Headaches affects a significant number of individuals at some time in their lives, but migraine headache is a common headache that causes individuals to seek medical attention. The pain of migraine can be disabling, forcing people to miss work or other activities.
What Is a Migraine?
A migraine is a headache with throbbing pain that is usually worse on one side of the head. The pain is often severe enough to hamper daily activities and may last from four hours to three days if untreated. There are many things that can trigger a migraine headache and include certain foods, stress, and hormones.
Who Gets Migraines?
Migraines most often strike in the prime of life – between the ages of 20 and 60. Women are three times more likely to have migraines than men. If you have a close relative with migraines, you are much more likely to have them, too. Experts believe migraines may be related to mutations in genes that affect certain areas of the brain. Migraines are also more common among people who have epilepsy, depression, asthma, anxiety, stroke, and some other neurologic and hereditary disorders.
How do you know that you are having a migraine headache?
Throbbing pain typically occurs on one side near the temples, forehead, and eyes. Migraines can make you very sensitive to light, sound, or mild exertion, such as climbing the stairs. Many people have nausea, vomiting, or vision problems.
Migraine with Aura
About 20% of people who suffer from migraines will have an aura about 20 minutes to an hour before the pain. They may see flashing lights, wavy lines, or dots, or they may have blurry vision or blind spots. These are called “classic migraines.”
Migraine Warning Signs
Some people may have a change in mood before a migraine begins. They may become more excitable or irritable or depressed. Others may detect a sensation, such as a funny smell or taste. They may feel more fatigued, yawn frequently, or experience muscle tension. About 1 in 4 people experience this prodrome phase, which can occur as early as 24 hours before any head pain.
What Causes Migraine headaches?
The exact cause of migraines is still not well understood, but the problem is considered to be neurological (related to the nervous system). It is believed that brain chemicals, blood vessels, and nerves of the brain are involved.
What are some common migraine triggers?
Flashing Lights
Migraines may be set off by some specific cause, such as flickering lights. This could be a reflection from snow or water or from fluorescent bulbs or television or movie screens. Wearing polarizing sunglasses outside and using daylight spectrum fluorescent bulbs inside may help.
Anxiety and Stress
Emotional stress is a common trigger of migraines. While it is impossible to completely avoid stress, relaxation exercises can help you cope. Medication and breathing exercise can help reduce stress. Some people find that thinking of a peaceful scene or listening to favourite music can help.
Lack of Food or Sleep
Low blood sugar from skipping meals can trigger a migraine. Eating too much sugar also can cause a spike, then a “crash” in blood sugar. Drink water throughout the day to avoid dehydration and sleep at least seven to eight hours a night.
Hormonal Changes
For many women, migraines are tied to their menstrual cycle, occurring either a few days before or during their period, when oestrogen levels drop. Some women may benefit from anti-inflammatory medication before their headaches begin, or hormonal birth control such as pills, and patches. Others may have no benefit or worse migraines with hormonal birth control.
Foods
Migraine sufferers often report that certain foods trigger their headaches. Common culprits include MSG, red wine, cheese, chocolate, soy sauce, and processed meats. However, scientific studies have not confirmed any particular food as a migraine trigger.
Tyramine
Aged, fermented, and stored foods have higher levels of tyramine, a substance created from the breakdown of the amino acid tyrosine. Tyramine may cause blood vessels to constrict then expand, and it may be a trigger for some migraines. Some headache experts advise limiting fermented or aged foods, such as cheese, soy sauce, pickles, and pepperoni.
Caffeine and migraine
When combined with some pain medications, caffeine can help provide relief. Most migraine sufferers can drink a cup or two a day of coffee without any problems. However, too much caffeine can lead to headaches when the stimulant effect wears off.
When to see your doctor
Any new headache that is unusually severe or lasts more than a couple of days should be checked by a doctor. It is also important to let your health care provider know if the pattern of headaches changes — for example, if there are new triggers. If you have a headache accompanied by paralysis, confusion, fever, or stiff neck, seek emergency medical care.
Diagnosing Migraine
Migraines are diagnosed primarily from symptoms, but your doctor may want to do a brain scan to rule out other causes of headaches, such as a brain tumour or bleeding in the brain.
Treatment:
Over-the-Counter Drugs
Combinations of common pain relievers and anti-inflammatories may help: aspirin, naproxen sodium, ibuprofen, and acetaminophen. Some have been formulated specifically to treat migraines. However, overuse may actually make headaches worse or may lead to ulcers or other gastrointestinal problems.
Other medications
A number of doctor prescribed medications are available for treating migraine. You and your doctor will be able to decide on a treatment plan.
Overuse of medications can sometimes lead to chronic headaches. You should not take prescribed medication more than two times per week. You can get rid of the chronic headaches by tapering and discontinuing medication — under a doctor’s supervision. Pain medicines containing narcotics should be taken only when other medications fail to relieve pain because they can be habit-forming.
Preventive Medication
If migraines are frequent or very severe, you may need to take a drug every day to prevent attacks. Drugs used to treat high blood pressure can be prescribed for this purpose.
Biofeedback therapy
Biofeedback and relaxation training can give you relief that is similar to the help you get from medications. Biofeedback uses a monitor to train you to recognize the onset of muscle tension and changes in body temperature that are signals of stress.
Conclusion
There are many different types of headaches, some can be life threatening while others are not too serious. Migraine headaches which tend to affect more women than men can cause much pain and discomfort and can lead can have an economic impact as a result of days off from work and decrease productivity. If you have migraine headaches you should get professional help.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
