Migraine - More Than Just a Headache
Next time someone tells you that they suffer with migraine, pay attention to one just word in the sentence. Suffer. Migraine is more than just a headache.
In this hub we'll look at what a migraine is (if you're not sure that you get migraines), how to understand a loved one who gets them and if you're a newly diagnosed sufferer, we'll look at the treatments that are available.
Migraine doesn't care who it affects - any age, either gender, any race or class. Two out of 3 sufferers are female and you're more likely to get it if you're aged between 20 and 50 years.
It's one of the most common neurological problems with a lot written about it, a lot of speculation and research but no permanent cure yet.
First signs of migraine.
People with migraine are often called 'migraineurs'.
They may experience a warning that a migraine is imminent with odd feelings of not quite being oneself, feeling strange, on edge or excitable, having food cravings, tiredness, mood changes or excessive yawning. These symptoms are referred to as a prodrome and can be quite subtle to the sufferer but those around her may notice them.
A migraine attack.
This may start with a simple headache but there are many different ways a migraine can display itself.
In babies and children it is often with abdominal pain rather than a headache, accompanied by nausea and vomiting.
In adults, common features are:
- throbbing headache, often only on one side of the head
- visual disturbance such as blind spots or flashing lights
- nausea, vomiting or diarrhoea
- light sensitivity
- sensitivity to smells,
- neck and shoulder stiffness.
If you have 2 or more of these symptoms it is likely that you have a migraine.
There are other neurological symptoms that can go along with a migraine. Called an aura, they include:
- lack of concentration
- difficulty in speaking
- limb stiffness
- paralysis (very rare)
- loss of consciousness (also very rare).
What causes migraine?
It's believed that a chemical imbalance is the most likely cause. Serotonin is released from storage sites into the bloodstream and causes chemical changes in the neurotransmitters and blood vessels in the brain. Neurotransmitters are other chemicals that are released from nerve endings.
No one knows exactly what causes the imbalance but scientists (and sufferers) have identified several possible triggers. It might be a single migraine trigger or a combination that cause an attack. These triggers include:
- emotional (e.g. stress, anger, tension, excitement, shock etc)
- or physical (e.g. over tiredness, changes in sleep patterns such as shift working, travelling, neck/shoulder tension)
- diet and food play their part too (fasting or dieting where meals are infrequent; dehydration; hypoglycaemia; foods with some additives such as monosodium glutamate (MSG), caffeine, tyramine, aspartamine; citrus; chocolate; cheese).
- Alcohol, especially red wine.
Triggers in the environment are things like
- loud noise, especially at high pitch
- intense smells
- bright light, for example car headlamps or supermarket lights
- a stuffy atmosphere
- change in climate or weather
Hormonal triggers that women may suffer with:
- menstruation/monthly cycle hormone fluctuations
- taking the contraceptive pill
- taking HRT
And other triggers that can affect anyone:
- using sedatives or sleeping tablets
- having high blood pressure
- having tooth ache or other mouth/dental problems
- eye strain
- sinus problems or congested nasal passages.
More health information.
- Modern Health and Fitness
Answering your health and fitness questions
Migraine self help
If your migraines are getting you down it may be useful to keep a journal of what symptoms you have and what emotional, environmental or hormonal triggers you have experienced so that you can get to know what to avoid/deal with.
Balance is key - don't get too obsessive about this. It will help you deal with the problem but getting too wrapped up in analysing everything can be counter-productive.
Some treatments are available over the counter at the chemist and some are only available on prescription from your doctor.
Over the counter meds may be very effective for you so try them. What works for one migraineur may not work for another.
Aspirin is in the family of non-steroidal anti-inflammatory drugs (NSAIDs) that relieve pain by reducing inflammation. They're not for you if you have a peptic ulcer, are under 12 years old or have asthma. Take them after food if you can.
Ibuprofen (there are a lot of trade names) is also a NSAID, so it works in the same way but avoid if you have liver or kidney problems.
Paracetamol should be avoided by anyone with liver or kidney problems. It can be used alongside an NSAID, taken at the same time or 2 hours later so that you can take a pain killer every 2 hours: eg paracetamol at 10am, NSAIDs at 12, paracetamol at 2pm, NSAIDs at 4pm etc so that there's always something in the bloodstream working to relieve your pain.
Caffeine is useful in helping with the absorption of painkillers and is even incorporated in some of them. Drinking a cup of coffee or cola drink will do the same job but avoid caffeine if you want to sleep or it’s a trigger.
Codeine is related to morphine and is an opiate drug. It's used in small amounts in over the counter meds. It can cause constipation.
Sumatriptan, zolmitriptan and eletriptan are drugs designed specifically for migraine and aim to control the serotonin imbalance. If you have uncontrolled high blood pressure, kidney problems, heart disease, are under 18 or over 65 they’re not advisable for you. Also if you're pregnant or taking certain antidepressants you should talk to your doctor or pharmacist. Some of these (eg Zomig Nasal and Imitrex Nasal) also come as a nasal spray.
Any tablets should be taken with plenty of water or dissolve them if their formulation allows this. Dissolved tablets will work faster.
Take pain meds sooner rather than later . Gastric stasis often occurs during a migraine and means that the stomach's normal activity is slowed, adding to the nausea you feel. Painkillers are therefore less easily absorbed.
Domperidone or metroclopromide are 2 anti-nausea drugs so talk to your pharmacist about these too.
If you need to talk to your doctor about prescribing meds, stronger NSAIDs and painkillers combined with anti-nausea medication are available.