What is Migraine?
Migraine is a type of headache that causes intense, throbbing pain usually on one side of the head. It can last for hours or even days and may come with nausea, vomiting and sensitivity to light and sound. Some people also experience visual disturbances called “auras” before a migraine starts.
Statistics About Migraine
Here are some key statistics:
- Global Prevalence: About 14% of people worldwide experience migraines. Its equating to around 1 billion people.
- United States: About 39 million people suffer from migraines in the U.S.
- Gender Disparity: Migraines are more common in women than men.
- Age Factor: The highest incidence of migraines is observed in individuals aged 10–14 years.
- Global Burden: Migraine ranks as the third most common illness globally.
- Global Impact: There were an estimated 581.8 million migraine cases worldwide in 2019, marking a 16% increase from 1990.
What Are The 9 Causes Of Migraine?
1. Neurological and Genetic Factors
- Brain Chemistry Imbalance: Changes in neurotransmitters like serotonin (helps regulate pain), can contribute to migraines. Sudden drop in serotonin levels may lead to blood vessels to widen and cause to pain.
- Genetics: About 80% of people with migraines have a family history of the condition. Specific genes linked to migraines effect how the brain processes pain and sensory stimuli.
2. Hormonal Changes (More Common in Women)
- Menstruation: Many women experience migraines around their menstrual cycle because of fluctuating estrogen levels. This is called “menstrual migraine.”
- Pregnancy: Some women see improvement in their migraines during pregnancy and some others experience worsening symptoms.
- Menopause and Hormone Therapy: Estrogen fluctuations during menopause or the use of birth control pills/hormone replacement therapy can trigger migraines.
3. Dietary and Nutritional Triggers
- Caffeine: Too much caffeine or caffeine withdrawal can lead migraines.
- Alcohol: Red wine, beer and other alcoholic beverages can trigger attacks.
- Processed and Aged Foods: Aged cheese, smoked meats and foods with preservatives (nitrates, MSG, aspartame) can contribute to migraines.
- Skipping Meals: Not eating regularly can lead low blood sugar levels and cause to a migraine.
- Dehydration: Not drinking enough water is a common trigger.
4. Stress and Emotional Factors
- Mental Stress: Anxiety, depression and emotional distress can trigger migraines.
- Physical Stress: Overexertion, intense exercise or sudden relaxation after stress (weekend migraines) can also be a factor.
5. Sleep Patterns
- Too Little or Too Much Sleep: Inconsistent sleep schedules, insomnia or oversleeping can contribute to migraine attacks.
- Shift Work and Jet Lag: Changes in sleep-wake cycles disrupt the body’s natural rhythm and can lead to migraines.
6. Environmental Triggers
- Bright or Flickering Lights: Computer screens, fluorescent lighting and sunlight glare can be problematic.
- Strong Odors: Perfumes, cigarette smoke, paint and chemical fumes can trigger migraines.
- Weather Changes: Shifts in barometric pressure, humidity, extreme heat or cold can cause to migraines.
7. Medications and Drug-Related Triggers
- Certain Medications: Birth control pills, hormone replacement therapy and vasodilators (like nitroglycerin) may lead to migraines.
- Medication Overuse: Taking pain relievers (like ibuprofen, aspirin or triptans) too frequently can cause to “rebound headaches” or medication overuse headaches.
8. Sensory Overload
- Loud Noises: Concerts, construction work or crowded areas with high noise levels can trigger migraines.
- Motion Sickness: Traveling by car, boat or airplane can sometimes cause to migraines in people who are sensitive to motion.
9. Physical Triggers
- Neck or Shoulder Tension: Poor posture, prolonged screen time or muscle strain can contribute to migraines.
- Head Injuries: Previous head trauma or concussions may increase migraine frequency.
What Are The Symptoms Of Migraine?
1. Prodrome (Pre-Migraine Phase) – Hours or Days Before the Attack
About 60% of migraine sufferers experience prodrome symptoms could be seen as early warning signs before the headache starts. These symptoms can begin several hours to two days before the attack.
Common Symptoms in the Prodrome Phase:
- Mood Changes: Feeling unusually irritable, anxious, depressed or even euphoric.
- Food Cravings: Sudden and strong cravings for specific foods and often salty or sweet items.
- Frequent Yawning: Some people notice excessive yawning even when they’re not tired.
- Neck Stiffness: Tight or sore neck and sometimes mistaken for tension.
- Fatigue and Difficulty Concentrating: Feeling mentally slow or easily distracted.
- Increased Thirst and Urination: Some people drink more fluids and urinate more frequently.
- Digestive Issues: Constipation or diarrhea before a migraine attack.
2. Aura (Not Present in All Migraines) – 10 to 60 Minutes Before the Headache
About 25-30% of migraine sufferers experience aura and it consists of temporary neurological disturbances before or during the headache. Auras usually last between 5 and 60 minutes and can be visual, sensory or motor-related.
