Headache and Migraine Treatment

Headaches and migraines can be life-altering at any stage of life. At best, they go away with a little medication. At worst, you’re out of action for the day. A migraine is a type of primary headache that usually causes an intense pounding headache that can last for hours or days, but did you know there are silent migraines that don’t cause headaches? Learn more about headaches and migraines and when to get treated, especially if they are starting to disrupt your daily life.

What Is a Headache?

A headache is a discomfort or pain affecting the head or upper neck region. It has two classifications:

• Primary headaches – occur on their own and are not caused by another medical condition. Here are some of the primary headache subtypes:
  • Migraine – characterized by repeated attacks of moderate to severe pulsating and throbbing pain on one side of the head.
  • Tension-type headache – the most common headache type, tension-type headache can be triggered by mental or emotional stress and contracting muscles in the face, neck, jaw and scalp.
  • Cluster headache – the most severe form of primary headache- involves sudden and excruciating headaches happening in “clusters.”
• Secondary headaches – headaches that occur as symptoms of another health condition.

What Is a Migraine?

Migraine is more than just a bad headache. It’s a neurological disease with a range of symptoms and treatment options that address symptoms aside from a headache. It affects more than 36 million Americans. A migraine can range from mild to severe:

• Severe pain – migraine is always there and with an intensity that makes it hard to talk, think or perform most of your daily activities.
• Moderate pain – migraine is always present and can make it challenging for you to sleep or concentrate, but you’re still able to perform most of your everyday activities.
• Mild pain – comes and goes and might be bothersome but does not significantly affect your usual activities.

Major Types of Migraine

• Migraine without aura – a headache that occurs without warning and is usually felt on one side of the head, along with:
  • Nausea
  • Confusion
  • Blurred vision
  • Mood changes
  • Fatigue
  • Increased sensitivity to light or noise
• Migraine with aura – occurs with visual disturbances and neurological symptoms as warning signs 10 to 60 minutes before the actual headache and usually does not last more than an hour. A migraine with aura may include:
  • Vision problems like seeing flashing lights or zigzag lines
  • Abnormal numbness, muscle weakness or sensation on one side of the body
  • Tingling sensation in the face or hands
  • Trouble speaking
• Silent migraine – no headache but with some of these symptoms present:
  • Common prodrome symptoms like irritability, food cravings and neck stiffness
  • Numbness or tingling in the limbs
  • Temporary paralysis or weakness on one side of the body
  • Sensitivity to light, noise or smells
  • Visual disturbances or vision changes like temporary blindness and seeing flashes of light
  • Vomiting and nausea

Other migraine types include:

What Causes Migraines?

A migraine is caused by abnormal changes in brain activity that many things can trigger, but the exact cause is unclear. These changes can affect blood flow in the brain and nearby tissues, resulting in pain. Migraine triggers differ for each person and may include:

• Anxiety, depression or stress
• Flashing or bright lights
• Hangover
• Head trauma
• Hormonal changes, such as before menstruation in women
• Insufficient or too much sleep
• Loud or sudden noises
• Low blood sugar
• Motion sickness
• Overexertion
• Skipping meals or not eating regularly
• Some medications
• Starting with period
• Strong odors
• Sudden weather changes
• Tobacco
• Too much caffeine

How Long Do Migraines Last?

Migraines have four distinct phases. Understanding them can help you or your doctor identify a migraine early and may prevent symptoms later. The phases are:

Not everyone experiences every migraine phase during a migraine attack. Every attack may be different for every person. Although common migraine attacks may last up to two days, an entire migraine attack involving all phases may last from a day to more than a week.

How Is a Headache or Migraine Diagnosed?

If you experience bothersome symptoms, consult with your primary care physician. They can diagnose migraine headaches and prescribe treatment. They may also refer you to a neurologist if needed. A migraine or headache diagnosis involves a physical examination and a neurological examination.

Your doctor will ask about your personal and family medical history. They will ask you questions about your symptoms, severity, frequency and more. Your doctor may order imaging and blood tests to rule out other possible causes of your headache.

Keeping track of your symptoms can help you and your healthcare provider better manage headaches. These are some of the things you can include in your headache/migraine tracker or journal:

• Time stamps of when pain increases or decreases.
• List of symptoms and their severity.
• Other details may help, such as detailing your food, sleep, medicine and other activities, including what you did to help relieve pain.

How Are Migraines and Headaches Treated?

Currently, there is no specific cure for headaches or migraines. Their causes or triggers vary for each person and require a personalized treatment approach. Migraine or headache treatment may include:

• Over-the-counter (OTC) medications – pain medicines like aspirin, ibuprofen and acetaminophen to help relieve headaches or mild migraines.
• Prescribed medications – in cases where OTC medicines are not enough, your doctor may prescribe other medications to help reduce the severity of your headache and prevent future occurrences, such as:
  • Antidepressants
  • Anti-seizure medications
  • Blood pressure medications
  • Botulinum toxin A (Botox) injections
• Lifestyle changes – the following are lifestyle changes that may help alleviate headaches and migraines:
  • Regular exercise
  • Avoiding trigger foods
  • Improved sleep habits
  • Relaxation techniques