migraine

Migraine 101: Symptoms, Causes, Triggers, Types & Remedies

Learn more about the different types of migraine and their causes, symptoms, triggers, remedies, treatment, and prevention.

by Lorraine Bunag, R.N.

What is a Migraine?

What is a migraine? A migraine can be described as an intense, throbbing (pulsating) pain, typically on one side of the head. Unlike other types of headaches, migraines usually come with other symptoms, such as nausea, vomiting, and sensitivity to sound and light. A migraine headache can last for hours to days.

One of the unique things that define migraine is “aura,” a symptom that happens right before a migraine. An aura can be in the form of flashing lights, difficulty sleeping, or tingling sensation. 

Difference Between Headache And Migraine

Is there a difference between a headache and a migraine? 

Migraine is one of the many types of headaches, which points to a pain someone experiences in any area of their head, face, and neck. Headaches occur because of an issue in pain-sensitive structures, such as the blood vessels or tissues, and can be caused by numerous reasons, from stress and dehydration to stroke and cancer

When people say they have a headache, they usually refer to tension or everyday headaches – the most common type of headache. One distinct difference between a tension headache and migraine is that the first doesn’t often come with an aura. Furthermore, tension headaches are not typically accompanied by other symptoms. 

Migraine Symptoms

Migraine symptoms vary from person to person, but in many cases, they appear in four stages, namely: prodrome, aura, attack, and post-drome. 

Below are their explanations in detail:

Prodrome

Prodrome is described as a set of symptoms happening one to two days before you feel the migraine pain. You might observe these symptoms as shifts in your mood or physical changes, such as:

  • Stiff neck
  • Increased thirst
  • Uncontrollable yawning
  • Food cravings
  • Constipation 
  • Increased urination

Please note that prodrome, which others also call pre-headache, doesn’t always occur. Some people may also experience them only a few hours before the migraine pain, not days. 

Aura

One of the most unique and notable symptoms of migraine is aura, which are reversible nervous systems symptoms.  Most of the time, a migraine aura happens right before the attack (5 to 60 minutes). However, some people also develop an aura during their migraine pain. Some of the reported migraine aura symptoms include:

  • Visual symptoms, including seeing shapes, flashing lights, or bright spots. Some people also experience vision loss. 
  • Hearing unusual sounds or music. 
  • Difficulty in speaking. 
  • Uncontrollable jerking movements. 
  • Numbness or weakness, usually on one side of the face or body. 
  • A sensation or feeling that you are being touched or grabbed. 
  • Pins and needles in the arms, legs, or lips. 

Attack or Headache

Usually, after the migraine aura, the headache begins. For many people “ache” doesn’t do the pain justice. Generally, it starts as a mild ache, but it progresses into a drilling, throbbing, or pulsating pain. Some people also describe the feeling as “having an icepick” in the head. 

During the attack, you may feel the following migraine symptoms:

  • The pain starts on one side of the head, and then it affects both sides. 
  • Sensitivity to noise, touch, or light. 
  • Nausea and vomiting

Left untreated, migraine pain can last anywhere from 4 to 72 hours. 

Post-drome

The last in the migraine phases is post-drome, which refers to migraine symptoms after the attack. Postdrome migraine symptoms may last for an entire day or two, with patients feeling drained, weak, or exhausted. 

People also call postdrome as “migraine hangovers”, and about 80% of patients experience it. 

Types of Migraine

You might not be familiar with them, but there are several types of migraines acknowledged by experts. They are as follows:

Complicated Migraine

People called a migraine with aura, complicated migraine. Reports say about a quarter of patients experience aura with their headache. They also report that having aura is a significant warning sign that an intense headache is on the way. 

Common Migraine

Common migraine refers to one that happens without an aura. It’s quite difficult to diagnose because, as mentioned earlier, a migraine aura is one of the distinguishing characteristics of migraine headaches. 

But, despite the lack of migraine aura, patients still feel an intense, throbbing or pulsating pain. 

Migraine Without Head Pain

Not many are familiar with it, but a migraine may occur without the telltale headache. This can be very confusing, since you might experience prodrome and aura symptoms without the actual head pain. 

People also call this type of migraine as Silent or Acephalgic Migraine. Others would like to refer to it as aura without a headache

Retinal Migraine

Retinal migraine happens when a person temporarily loses their vision in one eye. This vision loss may last from a few minutes to a few months, but are often fully reversible. 

Still, if you experience retinal migraine, the doctor might want to look closely into your condition since it may signal an underlying problem. 

Also, retinal migraine is more common among women of childbearing years. 

Hemiplegic Migraine

Hemiplegic migraine points to the migraine headache that comes with one-sided symptoms. People who experience a hemiplegic migraine often fear they’re experiencing a stroke because the symptoms involved are visual aura, pins and needles on one side of the body, and weakness, also on one side of the body. 

