Migraines: Symptoms, treatments, and causes

Migraines are severe, recurring, and painful headaches. They can be preceded or accompanied by sensory warning signs and other symptoms.

The extreme pain that migraines cause can last for hours or even days.

According to the American Migraine Association, they affect 36 million Americans, or approximately 12 percent of the population.

Migraines can follow an aura of sensory disturbances followed by a severe headache that often appears on one side of the head. They tend to affect people aged 15 to 55 years.

Fast facts on migraines:

Some people who experience migraines can clearly identify triggers or factors that cause the headaches, such as allergies, light, and stress.

Some people get a warning symptom before the start of the migraine headache.

Many people with migraine can prevent a full-blown attack by recognizing and acting upon the warning signs.

Over-the-counter (OTC) medications can eliminate or reduce pain, and specific medications can help some people with migraine.

People who have severe attacks can take preventive medicines.

Triggers

The cause of migraines is not yet known.

It is suspected that they result from abnormal activity in the brain. This can affect the way nerves communicate as well as the chemicals and blood vessels in the brain. Genetics may make someone more sensitive to the triggers that can cause migraines.

However, the following triggers are likely to set off migraines:

Hormonal changes: Women may experience migraine symptoms during menstruation, due to changing hormone levels.

Emotional triggers: Stress, depression, anxiety, excitement, and shock can trigger a migraine.

Physical causes: Tiredness and insufficient sleep, shoulder or neck tension, poor posture, and physical overexertion have all been linked to migraines. Low blood sugar and jet lag can also act as triggers.

Triggers in the diet: Alcohol and caffeine can contribute to triggering migraines. Some specific foods can also have this effect, including chocolate, cheese, citrus fruits, and foods containing the additive tyramine. Irregular mealtimes and dehydration have also been named as potential triggers.

Medications: Some sleeping pills, hormone replacement therapy (HRT) medications, and the combined contraceptive pill have all been named as possible triggers.

Triggers in the environment: Flickering screens, strong smells, second-hand smoke, and loud noises can set off a migraine. Stuffy rooms, temperature changes, and bright lights are also possible triggers.

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Treatment

There is currently no single cure for migraines. Treatment is aimed at preventing a full-blown attack, and alleviating the symptoms that occur.

Lifestyle alterations that might help reduce the frequency of migraines include:

getting enough sleep

reducing stress

drinking plenty of water

avoiding certain foods

regular physical exercise

Some people also find that special diets can help, such as gluten-free.

Consider seeking further treatment if the above changes do not relieve the symptoms or frequency of migraines. The treatment of migraine symptoms focuses on avoiding triggers, controlling symptoms, and taking medicine.

Surgery

The last decade has seen the development of new approaches to the treatment of migraines. A doctor may administer an injection of botulinum toxin, or Botox, to the extracranial sensory branches of the trigeminal and cervical spinal nerves. These are a group of nerves in the face and neck linked to migraine reactions.

A 2014 review also showed that surgical decompression of these nerves could reduce or eliminate migraines in patients who do not respond to first-line treatment.

Medications

Migraines are often managed through a course of medication. There are many different types of migraine medication, including painkillers.

Painkillers should be taken early in the progress of a migraine rather than allowing the headache to develop.

Over-the-counter (OTC) medications effective for treating migraines include:

naproxen

ibuprofen

acetaminophen

Other painkillers, such as aspirin with caffeine and acetaminophen, can often stop the headache or reduce pain.

Many painkillers are available to buy online, including naproxen, acetaminophen, and aspirin with caffeine. Always speak to a doctor before taking new medication.

Drugs that treat nausea

Some people who experience migraines will need to take medications that treat the accompanying symptoms.

Metoclopramide may be used to control certain symptoms, such as nausea and vomiting. Serotonin agonists, such as sumatriptan, may also be prescribed for severe migraines or for migraines that do not respond to OTC medications.

Selective serotonin reuptake inhibitors (SSRIs) and antidepressants, such as tricyclics, are prescribed to reduce migraine symptoms, although they are not approved in all countries for this purpose.

Preventive medications

Migraine prevention begins with avoiding triggers. The main goals of preventive therapies are to reduce the frequency, pain level, and duration of migraine headaches and increase the effectiveness of other therapies.

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