aged cheeses;
chocolate; fermented, pickled or marinated foods; aspartame; caffeine;
monosodium glutamate — a key ingredient in some Asian foods; certain
seasonings; and many canned and processed foods. Skipping meals or
fasting also can trigger migraines.
- Stress. A
period of hard work followed by relaxation may lead to a weekend
migraine. Stress at work or home also can instigate migraine headaches.
- Sensory stimulus.
Bright lights and sun glare can produce head pain. So can unusual smells
— including pleasant scents, such as perfume and flowers, and unpleasant
odors, such as paint thinner and secondhand smoke.
- Physical factors.
Intense physical exertion, including sexual activity, may provoke
migraines. Changes in sleep patterns — including too much or too little
sleep — also can be a problem.
- Changes in the
environment. A change of weather, season, altitude level,
barometric pressure or time zone can prompt a migraine.
Certain medications can aggravate migraine headaches.
At one time, aspirin was almost the only available
treatment for headaches. Now there are drugs specifically designed to
treat migraines. Several drugs commonly used to treat other conditions
also may help relieve migraines in some people. All of these medications
fall into two classes — those that reduce or prevent migraines (preventive
medications), and those that stop pain once it has started (pain-relieving
Choosing a preventive strategy or a pain-relieving
strategy depends on the frequency and severity of your headaches, the
degree of disability your headaches cause and other medical conditions you
may have. You may be a candidate for preventive therapy if you have two or
more debilitating attacks a month, if you use pain-relieving medications
more than twice a week, if pain-relieving medications aren't helping or if
you have uncommon migraines.
Some medications aren't recommended if you're
pregnant or breast-feeding. Some aren't used for children. Your doctor can
help find the right medication for you.
For best results, take pain-relieving drugs as soon as you
experience migraine signs or symptoms. It may help if you rest or sleep in
a dark room after taking them:
antiinflammatory drugs (NSAIDs). These medications, such as
ibuprofen or aspirin, may help relieve mild
migraines. Drugs marketed specifically for migraine, such as the
combination of aspirin and caffeine also may ease moderate migraines, but aren't effective alone for severe
migraines. If over-the-counter medications don't help, your doctor may
suggest a stronger, prescription-only version of the same drug. If taken
too often or for long periods of time, NSAIDs can lead to ulcers,
gastrointestinal bleeding and rebound headaches.
therapies may be helpful if you suffer from chronic headache pain:
In 1998, the National Institutes of Health (NIH) issued a long-awaited
statement on acupuncture. Among other benefits, NIH researchers found
that acupuncture may be helpful for headache pain. This treatment uses
very thin, disposable needles that generally cause little or no pain or
Magnetic therapy. The application of static high strength magnets at
the point of pain. Wearing a magnetic necklace or sleeping on a magnetic
pillow will reduce migraine headaches.
Biofeedback appears to be especially effective in relieving migraine
pain. This relaxation technique uses special equipment to teach you how
to monitor and control certain physical responses, such as muscle
Although massage is a wonderful way to reduce stress and relieve
tension, its value in treating headaches hasn't been fully determined.
For people who have tight, tender muscles in the back of the head, neck
and shoulders, massage may help relieve headache pain.
manipulation. There are no scientifically valid studies that
prove that chiropractic or other spine manipulation treatments are
effective in the treatment of migraine.
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