Migraine Headaches: Ways to Deal With the Pain
What causes migraine headaches?
Migraine headaches seem to be caused in part by changes in the level of a chemical made in the brain called serotonin. Serotonin plays many roles in the body, and it can have an effect on blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems.
Many things can affect the level of serotonin in your body, including your level of blood sugar, certain foods and changes in your estrogen level if you're a woman.
What does a migraine feel like?
The pain of a migraine headache can be intense. It can get in the way of your daily activities. Migraines aren't the same for all people. Possible symptoms of migraines are listed in the box below.
You may have a "premonition" several hours to a day before your headache starts. Premonitions are feelings you get that can signal a migraine is coming. These feelings can include intense energy, fatigue, food cravings, thirst and mood changes.
What are the possible symptoms of migraines?
Intense throbbing or dull aching pain on one side of your head or both sides
Pain that worsens with physical activity
Nausea or vomiting
Changes in how you see, including blurred vision or blind spots
Being bothered by light, noise or odors
Feeling tired and/or confused
Stopped-up nose
Feeling cold or sweaty
Stiff or tender neck
Light-headedness
Tender scalp
Are there different kinds of migraine headaches?
Yes. The most common are classic migraine and common migraine.
Classic migraines start with a warning sign, called an aura. The aura often involves changes in the way you see. You may see flashing lights and colors. You may temporarily lose some of your vision, such as your side vision.
You may also feel a strange prickly or burning sensation, or have muscle weakness on one side of your body. You may have trouble communicating. You may also feel depressed, irritable and restless.
Auras last about 15 to 30 minutes. Auras may occur before or after your head pain, and sometimes the pain and aura overlap, or the pain never occurs. The head pain of classic migraines may occur on one side of your head or on both sides.
Common migraines don't start with an aura. Common migraines may start more slowly than classic migraines, last longer and interfere more with daily activities. The pain of common migraines may be on only one side of your head.
How long do migraines usually last?
Migraines can last from 4 to 72 hours. They may happen only once or twice a year, or as often as daily. Women are more likely to have migraines than men.
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What can set off a migraine?
Things that can set off migraines include the following:
Strong or unusual odors, bright lights or loud noises
Changes in weather or altitude
Feeling tired, stressed or depressed
Changes in sleeping patterns
Certain foods (see the list below), especially those that contain tyramine, sodium nitrate or phenylalanine
Missing meals or fasting
Menstrual periods, birth control pills or hormonal changes (in women)
Intense physical activity, including sexual activity
Smoking
Fumes
How are migraines treated?
There are 2 types of medicines for migraine treatments. One type focuses on relieving the headache pain. This type of treatment should be started as soon as you think you're getting a migraine. The other type includes medicines that are used to prevent headaches before they occur.
Can nonprescription medicines help relieve the pain?
Yes. Nonprescription medicines that can help relieve migraine pain include aspirin, acetaminophen (one brand name: Tylenol), an acetaminophen, aspirin and caffeine combination (one brand name: Excedrin Migraine), ibuprofen (one brand name: Motrin), naproxen (brand name: Aleve), and ketoprofen (brand name: Orudis KT).
What about prescription medicines?
People who have more severe pain may need prescription medicine. A medicine called ergotamine can be effective alone or combined with other medicines. Dihydroergotamine is related to ergotamine and can be helpful.
Other prescription medicines for migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan, eletriptan and frovatriptan.
If the pain won't go away, stronger medicine may be needed, such as a narcotic, or medicines that contain a barbiturate. These medicines can be habit- forming and should be used cautiously.
Can medicine help prevent migraines?
Yes. Medicine to prevent migraines may be helpful if your headaches happen more than twice a month or if your headaches make it hard for you to work and function. Examples of medicines used to prevent migraines include propranolol, timolol, divalproex and some antidepressants.
Talk to your doctor about which medicine is best for you. Nonprescription and prescription medicines that are used often or in large doses may cause other problems.
What else can I do to prevent migraines?
Try to avoid foods or other things that seem to cause migraines for you. Keep a journal to help you identify triggers. Get plenty of sleep and drink plenty of fluids. Try to relax and reduce the stress in your life. Also try to get regular exercise. Aerobic exercise can help reduce tension as well as keep your weight in check. Obesity can contribute to migraines.
What are some tips on reducing the pain?
Lie down in a dark, quiet room.
Put a cold compress or cloth over your forehead.
Massage your scalp using a lot of pressure.
Put pressure on your temples.
Migraine Headache in Children and Adolescents
Do children get headaches?
Yes. The most common cause of headaches in children is a viral infection such as a cold or the flu. Children and adolescents can also get tension-type headaches and migraine headaches. Brain tumors can cause headaches, but these tumors are very rare. In addition to a headache, brain tumors almost always cause problems with coordination, balance, speech, sight and walking.
What is a migraine headache?
A migraine is usually an intense pounding headache with nausea. The pounding or pulsing pain usually begins in the forehead, the side of the head or around the eyes. The headache gradually gets worse. Just about any movement or activity seems to make it hurt more. Nausea and vomiting are common. Bright lights or loud noises make the headache worse. The headache can last for 2 hours or even up to 2 or 3 days.
Some people see a pattern of lines or shadows in front of their eyes as the headache is beginning. This is called a "warning aura." Most people who have migraine headaches do not have this.
Do many children get migraine headaches?
As many as 5% of children in grade school have migraine headaches. During the high school years, about 20% of adolescents get migraine headaches. These headaches are more common in girls than in boys. Boys who get migraines have them more often when they are about 10 to 12 years old. It is not unusual for them to have 2 to 3 migraine headaches a week.
How do children describe their migraine headaches?
"It feels like my heart is pounding in my head."
"All I want to do is throw up."
"It is like being inside a big bass drum."
"I just want to go into a dark room and lie down."
How is migraine diagnosed?
Your doctor can diagnose migraines by the symptoms your child describes. After talking to your child about his or her symptoms, your doctor will perform a physical exam. Your doctor may also want to do blood tests or imaging tests, such as an MRI or CAT scan of the brain, to be sure that there are no other causes for the headache. Your child may also be asked to keep a "headache diary" that will help your doctor identify any "triggers" for your child's migraines.
What can help my child feel better?
When a migraine headache happens, your child should go to a cool, dark place and lie down with a wet cloth across his or her forehead. If the doctor has given your child a medicine for migraines, your child should take it as soon as he or she knows a headache is starting. Don't wait! If your child has nausea, the doctor can also prescribe a medicine for that.
How can my child keep from having migraine headaches?
While there are no sure ways to keep from having migraine headaches, here are some things that may help:
Eat regularly and do not skip meals.
Keep a regular sleep schedule.
Exercise regularly.
Look for things that might trigger an attack, like certain foods, stress, too much exercise or physical activity, certain activities or stress. Sometimes, life stresses are a trigger. Many psychologists can teach stress management and/or biofeedback to help your child manage stress.
Look for foods that might trigger an attack, like cheese, processed meats, chocolate, caffeine, MSG (a preservative in many foods), nuts or pickles. About one third of people with migraine can identify food triggers. Your child only needs to avoid eating these foods if one of them triggers headaches.
If your child has frequent migraine headaches, your doctor may prescribe a daily preventive medicine to try to make the headaches less frequent and less severe.