migraine headaches

What Are Migraine Headaches?

Migraine headaches are a widespread, well-known condition. Research suggests that they are the most common of all primary headache types. However, they are a type of pain that can severely impact a person’s overall quality of life.

Women appear to be at three times the risk of migraine headaches compared to men. For many female patients, the onset of migraine pain may be related to the stages of their menstrual cycle. Read on to learn the common symptoms and causes of migraines, along with treatments that work.

Migraine Symptoms

Migraine headaches are considered a primary neurological condition. They occur in regular episodes throughout the year that may involve:

  • Extremely severe pain perceived as coming from within the skull
  • Sensations of throbbing on one side of the head
  • Nausea or vomiting
  • Strong sensitivity to external environmental factors such as sound, light, or smells

These symptoms may last anywhere from a number of hours to a number of days.Migraines are regarded as a primary condition in their own right, i.e. not occurring as a symptom of another disorder. However, some symptoms associated with migraine may in fact be signs of serious neurological events.

In rare cases, they may indicate the presence of a brain tumor, aneurysm, or meningitis. If these conditions are suspected, one should seek immediate medical assistance. Signs of a serious event may include:

  • Sudden-onset severe headache pain, especially if such pain is normally unusual for the person in question
  • Aura symptoms, especially if this is not normally experienced
  • Neurological events such as emotional or behavioral abnormalities, sudden falls, loss of balance, dizziness, speech disturbances, confusion, numbness, or tingling
  • Seizure
  • Headache pain severe enough to cause waking from sleep
  • Passing or blacking out
  • Stiffness in the neck
  • Rash or fever accompanied by headache
  • Severe pain that follows head trauma

Check out the following video for more information about migraine headaches.

 

Types of Migraines

There are few different types of migraines. These include:

  • Ocular migraines, or optical migraines, which cause vision issues along with head pain
  • Hemiplegic migraines, which are severe migraines with stroke-like symptoms
  • Abdominal migraines, where pain is felt in the abdomen instead of the head and is most common in children
  • Vestibular migraines, which are associated with vertigo or dizziness
  • Basilar migraine, which originate near the brain stem or base of the head
  • Menstrual migraines, which are experienced during changes in menstruation
  • Migraines with auras, where you may experience or see shimmering lights or lines in your field of vision
  • Silent migraines, which is a headache with all the phases of a migraine, except for the head pain

The 4 Migraine Stages

Most researchers and clinicians regard an episode of migraine as going through these four stages:

  • Prodromal: This stage can occur several hours before the onset of pain. Many patients see this as a precursor to pain, and learn to expect it at the prodromal stage. It may involve signs and symptoms such as mood swings, lethargy, unusual food cravings, compulsive yawning, and an increased need for the restroom.
  • Aura: This next stage may involve neurological events, known as auras, which precede an episode of pain. Auras may begin 20 to 60 minutes prior to actual migraine pain. They may manifest as seeing metallic lines, changes in sensation, motor deficits, or speech abnormalities. Auras are not common to all migraine sufferers, however.
  • Attack: This stage involves pain and other symptoms such as light sensitivity. This may last up to 72 hours without treatment.
  • Postdromal: This occurs after the episode of pain has ended. Patients may feel drained and fatigued at this stage. Some may experience mild euphoria.

 

Causes Of Migraine Headaches

Brain tissue itself does not normally feel pain. The pain of most headache types is related to chemical or mechanical damage to the tissues in close proximity to the brain, including the nerves, skull, sinuses, muscles, blood vessels, eyes, ears, and various membranes. The exact cause of migraine headaches is not completely defined. Early research into the subject led to conclusions that it is a vascular condition, or related to changes in the blood vessels of the brain’s surface. However, this was subsequently debunked. Current research tends to link mutations in certain genes to the increased probability of developing migraine headaches.

This type of head pain is relatively common and may occur in conjunction with other illnesses. Migraine headaches may be difficult to diagnose, as their symptoms are also factors of other similar conditions. A pain doctor may distinguish a case of migraine by asking detailed questions about:

  • Pain episode onset
  • Prior medical history
  • Any family history of migraine
  • Other symptoms

Headaches are difficult to diagnose with techniques other than patient interview. A physician may use some standard rating scales to assess the degree of migraine headache-related pain. These can also help them determine whether it’s a migraine or another type of headache.