Types of Aura Symptoms:
Visual Aura (Most Common – 90% of Cases)
- Flashing lights, bright spots or zigzag patterns
- Blind spots (scotomas) or temporary vision loss
- Distorted vision (things appearing larger or smaller than they really are)
Sensory Aura
- Tingling or numbness in the face, arms, hands or legs
- Pins-and-needles sensation that spreads across one side of the body
Speech and Language Aura (Less Common)
- Slurred or difficult speech (dysphasia)
- Trouble understanding or forming words
Motor Aura (Rare – Hemiplegic Migraine)
- Temporary weakness or paralysis on one side of the body
- Loss of coordination
3. Headache (Attack Phase) – 4 to 72 Hours
This is the most intense phase of a migraine and can last anywhere from 4 hours to 3 days if untreated. The headache is usually moderate to severe and worsens with movement.
Common Symptoms in the Headache Phase:
- Severe, throbbing or pulsating pain: Often on one side of the head but can effect both sides.
- Sensitivity to Light (Photophobia) and Sound (Phonophobia): Many people retreat to a dark and quiet room.
- Nausea and Vomiting: Up to 80% of migraine sufferers experience nausea and about 30% vomit.
- Blurred Vision: Vision may be foggy or out of focus.
- Dizziness and Vertigo: Feeling unsteady or like the room is spinning.
- Stuffy Nose or Watery Eyes: Some people experience sinus-like symptoms.
- Pain Worsens with Movement: Activities like walking, bending over or climbing stairs can intensify the pain.
4. Postdrome (Recovery Phase) – Up to 24 Hours After
Many people feel exhausted or mentally drained after the headache subsides. This is sometimes called the “migraine hangover.”
Common Symptoms in the Postdrome Phase:
- Extreme Fatigue: Feeling wiped out and needing extra sleep.
- Brain Fog: Difficulty thinking clearly or concentrating.
- Mild Headache or Sensitivity: Some people experience lingering head pain.
- Mood Changes: Some feel depressed and others feel euphoric and relieved.
What Are The Treatment Ways Of Migraine?
1. Acute (Abortive) Treatment – Stopping a Migraine Attack
These treatments work best when taken early in the migraine attack before symptoms worsen.
Over-the-Counter (OTC) Medications
- Pain Relievers: Ibuprofen (Advil), aspirin, naproxen (Aleve) or acetaminophen (Tylenol) can help mild migraines.
- Combination Medications: Some OTC drugs (like Excedrin Migraine) combine aspirin, acetaminophen and caffeine.
Prescription Medications for Moderate to Severe Migraines
- Triptans: Sumatriptan (Imitrex), Rizatriptan (Maxalt), Zolmitriptan (Zomig) work by narrowing blood vessels and blocking pain pathways in the brain.
- Ergots: Dihydroergotamine (DHE) and ergotamine are used if triptans don’t work.
- Gepants: Newer drugs like Rimegepant (Nurtec ODT) and Ubrogepant (Ubrelvy) block migraine related proteins.
- Ditans: Lasmiditan (Reyvow) is used for people who can’t take triptans.
- Antiemetics: Metoclopramide (Reglan) or prochlorperazine (Compazine) help relieve nausea and vomiting.
- Corticosteroids: Sometimes used for prolonged migraines (status migrainosus).
Lifestyle Measures During an Attack
- Rest in a dark and quiet room to reduce sensitivity to light and sound.
- Apply a cold or warm compress to the head or neck.
- Drink plenty of water to prevent dehydration.
- Try deep breathing or relaxation techniques to ease tension.
2. Preventive (Prophylactic) Treatment – Reducing Migraine Frequency
Preventive treatments are for people who have frequent or severe migraines (4+ attacks per month or migraines lasting more than 12 hours).
Medications for Prevention
- Beta-blockers: Propranolol, Metoprolol and Atenolol help regulate blood flow in the brain.
- Calcium Channel Blockers: Verapamil can help prevent migraines.
- Antidepressants: Amitriptyline (Elavil) and Venlafaxine (Effexor) effect serotonin levels to reduce migraines.
- Anti-Seizure Medications: Topiramate (Topamax) and Valproate (Depakote) help stabilize nerve activity.
- CGRP Inhibitors: Erenumab (Aimovig), Fremanezumab (Ajovy), Galcanezumab (Emgality) and Qulipta (Atogepant) target a migraine-related protein.
- Botox Injections: Approved for chronic migraines (15+ days/month).
3. Lifestyle and Home Remedies
- Identify Triggers: Keep a migraine diary to track food, sleep, stress and weather patterns.
- Follow a Regular Sleep Schedule: Avoid sleeping too little or too much.
- Manage Stress: Try yoga, meditation and deep breathing exercises.
- Exercise Regularly: Moderate exercise like walking or swimming helps prevent migraines.
- Stay Hydrated: Dehydration is a common trigger.
- Eat Regular Meals: Skipping meals can cause to migraines.
4. Alternative and Natural Treatments
- Acupuncture: Can help reduce migraine frequency.
- Massage Therapy: Can ease neck tension and improve blood flow.
- Herbal Supplements: Feverfew and Butterbur have been studied for migraine prevention.
- Magnesium, Riboflavin (Vitamin B2) and Coenzyme Q10: Some studies suggest these supplements for help prevent migraines.
5. Emergency Migraine Treatment
- IV Fluids: For treat dehydration.
- IV Medications: Including anti-nausea drugs, triptans, steroids or pain relievers.
- Oxygen Therapy: Sometimes used for migraine with aura or cluster headaches.
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