The confusion between stroke and hemiplegic migraine often comes from the fact that, like migraine without a head pain, this type of migraine may also come without an intense headache. 

Chronic Migraine

Someone has a chronic migraine if he or she experiences migraine headaches more than 15 days in a month. The intensity of the headache varies. Sometimes, they are intense, other times they are mild. In fact, cases when they are mild make people feel like it’s not a migraine, but a tension or sinus headache. 

Abdominal Migraine

Abdominal migraine is more common in kids. A child who experiences abdominal migraine may have vomiting, but may not have a throbbing head pain. Finally, note that abdominal migraine may occur once a month. 

Menstrual Migraine

Menstrual migraines are not as different as the usual migraines, but experts call it such because it happens before, during, or after a woman’s period. 

Ocular Migraine

If you’ve been having migraines for a while now, you must have heard some people say they experience ocular migraine. 

Interestingly, ocular migraine doesn’t have its own definition. When people talk about ocular migraine, they most probably refer to the visual auras or retinal migraine. 

To recap, visual auras point to changes you experience in your sense of sight, such as seeing flashing lights, zigzag lines, and other various shapes. Retinal migraine is when you experience temporary vision loss with your migraine. 

Vestibular Migraine

Finally, we have the vestibular migraine. The term vestibular describes the inner ear and systems in the body that promote balance. A vestibular migraine is often associated with vertigo, a condition where the patient feels a moving, spinning, or falling sensation. In some cases, it means you feel as if the room is spinning or waving. 

Migraine Causes

The exact cause of migraine headaches is still not well understood, but experts believe both genetics and environmental factors play a role.

Additionally, they found that migraine headaches are associated with issues in pain-sensitive structures of the head, such as nerves, as well as imbalances in neurotransmitters, like serotonin. 

Migraine Risk Factors

While medical experts are still looking into the possible migraine causes, they have identified some factors that contribute to migraine attacks. These migraine risk factors include:

  • Age: Although migraines can happen to anyone, reports say attacks are more common in teenagers. 
  • Gender: Women are more prone to migraine headaches. 
  • Family History: Genetics is also a recognized factor in experiencing migraine headaches. 
  • Medications: Some medications, like oral contraceptives and hormone replacement therapy, seem to predispose a person in experiencing migraines. Additionally, the excessive use of painkillers to treat headaches might result in rebound headaches. 

Migraine Triggers

Besides the risk factors, some things may also trigger a migraine attack. Below are the most common migraine triggers. 

Drinks

Some people report experiencing migraine headaches after they’ve had alcoholic drinks (particularly red wine) or too much coffee or tea. 

Foods

Interestingly, some foods seem to serve as migraine triggers. These foods may include: 

  • Aged cheese
  • Salty and processed foods
  • Chocolate
  • Foods with MSG or monosodium glutamate
  • Fermented foods 
  • Some fruits and nuts
  • Aspartame 

Also, please take note that eating habits, such as skipping meals, also contribute to migraine attacks.

Hormonal Changes

The risk of having a migraine attack increases when women experience shifts in their hormonal levels. This is one of the reasons why we have menstrual migraines as the level of estrogen fluctuates before, during, and after the period. 

Migraine during pregnancy and menopause is also likely because women also experience hormonal fluctuations. 

Physical Activity

Some people say they have migraine attacks right after a physical activity, such as exercise or even sex. Also, changes in sleeping patterns could trigger migraines in some individuals. 

Environmental Stimuli

Stimuli in the environment, such as loud sounds and bright or flashing lights may cause migraine attacks. A strong smell or scent (perfume, paint thinner, secondhand smoke, etc.) might also serve as migraine triggers. 

Stress

And finally, let’s not forget that stress may result in migraines, too, especially on occasions when you are overworked or have many things in mind. 

When Should You See a Doctor for Migraine?

In most cases, people who experience migraines do not go to the doctor because of their headaches, especially when they are “used to them.” Still, it’s advisable to keep a headache diary. 

In this diary, consider writing everything related to your migraine attack. Here are some of the examples you can include in the diary:

  • Date and time of the migraine. 
  • Duration of the pain and how intense it is (you can rate it from 1 to 10)
  • Additional symptoms you experienced along with your migraine. 
  • What were you doing when the attack occurred?
  • Did you eat or drink anything that set off the attack? 
  • Things you did to make the pain disappear and whether they are effective or not. 

On your next visit to the doctor, be sure to hand the diary over to them. The doctor will then look into your migraine attacks more closely and see if there’s a need to undergo further tests. 

