Have you ever had big plans – a crucial day at work or a fun night out with family or friends, only to be sidelined by a horrible headache? That may have been a migraine.

What is a Migraine?

A migraine is a debilitating, recurrent headache. It usually presents as a pulsating and throbbing pain on one side of the head. It can last from four to 72 hours. The intense migraine pain often leaves sufferers unable to participate in their daily activities.

People with migraines may experience migraine attacks as infrequently as a couple of times a year or as often as 15 days or more a month.

Types of Migraine

There are two major types of migraines and eight less common types.

Migraine With Aura

Also known as a classic migraine, a migraine with aura occurs in about 20% of migraine sufferers. An aura refers to temporary neurological symptoms that appear up to an hour before the migraine headache pain begins.

Migraine Without Aura

Often called a common migraine, migraines without aura occur in about 75% of people with migraines. There are no aura warning signs, but there may be some other clues you can look out for.

Other Types of Migraine

Some other less common types of migraine include:

  • Abdominal migraine
  • Basilar-type migraine
  • Hemiplegic migraine
  • Menstrual migraine
  • Migraine without headache
  • Ophthalmoplegic migraine
  • Retinal migraine
  • Status migrainosus

Phases and Symptoms of Migraine

We characterize migraine in four phases, although you may not experience all of them with every migraine.

Phase 1: Prodrome

You may experience some very early migraine symptoms up to a day or two before your migraine headache, including:

  • Constipation
  • Fluid retention
  • Food cravings
  • Frequent urination
  • Increased thirst
  • Mood changes (depression, irritability, excitement, happiness)
  • Neck stiffness
  • Uncontrollable yawning

Phase 2: Aura

If you experience a classic migraine, you may have aura symptoms immediately or up to 24 hours before the migraine pain. Some aura symptoms include:

  • Confusion
  • Difficulty speaking
  • Dizziness
  • Numbness and tingling
  • Seeing flashing lights and geometric shapes
  • Visual blind spots

Phase 3: Migraine Headache

Your migraine headache may start slowly and worsen with bright lights, loud noises, physical activity, and strong odors. Symptoms of migraine headaches include:

  • Pulsating and throbbing pain, usually on one side of the head
  • Dizziness
  • Nausea
  • Vomiting
  • Sensitivity to light, sound and touch

Phase 4: Postdrome

Once the headache pain resolves, you may experience a “migraine hangover.” This phase may last up to a day, and symptoms include:

  • Confusion
  • Fatigue
  • Head pain with sudden movement
  • Irritability

Non-Migraine Symptoms

Some symptoms could indicate a medical condition other than migraine and require immediate emergency attention. For example:

  • A headache after a head injury
  • An intense, worst headache of your life that comes on suddenly like a “thunderclap” 
  • Symptoms you have never had before, like –
    • Confusion
    • Difficulty speaking
    • Dizziness
    • Numbness and tingling
    • Seizures
    • Vision problems

Causes of Migraine

Migraine pain is caused by increased sensitivity of nerve fibers in the walls of blood vessels in the brain. However, the causes of nerve fiber irritation are still poorly understood.

Migraines are thought to be genetic, though the exact genes have not been identified yet. If you have one parent with a history of migraines, you have a 40% chance of having migraines. Your risk increases to over 70% if both parents have a history of migraines.

Migraine Risk Factors

In addition to having a family history of migraine, other risk factors include:

  • Female gender – women are three times more likely to have migraines
  • Tobacco use
  • Underlying medical conditions, such as
    • Anxiety
    • Bipolar disorder
    • Depression
    • Epilepsy
    • Sleep disorders

Migraine Triggers

More than 75% of people with migraines report various factors that trigger their migraine attacks. Reported triggers, from most reported to least reported, include:

  •  Stress
  • Hormonal changes (such as menstrual cycles and pregnancy)
  • Skipped meals
  • Weather changes
  • Too much or too little sleep
  • Strong odors
  • Neck pain
  • Exposure to lights
  • Alcohol consumption
  • Smoking
  • Heat
  • Foods (commonly aspartame, tyramine, and chocolate)
  • Exercise
  • Sexual activity

Diagnosing Migraine

Your provider won’t perform a specific diagnostic test to determine if you have migraines. Instead, they perform a neurological exam, review your medical history and headache patterns, and ask about your family’s medical history to make a diagnosis.

Your provider may perform lab and imaging tests to rule out other possible causes of your headaches, especially if you have new, worsening, or stroke-like symptoms.

Treatment for Migraine

There are two ways to treat migraines – abortive and preventive treatment.

Abortive Treatment

Abortive or acute treatment involves taking over the counter pain relievers or prescription medications at the earliest sign of a migraine to relieve the pain and symptoms.

You may also find migraine relief by:

  • Applying a cold or warm compress to your head
  • Drinking plenty of fluids, especially if you’re vomiting
  • Having a small amount of caffeine
  • Lying down in a dark, cool room
  • Sleeping – migraines often resolve during sleep

Preventive Treatment

Daily prescription medication may help prevent migraines or reduce their frequency and intensity.

You may also prevent migraines by:

  • Avoiding your migraine triggers
  • Eating regular, balanced meals
  • Engaging in relaxation techniques to manage stress
  • Establishing a regular sleep routine
  • Exercising regularly
  • Keeping a migraine journal

Turn to MainStreet Family Care

If you’re struggling with migraines, register online to be seen at the closest MainStreet Family Care clinic.

You can wait from the convenience of your home or in your car until we’re ready to see you. We’ll text you when it’s time to head to the clinic.

MainStreet loves walk-ins and accepts them daily! Walk-ins may face longer in-clinic wait times, so we highly recommend our online registration system. Walk-ins join the same queue as those who register online.