If you suffer from migraine headaches, you know they’re different from your run-of-the-mill tension-type headaches. It’s not just headache pain, it’s throbbing pain that might be on one side of the head. With migraine symptoms, you might feel like all your senses are on steroids. You could see an aura or have visual disturbances like bright, flashing or zigzagging lights. Light and noise can be unbearable. When you move, it can feel like your brain is sloshing inside your skull. You could find it difficult to speak or even think, and you might feel disoriented afterward.
What are migraines?
Joshua Tobin, MD, a neurologist with Banner Brain & Spine, said, “Migraine is a particularly severe form of headache. Along with head pain, it can cause many other bothersome symptoms such as nausea and vomiting, sensitivity to light and sound and even touch and smell sensitivity. It is one of the top causes of disability in working-age adults.”
What triggers migraines?
Two of the most common triggers for migraine attacks are stress and poor sleep, so finding ways to reduce stress and sleep better can help get your migraines under control. Triggers are different for different people, though, and just about anything can trigger migraines. Dr. Tobin saw one patient whose migraines were triggered by the smell of coffee, even the lingering smell of coffee someone else drank that morning.
Other migraine triggers include:
- Some health conditions
- Certain foods and food additives
- Skipping meals
- Motion sickness
- Hormone fluctuations around your menstrual cycle (menstrual migraine)
- Exposure to light
- Allergy symptoms
- Sounds
- Scents
- Some medications
- Dehydration
- Changes in the weather
It can be helpful to keep a headache journal to identify factors in your life that might be triggering your migraines. Once you understand what’s behind them, you can try some drug-free methods to combat them. If these don’t help, there are other options to consider.
Treatment options for migraines
Untreated, migraines can last for four to 72 hours (three days). And, since the pain from migraines is so severe, it can be tempting to try just about anything to find relief. “Do not use the internet to make decisions. Use it to gather questions and ideas,” Dr. Tobin said. “Friends and family members can also be important resources.” Prepared with these thoughts, you can talk to a doctor who is knowledgeable about headaches.
The good news is migraines are very treatable. “While there are people who have tried a lot of treatments and aren’t better, they are a small minority. Usually, the migraines can be very well controlled,” Dr. Tobin said. “Today is a better time than any other time in history to be someone who suffers from migraine headaches.”
We now have a better understanding of other health conditions that can trigger migraines. “By identifying and treating these other conditions, we can help someone feel better and improve their health,” he said.
Migraine treatment options headache specialists recommend include:
- Prescription drugs. You can take migraine prevention medications regularly to help make migraines less frequent and use rescue medications as needed for pain relief. You can administer some fast-acting migraine medications as nasal sprays.
- Alternative therapies. Many people with migraines try remedies such as magnesium, riboflavin (vitamin B2), CoQ10 (coenzyme Q10,) and butterbur to reduce their frequency. There’s less evidence to support the use of other options such as feverfew, tree bark, lavender, peppermint and ginkgo biloba, according to the American Migraine Foundation.
- Nerve stimulation devices. Currents or magnets that change your brain activity can help prevent or stop migraines. Different devices target different nerves and stimulate them in different ways. Options include occipital nerve stimulation, remote electrical neuromodulation, single-pulse transcranial magnetic stimulation, supraorbital stimulation and vagus nerve stimulation.
- Peripheral nerve blocks. These injections can numb certain nerves and prevent them from causing pain. On average, people derive about 6 weeks of relief from them, though some people receive much more and others much less time.
- Botox (onabotulinum toxin A). If you’re having headaches 15 days or more a month and they aren’t responding to medication, you may want to try Botox therapy, which affects the brain cells involved in pain transmission. Treatment involves 31 injections with tiny needles—the feeling is described as a pinprick—over the head, scalp, temple and neck every 12 weeks.
You may have heard of a treatment option called a SphenoCath device, which can block nerve impulses and relieve pain. Dr. Tobin has had mixed results with this treatment option and doesn’t recommend it for his patients.
The bottom line
The pain from migraine headaches can be severe, so getting to the bottom of what’s causing them and finding relief is crucial. Identifying and avoiding your triggers, getting plenty of restorative sleep and finding ways to manage your stress can help treat chronic migraines.
Your doctor can also help you get other medical conditions under control and can recommend treatment options that can help keep your migraines at bay.
Need help evaluating or treating migraines?
Schedule an appointment with a primary care provider.
Schedule an appointment with a neurologist.
