Last updated on August 26, 2021.
Did you know that migraine is the third most common disease in the world and that it is more prevalent than asthma, diabetes, and epilepsy combined? It is estimated that 2% of the world population is affected by chronic migraines and that the disease is likely hormonally-driven. In fact, migraines are three times more common in women. They can happen several times a month or on rare occasions. So what causes a migraine, what does it feel like and is there anything to help relieve them? Here is Healthy Matters’ complete guide to severe headaches aka migraines.
Migraine and headaches: what’s the difference?
Migraines are headaches that are considered intense or severe. Most often migraines have other symptoms in addition to head pain and the pain is typically felt on one side of the head (however, it is possible to have both sides affected).
Causes of migraines
Researchers are not sure why some people get migraines and some don’t. Current thinking is they are the result of abnormal brain activity affecting nerve signals and blood vessels inside the brain. We also know that intense headaches run in families and that certain environmental triggers seem to bring them on.
The following triggers are associated with the onset of a migraine:
- Hormonal changes particularly estrogen fluctuations seem to be associated with migraines in women. Many women will have one when their estrogen levels drop: just before or during their periods, during pregnancy and during menopause.
- Every migraine sufferer has a different set of foods and food additivesthat trigger an attack. Some common catalysts are: aged cheeses (particularly blue cheeses), salty or processed foods containing nitrates. Additionally, MSG and aspartame are common migraine triggers.
- Drops in blood sugar caused by too long between meals.
- Any food or drinks with tannins in them can cause a migraine – wine, tea, red apples/pears and ciders. Caffeine-containing drinks should also be avoided.
- Sensory stimuli such as bright lights, loud sounds, and strong smells. Perfume is a common migraine trigger.
- Common weather-related triggers include sunlight, extreme heat or cold, high humidity, dry air, windy/stormy weather or barometric pressure changes.
Accuweather.com rates its forecast predictions based on how it may impact migraine sufferers. A great resource!
Symptoms of migraines
These headaches are characterized by disabling, throbbing or pulsing pain usually on one side of the head. They often last for several hours to days at a time.
Stages of migraines
Such severe headaches span hours or days and go through four stages – though not everyone experiences all four stages.
(1) The prodrome stage may include constipation, mood changes, food cravings, neck stiffness, increased thirst and urination, and frequent yawning. It usually occurs 1-2 days before the onset and acts as a warning of the upcoming migraine.
(2) Some migraine sufferers will experience pre- or during-migraine symptoms known as aura. Accounting for about a quarter of migraines, aura symptoms consist of dizziness, ringing in your ears, flashes of light, and/or light sensitivity.
(3) During the migraine attack, sufferers will experience disabling pulsing or throbbing pain on one or both sides of the head, blurred vision, light headedness, nausea, vomiting and extreme light and sound sensitivity. This phase may last from 4 to 72 hours.
(4) After a migraine, the final phase is known as post-drome. Most people will feel drained of energy and some will experience confusion, moodiness, sensitivity to light and sound, weakness, and/or dizziness.
Treatment of migraines
When an attack occurs, it’s helpful to have some tools at hand to alleviate the severity of your pain and duration of the migraine. Aspirin or paracetamol combined with codeine, caffeine or an anti-emetic (anti-nausea medications) are particularly effective.
Prevention of migraines
There are a number of ways to prevent severe headaches. UK-based The Migraine Trust has a comprehensive set of well-researched resources for those seeking more information on migraines and treatments.
The first step to prevent onset of a migraine is to keep a headache diary to record the duration of each migraine, any potential triggers you may have been exposed to, and how long it lasted. This will help you find patterns and better manage migraine triggers.
If the onset of your migraine is associated with hormonal swings, you may consider hormonal therapy or oral contraceptives.
Multiple studies have found that people who took supplements of vitamin B2, CoQ10 or magnesium daily have had fewer migraines after 3 months. Some vitamins can interact with other pharmaceuticals so it’s important to talk to your doctor if you’re taking other medications.
Both butterbur and feverfew show promising results in preventing migraines but can interact with other drugs and may not be safe for people with liver problems and/or diabetes. Butterbur, in particular, can cause liver toxicity so should only be used in close consultation with a doctor.
The UK’s National Institute for Health and Care Excellence (NICE) recommends patients be offered topiramate or propranolol to manage long-term migraines, under close physician supervision.
Acupuncture has been found to be an effective treatment for severe headaches. This is good news for us in Hong Kong where Chinese medicine is an integral part of life. Interestingly, acupuncture is offered in the UK’s public health service (NHS) as a migraine treatment if other medications have not been effective.
If migraines or headaches are affecting your quality of life, it’s important to be proactive and seek treatment from your physician, a complementary medicine practitioner, or a HK-registered Chinese medicine practitioner.