Migraines - What Can Help?
You're Not Alone
Do you suffer from migraines? 28 million Americans suffer along with you. More women suffer than men. The World Health Organization ranks it as among the world's top 20 leading causes of disability. Although migraines cause missed days at work and loss of on-the-job productivity, it is still under-diagnosed and under-treated.
There may not be a cure, but there are ways to prevent and manage migraine headaches. Know your triggers and what medications may - or may not - help you.
The History of the Headache
Ancient cultures believed that headaches were caused by evil spirits, and trepanation - the removal of a section of the skull - was practised. This treatment was used up until the 17th century. The Egyptians bound a clay crocodile against a sufferer's head with a strip of linen inscribed with the names of their healing gods. In the 5th century, Hippocrates described the symptoms of the migraine - bright light followed by terrible pain in the temples - and believed the act of vomiting relieved pain. In medieval times, a poultice of opium and vinegar was used for pain releif.
What is a Migraine?
A migraine is not an ordinary headache. It is generally characterized by intense throbbing in one location, such as the temple, the forehead, around the eye, or at the back of the head. A migraine is usually unilateral, occurring on one side of the head, and usually changes sides from one attack to the next. It can last several hours or even days. It can also be accompanied by nausea, vomiting, or diarrhea.
The Onset of a Migraine - How You Know What's Coming
The onset of a migraine is usually characterized by specific signs. Here are a few.
- cold hands and feet
- mood swings
- pins-and-needles sensation
- blurred vision
- sensitivity to light and sound
- cravings for sweet or salty foods
- a buzzing sound in the ears
Know Your Triggers
Knowing what triggers your migraines can increase your chances of preventing them in the first place. Keep a headache and food diary. Take note of the foods and circumstances that precede an attack. Share it with your doctor and refer to it for your own personal use. Chocolate and wine are common triggers. Some have cited oranges, pineapples, and caffeine.
- red wine
- cigarette smoke
- bright light
Avoiding a Migraine
Be sure to get plenty of sleep, and sleep in a regular pattern. If it's the weekend and you want to sleep in, get up at your normal time for a few minutes and then return to bed. Eat healthy, avoiding your trigger foods, and don't skip meals. If sunlight is a trigger, try wearing sunglasses. Stress can't always be avoided, so try readjusting your schedule, reading quietly, or listening to soft music. Some therapies, such as biofeedback and acupuncture, may also help.
Has a migraine already set in? A cold compress on the area where the headache is concentrated can help. Try relaxation and deep breathing techniques. Drink plenty of water but avoid caffeine. Sleep is also a good remedy.
A Word About Medicine - There Are Basically Two Choices in Non-Prescription Medication
You have analgesics, such as acetaminophen, and non-steroidal anti-inflammatory drugs, or NSAIDSs. Acetaminophen relieves pain by acting on pain centers in the brain. They are well-tolerated and easy on the stomach. However, large doses or use over an extended period of time can cause severe liver damage, and they should not be taken with alcohol, which can also damage the liver. Always read the package label on how to use them.
NSAIDs come in aspirin and non-aspirin form, and some need a prescription. They relieve the inflammation causing pain. Aspirin prevents the formation of blood clots, and can increase the risk of bleeding. It should not be taken by children or teenagers because of the risk of developing Reye's Syndrome, a neurological disease. NSAIDs should not be taken if you are already taking bloodthinners, such as warfarin.
What are Triptans?
Triptans were introduced in the 1990s. They are designed for the relief of migraines, and do not lessen the frequency or stop attacks from happening. They constrict the blood vessels and reduce the inflammation causing migraine pain. They should be used before the pain sets in or when the pain is still mild - within 20 minutes of an attack. Some less serious side-effects of triptans are facial flushing, tingling sensations in the skin, and a tightness around the chest and throat. Drowsiness, fatigue, and dizziness can also occur. Those who have had heart attacks or strokes or have symptoms of atherosclerosis should not take them.
One Last Word
Not all migraine sufferers are the same. Triggers vary with each person, as do the effectiveness of treatments and medications. Unfortunately, trial and error may decide what works for you and what doesn't. Try to be aware of what triggers your attacks. When a migraine does set in, take steps early on to relieve pain.
Dr. Bernstein is a neurologist who has treated thousands of migraine sufferers.
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