Migraine Headache: The Silent Pain

Many people consider migraine is normal headache, but it’s totally different and severe from other types of headache.

According to the World Health Organization, It affects 1 billion people around the world. Yes! In the US, about 39 million people suffer from migraines. And, it’s surprising to know women are three times more likely to have them than men.

Keep reading to learn about what migraines truly are, and the signs that will tell you it’s a migraine, not a typical head pain. 

What Are Migraines?

A migraine is not just a headache; it’s a condition that brings throbbing pain. It can last for hours or stretch to days. The exact cause stays unclear, but it links to brain and vessel issues.

Migraines are more than just head pain. Here’s what can come with them:

• Nausea and vomiting: Feeling sick often follows the ache.
• Light and sound trouble: Brightness and noise worsen the situation.

Types of Migraines

Migraines appear differently in people. Some start with strange warning signs, while others come without notice. Here are the main types:

• With aura: Strange sights, like flashes or wavy lines, show up before pain.
• Without aura: The most common kind—no warning, just sudden pain.
• Chronic migraines: More than 15 attacks in a month disrupt daily life.
• Other forms: Kids may get abdominal migraines. Hormonal shifts can cause menstrual migraines.

Migraine vs. Headache

Migraines and headaches are not the same. While people often equate migraines with headaches, migraines involve multiple symptoms beyond head pain. Headaches, on the other hand, can have various causes, such as stress or dehydration. Key migraine characteristics include:

• Throbbing or pulsing pain that worsens with movement.
• Pain is usually on one side of the head.
• Additional symptoms like sensitivity to light or sound, nausea, or vomiting.

Migraine Symptoms and Phases

Migraines often happen in four stages. Each stage shows different signs.

Prodrome Stage

This starts hours or even days before the pain hits. About 60% of migraine sufferers notice:

• Sensitivity: Bright light, strong smells, or loud sounds feel unbearable.
• Fatigue: Yawning a lot or feeling drained.
• Cravings or no appetite: Some want sweets; others avoid food.
• Mood changes: Feeling irritable, sad, or overly happy.
• Digestive trouble: Constipation or bloating may appear.

Fact: Some foods blamed for migraines, like chocolate, might be cravings from this stage.

Aura Stage

Not everyone gets to this stage, but 1 in 4 does. It lasts less than an hour and may involve:

• Vision trouble: Wavy lines, flashes, or black spots.
• Tingling or numbness: Often in the hands, face, or limbs.
• Speech issues: Words may slur, or sentences may not come out clearly.
• Other signs: Weakness on one side or ringing in the ears.

Attack Stage

This is the headache phase. Pain starts dull, then gets intense. Movement makes it worse. Pain may shift sides or stay in one spot.

During this time, you might also feel:

• Sick (nausea or vomiting).
• Dizzy or faint.
• Sensitive to light, sound, or smells.

This stage can last 4 hours to 3 days.

Postdrome Stage

After the pain ends, some effects linger. Up to 80% of people feel:

• Weak or tired.
• Sore muscles.
• Unfocused thoughts.
• Appetite changes.

Common Headache Types Compared

Not all headaches are migraines. Here’s how to tell them apart.

Tension Headaches

These come from stress or muscle tension. They:

• Feel like steady pressure on both sides of the head.
• Don’t cause nausea or sensitivity to light.

Cluster Headaches

These are sharp and intense. They:

• Start suddenly, around one eye.
• Cause red, swollen, or watery eyes.
• It lasts 15 minutes to 3 hours but can occur several times a day.

Cluster headaches are more common in men.

What Causes Migraines?

While the exact cause remains unknown, researchers believe migraines result from genetic factors and changes in brain activity. Here’s a quick look at what may cause them:

• Chemical Changes: When levels of serotonin and CGRP change, it messes with blood vessels. This causes pain and inflammation.
• Genetics: If your mom or dad gets migraines, there’s a good chance you might too. If both parents have them, your chances rise a lot.
• Brain Activity: Migraines are linked to changes in parts of the brain, like the brainstem, thalamus, and cortex.

What Triggers Migraine?

A trigger is anything that makes a migraine worse or starts one. Knowing what sets off a migraine helps you avoid it. Here are some common triggers:

• Stress: Both emotional and physical stress can set off migraines. Stress hormones mess with brain chemicals, causing pain.
• Hormonal Changes: Women often get migraines during certain times like their period, pregnancy, or menopause because of changes in estrogen.
• Certain Medications: Some medicines, like birth control or vasodilators, can bring on migraines.
• Sleep Problems: Missing sleep or sleeping too much can start a migraine.
• Weather Changes: Shifts in weather, especially barometric pressure, extreme heat, or humidity, can trigger migraines.
• Overdoing It: Doing too much physical activity can bring on a migraine, especially if you’re not hydrated or eating right.
• Addictive Substances: Too much caffeine, alcohol, or tobacco can cause migraines. Also, withdrawal from them can make them worse.
• Sensory Overload: Bright lights, loud sounds, and strong smells, like perfumes, can overwhelm the brain and cause pain.
• Skipping Meals: Missing meals can lower blood sugar, a common cause for migraines.

Expert Advice: Keeping a migraine journal can help you track triggers and patterns. Note down what you ate, your activities, stress levels, and environmental factors before an attack.

What Foods Trigger Migraines?

Certain foods have chemicals that may cause migraines. These chemicals include tyramine, nitrates, and MSG.