Migraine headaches are commonly linked to factors that trigger, or increase the risk of, an episode. Migraine triggers may include:

  • Psychological disorders, such as stress
  • Sensitivity to chemicals such as food preservatives
  • Caffeine intake
  • Weather changes
  • Tension
  • Fatigue
  • Sleep deprivation or changes to a normal sleep rhythm
  • Failing to eat regularly

Treatments For Migraine Headaches

A pain clinic or specialist may offer many treatments for migraine headaches. Patients with relatively mild to moderate pain may be advised to try conventional measures at home beforehand to assess their effect, if any. Natural at-home remedies for migraine treatment include:

  • Avoiding light or using green light therapy during a migraine attack
  • Drinking plenty of water
  • Restricting any caffeine or alcohol in your diet
  • Practicing a migraine diet centered around avoiding foods that trigger pain
  • Trying essential oils for migraines during an attack

If these fail, a patient may discuss more treatments with their specialist or physician. For example, a patient might be advised to try over-the-counter painkillers to test their efficacy and make sure the next line in treatment is necessary. Other more intensive therapies may include:

  • Acupuncture
  • Yoga
  • Certain herbs, like feverfew
  • Pressure point therapy
  • Botox injections
  • Biofeedback
  • Nerve block injections
  • Medications

Migraine Headache | PainDoctor.com

Biofeedback for migraines

There is some evidence that biofeedback training has some benefit in chronic pain conditions such as migraine headache. Biofeedback training educates patients in the use of biological metrics, such as electroencephalography, and how these change in response to pain and other symptoms. The patient uses this in conjunction with symptom tracking to apply relaxation techniques at an episode onset. The goal of this is to return the metrics to normal, and thus reduce pain and other symptoms. A patient may alleviate or even prevent an episode at its onset using biofeedback training.

Shots for migraines

If a patient doesn’t find relief from more conservative treatment methods, they can talk to their doctor about more interventional pain management techniques.

Patients with chronic and severe headache pain may wish to consider direct nerve treatments, which inhibit pain signals from major nerves. These include nerve blocks, in which a physician or pain specialist inserts a needle through numbed skin to deliver pain-relieving medications such as lidocaine to a nerve.

There are a number of nerve block types associated with effective migraine treatment, including those to the occipital nerve or sphenopalatine ganglion. A patient should discuss the risks, benefits, and treatment goals associated with these with their specialist or physician before considering this treatment.

occipital nerve block

Symptom tracking to prevent migraines

Finally, a pain doctor may also advise their patient to track their symptoms in cases of migraine associated with severe chronic pain. It’s been shown that tracking migraine triggers can help prevent pain. Symptom tracking involves keeping a record of:

  • Pain onset time
  • Pain severity
  • The time from an episode onset to the maximum severity of pain
  • Episode length
  • The presence of stages and their symptoms (e.g. aura)
  • Any other unusual symptoms

This may contribute to the identification of triggers and to improved prophylaxis against the onset of pain episodes. It can also help a pain doctor make the correct diagnosis when it comes to the type of migraine a patient is experiencing.

Conclusion

Migraine headaches are a widespread burden to health and your overall quality of life. Migraine headaches occur in regular episodes, in which a patient experiences severe headache pain, vomiting, nausea, or sensitivity to light or sound. The exact biochemical cause of migraine headaches is not completely understood. While most symptoms are related to simple migraine episodes, atypical symptoms may indicate a medical condition that should be addressed without delay.

Symptom tracking and biofeedback training may help to manage your migraine episodes. Some patients also respond well to other treatments such as nerve blocks. A discussion with your physician or pain specialist may help you to arrive at the most effective treatment for your case of migraine headaches.

To find a pain specialist in your area who can help you find a treatment that works for your migraines, click the button below.

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References

  1. Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E, Quality Standard Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. 2012;78(17):1346-53.
  2. Rapoport AM. Acute treatment of migraine: Established and emerging therapies. 2012;52(Suppl2):60-4.
  3. Rapoport AM. The therapeutic future in headache. Neurol Sci. 2012;33(Suppl 1):S119-25.
  4. Sacco S, Ricci S, Carolei A. Migraine and vascular diseases: A review of the evidence and potential implications for management. Cephalalgia. 2012;32(10):785-95.
  5. Shapiro RE. Preventive Treatment of Migraine. Headache. 2012;52(Suppl 2):65-9.
  6. Silberstein SD. Treatment recommendations for migraine. Nat Clin Pract Neurol. 2008;4(9):482-9.
  7. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E, Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1337-45.

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