In any given year, about 35 million Americans will suffer from a migraine – and it is estimated that as many as 43 percent of women and 18 percent of men will experience a migraine attack at some point in their lives. Despite how common migraines are, few people know how it occurs or why, and there are very few effective treatments. As part of a continued effort to help spread as much information about migraines and how to treat them, the month of June is National Migraine and Headache Awareness Month. Most people who experience a migraine do so between the ages of 35 and 45, although migraine can occur at any age. These neurological attacks are tremendously painful and disruptive, and for a portion of the population (more than 4 million adults), they can be a chronic problem.
What Is National Migraine and Headache Awareness Month?
The migraine and headache awareness community comes together to dedicate the month of June to the spreading of information and resources to help fight the long-term and debilitating effects of chronic and episodic migraines, as well as different headache conditions. June 2021 is dedicated to the message of “A New Era of Care,” prioritizing discourse and information about how advances in medicine can help headache and migraine sufferers better cope with their symptoms and seek out a drastically improved quality of life.
Understanding Migraines and Headaches
Migraines are a neurological condition, which means that it has its origin in the nervous system. The common theory is that abnormal brain activity triggers pain through the release of certain brain chemicals. Because migraines are very inheritable, the origin of this brain abnormality may be a specific gene mutation. This may occur spontaneously or in response to specific triggers (such as certain foods or stress). Migraines are characterized by:
- Extreme headache pain, usually to one side of the head.
- Nausea and vomiting.
- Difficulty speaking.
- Numbness, tingling.
- Sensitivity to light, sound, and/or smell.
The Main Stages of a Migraine
Migraines are often hereditary and far more likely to be diagnosed in women. Most episodes of a migraine begin long before the pain does. The prodrome stage of a migraine can be recognized through:
- Neck stiffness
- Frequent yawning
- Mood shifts
- Low energy
Some cases of migraines include visual symptoms, usually either light flashes or blind spots. These are known as a migraine with aura (or a classic migraine). The aura symptoms begin after the prodrome stage. Other symptoms accompanying the aura (or may begin in cases without aura) include difficulty speaking and temporary numbness or prickling.
After this comes the attack phase. This is where the pain begins. This phase itself can last four to 72 hours, depending on the episode and the person. The aforementioned symptoms accompanying the pain (primarily sensitivity and nausea) occur here. The postdrome phase occurs after the majority of the throbbing pain has subsided. It may or may not be accompanied by a dull headache. Some people experience a surge of joy during the postdrome phase, while others feel low energy and incredibly fatigued.
Migraines vs. Headaches
Migraines are often associated with other headaches but not a headache condition in and of itself. In some cases, a migraine can occur without head pain. But in most cases, the biggest and most disabling symptom is a severe throbbing pain that usually affects one side of the head. Other signs of migraines include so-called auras (visual disturbances), nausea and vomiting, as well as extreme sensitivity to light, touch, sound, and smell. A migraine attack usually lasts several hours and can last up to three days.
Migraines enjoy the company of other neurological and psychological conditions, often generated or exacerbated by extensive pain. These include anxiety attacks, symptoms of depression, and sleep disturbance conditions, including severe insomnia. Over 20 percent of people affected by migraines regularly are disabled, with the risk of disability rising steeply with the number of comorbid (accompanying) conditions.
Headaches describe any other condition characterized by head pain, usually either in primary headaches (or headache conditions) or secondary headaches (wherein the headache is a symptom of another condition). Primary headaches are further categorized into cluster headaches, tension headaches, and hypnic headaches.
- Cluster headaches are characterized by sudden headaches occurring in quick succession or clusters. Cluster headaches are usually shorter than migraine attacks and occur in one location on the head (usually the temple or behind an eye). Migraines last much longer on average and may cause pain in multiple parts of one side of the head (or, in some cases, both sides). The causes are believed to be similar. However: pressure on nerves in the head caused by abnormal brain activity.
- Tension headaches are characterized by mild to intense pain in the neck and head, usually around the forehead. These are usually caused by your muscles contracting painfully near the head. These contractions may be caused by stress, food combinations, or low temperatures. Eye strain can also trigger a tension headache (such as looking at a screen for too long).
- Hypnic headaches are headaches that wake you up. They only affect sleeping people. Researchers aren’t sure yet what causes a hypnic headache, but it is believed to be chemical interaction in the brain occurring during deep sleep.
Headache conditions can be chronic, meaning they are consistently recurring over the course of several months and years. The cause of any given chronic headache condition depends on what kind of headache it is.
Treatment Options for Migraines and Headaches
Treatment options for primary headache conditions and migraines differ from patient to patient and can include:
- Pain medication
- Hot-and-cold therapy
- Massage therapy
- Preventive medications
- Certain prescription medications like triptans
- Muscle relaxants
- Botox injections
- Nerve blocks
- And more
Lifestyle changes may be important as well. Dietary adjustments, regular exercise, and better sleep hygiene may help improve quality of life. However, for many patients – particularly chronic sufferers – these improvements do not replace a comprehensive and personalized medical plan. It is critical to consult a pain management and headache specialist when seeking help for head pain and migraines.