Common Food Triggers:

• Aged Cheese: Cheese like cheddar, blue cheese, and parmesan have high levels of tyramine, which can cause migraines.
• Alcohol: Wine, beer, and other drinks can make blood vessels expand and start a headache.
• Chocolate: Chocolate has caffeine and phenylethylamine. For some, these trigger migraines.
• Processed Foods: Hot dogs, bacon, and deli meats have nitrates, which are often linked to migraines.
• Food Additives: MSG, found in many fast foods and processed snacks, may cause headaches.
• Fermented or Pickled Foods: Foods like kimchi, pickles, and sauerkraut can have high amounts of tyramine, triggering migraines.

This is not a complete list, but it gives a clearer view of what may cause migraines. Scientists continue to explore, but understanding triggers and risks can help prevent them.

What Does a Migraine Feel Like?

Migraine pain feels different for everyone, but common descriptions include:

• Throbbing or pounding
• A pulsing sensation
• Dull but persistent pain

For some, the pain starts on one side of the head and then moves to the other. Others may feel it around their eyes, temples, jaw, or neck.

How Often Do Migraines Occur?

The frequency of migraines depends on the person. Some might have one migraine a year, while others experience them weekly. On average, most people have between 2 to 4 migraines per month.

Migraines often strike in the morning and can be unpredictable. However, certain triggers might signal their arrival, like hormonal changes during menstruation or high stress.

How do Doctors Identify Migraine Pain

When you go to a doctor with a migraine, they first do a physical check-up and a neurological test. These steps help them understand how your body is doing and find out if there are any problems causing your headaches.

They will ask you many questions about your pain and symptoms. Here are some questions you might hear:

• What does the pain feel like? Is it throbbing, sharp, or something else?
• Are you experiencing nausea, vomiting, photophobia, or phonophobia?
• On a scale of 1-10, how much does the pain hurt?
• How frequent and how long do the headaches last?
• Are they transient, or do they spend several days in the hospital?
• Is there something that triggers the pain? Perhaps it is food, stress, or activity?

Tests for Deeper Insight

At other times, your doctor may request for other tests to be done to exclude other causes. These might include:

• Blood tests: To determine whether you have any diseases such as anemia or infection.
• Imaging scans: Like MRI or CT scans to determine the physical condition of the brain.
• EEG (Electroencephalogram): An examination that records your brain’s activity in terms of electrical impulses.

Early accurate diagnosis is important. If the doctors are aware of everything, they can help you get the right care you need. But with the right help you can control the pain and lead a better life.

Migraine Management and Treatment

Migraines won’t vanish, but many ways exist to ease them. With the right guidance, you can find what works best for you. Here’s how you can manage:

• Take meds suited to your needs.
• Learn what sparks your migraines and steer clear of it.
• Look into other treatments for comfort.

Medications for Migraine Relief

Meds play a big role in migraine relief. They fall into two groups:

1. Abortive Medications: These meds help when a migraine starts. They stop symptoms like pain, nausea, or light sensitivity. Take them right away to stop it in its tracks.
2. Preventive Medications: For those with frequent or tough migraines, daily pills may reduce how often they strike or how severe they are.

Common Abortive Medications

• Triptans (like sumatriptan)
• Ditans (like lasmiditan)
• Gepants (like rimegepant, ubrogepant)
• Dihydroergotamine (mixed with anti-nausea drugs)

Common Preventive Medications

• Antiseizure drugs (like valproic acid, topiramate)
• Beta-blockers (like propranolol, atenolol)
• Calcium blockers (like verapamil)
• Monoclonal antibodies (like erenumab, fremanezumab)
• Antidepressants (like amitriptyline, venlafaxine)

Medication Formats

• Oral tablets
• Subcutaneous shots
• Nasal sprays
• IV (intravenous) infusions
• Suppositories

Your doctor will pick the best meds and delivery for you. Always follow their advice to stay safe and effective.

Over-the-Counter Options

For mild or moderate migraines, over-the-counter (OTC) drugs might do the job. These include:

• Ibuprofen
• Aspirin
• Acetaminophen
• Naproxen
• Caffeine-based pain relievers

Important Note: Don’t overuse OTC drugs. Too many could lead to “rebound headaches” or even dependency. If you’re taking these meds more than twice a week, talk to your doctor about long-term solutions.

Identifying and Avoiding Triggers

A crucial part of migraine management is understanding what triggers your episodes. Common triggers include stress, irregular eating habits, certain foods, hormonal changes, or environmental factors.

So, how you can track your trigger? Your doctor will recommend keeping a migraine journal to track patterns. Write down things like:

• Time and date of your migraine
• Symptoms you felt
• What you ate
• What you were doing before the migraine hit

Some apps make this easy. Spotting your triggers can help you avoid them, or act fast when a migraine starts.

Example: If you miss meals, set alarms to eat regularly. If stress is a problem, try relaxation exercises or get help from a counselor.

Alternative Remedies for Migraines

Other treatments beyond meds might help. Some of the top ones are:

• Supplements: Magnesium, vitamin B2, feverfew, butterbur, coenzyme Q10
• Relaxation: Yoga or meditation
• Acupuncture: Targeting pain points for relief
• Biofeedback: Control muscle tension
• Botulinum Toxin (Botox®): Works for chronic migraines

Before starting any alternative therapy, check with your doctor. You want to make sure it’s safe and works with your other treatments.

Last Words

Migraine is more severe than basic headaches, and that makes it critical for one to know how to handle it. When you know the signs, causes, and cures of the disorders, you can avoid situations that will worsen them. This means that to manage this condition effectively, you needs to consult a healthcare provider most of the time.