Christie Aschwanden CONSUMER HEALTH INTERACTIVEBelow: • What causes migraines? • What are the symptoms? • What are my treatment options? • Can migraines be prevented? • When should I see a doctor for my headaches?
What causes migraines? People get migraine headaches when blood vessels in the head expand, touching nearby pain receptors. Researchers aren't sure what causes these arteries to misbehave, but they think fluctuations in levels of neurotransmitters--which regulate the perception of pain--may be to blame. Other possible triggers include the hormonal changes that accompany menstrual periods (migraines are three times more common in women than in men), oral contraceptives, changes in sleep patterns, changes in weather, bright or flashing lights, and some foods--particularly chocolate, red wine, aged cheese, and smoked meat. Your genes may also predispose you to getting migraines, and age seems to play a role as well. Most people who get migraines have their first attack before age 30, and migraines often go away after age 50. What are the symptoms? About ten to 30 minutes before they get a migraine, most people begin to get irritable or restless or nauseated, or lose their appetite. Others experience visual changes called auras (neurological symptoms that can include vision loss, the appearance of shimmering borders around objects, or zigzag patterns); you might see flashing lights or colors as well. In rare cases, an aura can mimic a stroke, causing weakness, numbness, or difficulty speaking. Once the headache begins, you'll probably notice these symptoms: • Mild to severe pulsing or throbbing pain, usually on one side of the head, that lasts from several hours to several days |
• Worse pain if you move around or look at bright light or hear loud noise |
• Interference with daily activities and perhaps nausea or vomiting |
What are my treatment options? Over-the-counter pain relievers, such as aspirin and other analgesics, can be helpful. But for frequent migraines, prescription drugs are probably your best bet, particularly a class of drugs called triptans, which can stop a migraine in its tracks if taken at the first sign of symptoms. Some people have also found relief from acupuncture, relaxation exercises, yoga, biofeedback, and herbal remedies like feverfew, though no good studies support their use. Can migraines be prevented? Not always. But you can lessen your chances of getting a migraine: • Try taking over-the-counter pain relievers when you first notice symptoms. |
• Eat regular meals. When you skip a meal, your blood sugar levels crash, which can trigger a migraine. |
• Track your migraines in a diary that includes when you got the migraine, where you were when it came on, and what you ate and drank that day. Over time, the diary will help you recognize and avoid your individual triggers. |
• If you're on birth control pills and your migraines strike just before your period each month, some doctors may recommend a lower dose pill to even out your hormonal ups and downs, but this isn't always effective. |
• Some prescription drugs (including beta blockers, some antidepressants, calcium channel blockers, and anticonvulsants) are now used to prevent migraines in people who get frequent migraine attacks. Consult your doctor to find out whether any of these preventive treatments are right for you. |
When should I see a doctor for my headaches? • if your headaches interfere with daily life |
• if your headaches get stronger and more frequent |
• if your headaches last more than 24 hours or recur two or three times per week |
• if you also have numbness, blurred vision, memory loss, or dizziness |
• if you get a headache after hitting your head |
• if exercise brings on the headache |
• if your headache is accompanied by a fever of more than 100 degrees, you find it painful to bend your head forward, or light hurts your eyes |
• if the headache is accompanied by nausea, vomiting, or drowsiness |
References American Council for Headache Education
Marcus DA, et al. Nonpharmacological treatment for migraine: incremental utility of physical therapy with relaxation and thermal biofeedback. Cephalalgia 1998 Jun;18(5):266-72; discussion 242
Reviewed by James McDowell, M.D., staff physician at St. Peter Hospital in Olympia, Washington.
Last updated December 22, 2008
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