What you need to know about migraines

June 01, 2018
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According to the World Health Organization, up to 75% of adults between 18 to 65 years old have had a headache in the last year. Of those, at least 30% have reported a migraine.  Despite how commonplace headache is, it is often misunderstood and not recognized as a legitimate health concern by many.  Furthermore, those with a headache disorder are not professionally diagnosed and treated, which may be due to lack of awareness of available treatments, poor access to healthcare, or perceived stigma of having a headache disorder. 

Migraine headaches are the most common headache disorder. A person has migraine if he/she has had five or more attacks of unprovoked headache lasting 4-72 hours, severe enough to restrict daily activity and associated with nausea or light/ sound sensitivity in their lifetime. Some people with a migraine may experience auras, which most often manifest as temporary visual changes that usually occur before the migraine. While it is not entirely clear what causes migraine, the leading theory is that migraine likely has a genetic component and external triggers activate a chain of events involving hypersensitive areas in the brain leading to a migraine attack. 

If you are suffering from uncontrolled headaches, you should make an appointment with your primary care doctor, local neurologist or headache specialist for further evaluation and treatment. It is important to describe your symptoms in a concise manner so that your doctor can get the best sense of your headache and help you as best as possible.Your doctor will likely ask you the following questions:

  • When did you first start getting headaches?
  • Did any particular event(s) lead you to have increasing headaches?
  • How often are you getting a headache in an average week or month?
  • How would you describe your headache (location, quality of pain, duration, associated symptoms)?
  • Does anything make your headache better or worse?
  • Have there been any changes in the character or frequency of your headache?
  • What medications have you tried in the past or currently taking for your headache?
  • What testing have you had for your headache, if any?
  • Do you have any other medical conditions?  Are you taking any other medications?
  • Does anyone in your family suffer from headaches?

It would also be helpful to both you and your doctor if you keep a headache diary. One easy method is to mark the days on a calendar that you have a headache and bring the calendar with you when you have a doctor’s appointment. This way, you can track how often you are getting your headaches, and if your doctor starts you on a headache regimen then you can see if your headache pattern is improving. You might also find it helpful to jot down what happens around the time of your headache in order to figure out what your triggers are. It’s important to keep in mind that there is no universal headache trigger for everyone, and even in the same person that trigger might not always lead to a headache every time. That said, knowledge is power and the more you know about how your body responds to external triggers, the more control you have in avoiding future headaches.

Here are some common triggers for migraine:
  • chocolate
  • cheeses
  • caffeine
  • alcohol (red wine in particular)
  • lack or even excess sleep
  • sudden stress or release from stress
  • weather changes
  • menstruation for women
  • bright lights
  • skipping meals 
  • dehydration

A simplified way of thinking about triggers is that the “migraine brain” hates instability and the best way to avoid getting a headache is by keeping to a daily routine. One easy method would be getting up and going to bed at about the same time and being sure to eat regular meals every day.  Certain things such as weather changes are unavoidable, but other triggers such as ingesting certain foods or alcohol can be controlled.  Avoiding certain life stressors and issues with menstruation can be more nuanced and difficult to control, but remember that the first step to solving these problems is recognizing them.  From there you can take the necessary steps to definitively tackle the issue at hand.  

Again, if you are suffering from uncontrolled headaches, you should make an appointment with your primary care doctor, local neurologist or headache specialist for further evaluation and treatment.