Migraine Headaches
There are many kinds of headaches. The purpose of this Health Fact is to provide information about migraine headaches.
What Are Migraine Headaches?
Migraine headaches involve severe pain on one or both sides of the head, an upset stomach, sensitivity to lights and sounds, and at times changes in vision.
The pain of a migraine headache is described as intense, throbbing, or pounding and can be felt in the forehead, temple, ear, jaw, or around the eye. Migraine often starts on one side of the head but may spread to the other side.
Some people notice a variety of vague symptoms before the migraine starts. These can include mental fuzziness, mood changes, fatigue, and unusual retention of fluids. During the headache phase of a migraine, a person may have diarrhea and increased urination, as well as nausea and vomiting. The pain of a migraine can last several days.
Other people may have neurological symptoms called an aura up to an hour before the headache begins. The person may see flashing lights or zigzag lines, or may temporarily lose vision. Other symptoms of aura may include trouble talking, weakness of an arm or leg, tingling of the face or hands, and confusion.
Migraine can strike as often as several times a week, or as rarely as once every few years. In some cases migraine can occur daily or near daily. This is called chronic migraine. Some people have migraines at predictable times – near the days of menstruation or every Saturday morning after a stressful week of work.
What causes a migraine?
There are several theories about the causes a migraine. Complex changes occur in the brain during and between migraine attacks. Often, migraine runs in families.
The factors that trigger a headache are different for each person. Some migraine sufferers do not know of anything in particular, while others list one or more triggers. What may trigger a migraine one time may not trigger a headache another time. Common triggers include stress, hormonal changes, certain foods, alcohol, too much or too little sleep and skipping meals.
Medication overuse headaches may occur when a person consumes eithe caffeine or short-acting pain medications on more than two days a week. For more information on these headaches see Health Facts for You #5896.
Migraine Treatment
The goal of migraine treatment is to reduce the frequency and severity of your headaches, allow you to be active, regain control of your life, and enjoy life as fully as you can with as few side effects as possible. You should be aware that there are many kinds of treatments available for migraine and that success often involves a combination of approaches including lifestyle changes and medicines.
Medicines, biofeedback training, stress reduction, and elimination of caffeine and sometimes certain foods from the diet are the most common methods used to prevent and control migraine and other types of headaches.
Regular exercise, such as swimming or vigorous walking, can also reduce the frequency and severity of migraine headaches. Some people find that yoga and whirlpool baths help reduce headaches.
Medicines.
- Preventive (prophylactic) medicines are intended to reduce the frequency and intensity of the attacks.
- Abortive medicines are intended to treat a headache once it has started.
Preventive (prophylactic) medicines. If you have headaches more than twice a week or headaches that debilitate you more than 1-2 days per month, you should be prescribed a preventative or prophylactic medicine. Medicines used to prevent or reduce the number of headaches include propranolol, amitriptyline, valproate, topiramate, and others. You need to take these medicines regularly every day for them to work. It may take a few weeks for them to start working, so be patient.
For a select group of patients iwth chronic migraine (daily or near daily headaches) treatment may include Botox injections.
Abortive medicines. For infrequent migraine, medicines can be taken at the first sign of a headache in order to stop it or to at least ease the pain. Overuse of abortive medicines can cause medication overuse headaches.
During a migraine headache, short term relief can sometimes be obtained by using a cold pack.
One of the medicines often used to stop an attack of migraine is triptan (sumatriptan, rizatriptan, naratriptan and others). For best results, these need to be taken during the early stages of an attack.
Other pain medicines can sometimes help to stop a migraine attack. These include over-the-counter medicines such as aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), Naprosyn (Aleve®). You should always get your doctor’s advice before you use these regularly to treat migraine. Opioid medications (hydrocodone, oxycodone, and others) are also occasionally presecribed, but can be problematic because of the high risk for medication overuse and paradoxical worsening of headaches.
Caffeine can also be an abortive medicine for headache, but daily caffeine use can cause worse migraines or medication overuse headaches. At times, you may need to completely stop using caffeine to help your headaches get better.
Side effects. Many antimigraine medicines can have side effects. But like most medicines they are fairly safe when used with care and under your doctor's supervision. Make sure you understand the side effects of your medicines. Your doctor can help you answer any questions..
Biofeedback and relaxation training. Drug therapy for migraine is often combined with biofeedback and relaxation training. Biofeedback is a way to give people better control over body functions such as blood pressure, heart rate, temperature, muscle tension, and brain waves. Biofeedback may be combined with relaxation training, during which patients learn to relax the mind and body.
Biofeedback can be practiced at home with a portable monitor. But the goal of treatment is to do biofeedback without a machine to help you. You can then use biofeedback anywhere at the first sign of a headache.
Diet. A number of people with migraine will be helped by changing their diet. Talk to your doctor about whether a diet change would be helpful for you.
Planning your treatment. Your doctor will help you set up a treatment plan for your headaches. Write it down and keep a copy with you. If you need to see a different doctor about your headaches, your treatment plan will help you get the best care.
For more information about Headaches
American Council for Headache Education
1-800-255-ACHE (1-800-255-2243)
www.achenet.org
National Headache Foundation
1-800-843-2256
www.headaches.org
National Institutes of Health Neurological Institute
1-301-496-5751
www.ninds.nih.gov
The Spanish version of this Health Facts for You is #6764.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 01/22/2013
Copyright © 01/22/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5355
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