When To Immediately Seek Medical Help

Despite migraines being a usual occurrence for many people, you should still take note of red flags indicating you need to go to the doctor or hospital immediately

Be sure to seek medical help right away if you:

  • Feel as though you’re having a sudden, severe headache (thunderclap headache). 
  • Have a headache after a head injury (blow to the head, fall accident, etc.)
  • Have a headache along with symptoms such as stiff neck and fever (it might point to meningitis) or numbness, weakness, and trouble speaking (it might point to stroke). 
  • Experience chronic headache that worsens after exertion, straining, coughing, or sudden movement. 
  • Have a new headache after the age of 50. 

Migraine Diagnosis

Unlike other conditions which can be identified through specific diagnostic tests, migraines are different. Because migraine attacks are unpredictable, the doctor often relies on your report and headache diary if you have one. 

In the doctor’s office, expect a thorough health interview and physical exam which checks for your:

  • Vision
  • Reflexes
  • Coordination
  • Sensation

Only after a thorough assessment will they advise you on the treatment plan or need to undergo additional tests. 

In case it’s still not possible for you to visit the hospital or clinic for your check-up, our telemedicine service could help. You could meet with one of our doctors online to discuss the specifics of your migraine attacks. Likewise, we can also connect you with a House Call Doctor who would visit you at home. 

How to Treat Migraine Headaches

A migraine cure typically involves medications that provide fast headache relief. This allows you to feel better immediately and reduce the time it takes for you to get back to your activities. However, since migraines also come with other symptoms, such as feeling sick, you may need to take other medicines, too. 

Of course, besides migraine medicines, there are also some home remedies for migraines. 

Migraine Medication

The most common migraine medication include:

  • Combination Analgesics: Combination analgesics, usually composed of acetaminophen, aspirin, and caffeine, are affordable medicines to get rid of a migraine. Often, you don’t need a prescription for them since they don’t have the contraindications associated with other migraine medications. 
  • NSAIDs: Mild or moderate migraine that doesn’t come with other symptoms may respond well to non-steroidal anti-inflammatory drugs, like high-dose aspirin, ibuprofen, and mefenamic acid. 
  • Triptans: Triptans are migraine-specific medicines typically taken by patients who experience moderate to severe attacks. Those who have moderate migraines that don’t respond to non migraine-specific pain relievers also sometimes use them. 
  • Combination of Triptan and NSAIDs: This combination migraine medication may be used for acute treatment. 
  • Other Medications: Besides the medicines to get rid of the migraine headache, the doctor may also give you drugs to address your other symptoms. For example, they might give you anti-sickness medicine if you’re nauseous or vomiting. Likewise, they might order some muscle relaxants. 

If you have a migraine during pregnancy, please be cautious. Acetaminophen is generally safe to take, while NSAIDs should only be considered until the third trimester. To be on the safe side, always consult your doctor first before taking any medicine for migraine if you’re pregnant. 

Do you need help with your migraine medicine? Homage offers a migraine medicine delivery service to ensure you always have your medicine when you need them. After getting the prescription from one of our physicians, we can take care of the migraine medication purchase. Furthermore, we will also deliver it to your doorstep. 

Migraine Remedies and Prevention

The steps on how to cure migraine are generally also the ways to prevent attacks. Consider the following practices:

Reduce or Avoid Exposure To Stimuli

During a migraine headache, stay away from the potential environmental trigger that caused it. Go to a calm place with the lights and sounds turned down. 

Drink Some Coffee

Is your migraine just starting? If so, consider having a small amount of coffee alone or together with your pain reliever (so long as it’s not contraindicated). However, don’t rely too much on caffeine since excessive amounts might result in withdrawal headaches. 

Try Temperature Therapy

Cold compress on the head and neck area could have a numbing effect that dulls the pain. On the other hand, a warm compress could promote muscle relaxation. Whatever you choose, please protect your skin accordingly to avoid burns. 

Take Note of Your Diet

As much as possible, refrain from consuming foods you believe trigger your migraine attacks. Also, don’t forget to establish a routine: try to eat meals at the same time each day and never skip meals. 

Get Adequate Rest and Sleep

Sleep deprivation or a poor night sleep can trigger migraine headaches. Create a sleep routine and stick to it. Don’t forget to aim for 7 to 9 hours of sleep, too. 

Manage Stress

One of the most practical home remedies for migraine is to keep stress at bay or at least keep it at a manageable level. Take frequent, short breaks during the day and set time to unwind. To help prevent burnout, prioritize tasks and delegate when needed. 

Exercise Regularly

Physical activity may be a good migraine cure because the act itself releases hormones that block pain signals to the brain. However, don’t jump right on a physical activity since exertion is a known migraine trigger.

Homage provides caregiving services for your loved ones at every stage. Our trained care professionals are able to provide companionship, nursing care, night caregiving, home therapy and more, to keep your loved ones active and engaged. 

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References
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About the Writer
Lorraine Bunag, R.N.
Lorraine is a registered nurse who spends most of her time writing informative articles on health and wellness. At the end of the day, she relaxes by reading a book or watching documentaries about unsolved mysteries.
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