What is a migraine headache?
Migraine headache is a brain dysfunction of poorly understood cause and mechanism, which involves the nervous system and vascular system. It is characterized by throbbing or pounding pain on one side of the head (unilateral). Moreover, it may sometimes accompany-
- Photophobia (increased sensitivity to bright light)
- Phonophobia (increased sensitivity to loud noise)
It is one of the most common human brain disorders, affecting 12% of men and 15% of women. Look for effective migraine treatment if the condition is disrupting your living. The prevalence is increasing with each decade and has become a global problem. A migraine headache usually starts in childhood or adolescence, but it can affect the whole family. There are two main groups of this disease-
- Migraine without aura (common migraine)
- Migraine with aura (classic migraine)
Headache with aura has the presence of focal neurological symptoms that usually last less than 1 hour and are fully reversible. The most common site for these abnormalities in the visual cortex is on the back of the brain in both hemispheres.
Headache without aura has the presence of unilateral, pulsatile headache associated with nausea, vomiting, photophobia, and phonophobia. However, they do not accompany neurological symptoms that meet the definition of migraine with aura.
What are migraines’ symptoms?
These head pains may start suddenly or gradually, usually lasting from 4-72 hours, although the most common period is 4-24 hours. They cause a unilateral (one-sided) throbbing pain, affecting one-half of the head or face on average. However, it can affect both sides at once. In some cases, they may come with vomiting and nausea due to aggravation of the vomiting center. Other symptoms may include-
- Photophobia (increased sensitivity to light)
- Phonophobia (increased sensitivity to sound)
- Osmophobia (increased sensitivity to odors)
If you notice these symptoms along with a severe headache, that too on one side of your head, consult with your doctor. He or she may help find a successful migraine treatment.
What causes migraines?
The correct reason for migraines headaches is mysterious. However, genetic and environmental factors can result in triggering attacks (e.g., hormonal changes in women, sleep deprivation, and psychological stress). However, experts believe that these headaches may result from abnormalities of the cortical, spreading depression (a wave of nerve cell hypoactivity), and activation (swelling and itching) of meningeal nerves (the network of nerves located around the brain and spinal cord). It further causes dilatation of cranial blood vessels, which feed the brain, along with the release of various neurotransmitters (e.g., serotonin, histamine).
What are the migraine triggers?
Different factors or triggers may cause a migraine attack. However, the most common ones are-
- Hormonal changes (e.g., menstruation)
- Lack of sleep
- Certain odors or perfumes
- Weather conditions changes
- Bright lights or loud sounds
- Strong emotions (such as fear, anxiety, or excitement)
How is a migraine diagnosed?
Migraine headache is a common ailment of the nervous system. It is usually classified according to its clinical features and specific diagnostic criteria. The international classification of headache disorders defines migraine as recurrent attacks that are throbbing in character lasting from 4 to 72 hours if untreated. In adults, the two main types are migraine without aura (common migraine) and migraine with aura (classic migraine). After ruling out the disease, your doctor may help in picking the suitable migraine treatment for you.
Experts diagnose the condition while considering the history of the patient. Your episodes of headache can be often recognized from their clinical features, even in patients who have never had a headache before. A neurologist may perform a physical examination to rule out other neurological conditions (such as subarachnoid hemorrhage and brain tumor). The diagnosis of migraine is done according to the criteria defined in the International Classification of Headache Disorders (ICHD-3 beta) published by the World Health Organization.
What are the most effective ways to treat migraine headaches?
The most effective ways to treat migraine headaches are simple home remedies. Some examples are regular exercise, adequate sleep, relaxation techniques, healthy dieting, and avoiding certain daily triggers or medications that may induce migraines or make them worse.
- Keep a journal
One effective way to treat headaches is to keep a journal of the specific time of day when migraine headache starts. Mention what you were doing at that time, whom you were with, and any other activities in the journal. By keeping track of this information, the record may help people understand what triggers their migraines or when they are most likely to occur. Once it is known when the headache occurs, you can make notes on how much sleep was received, what daily activities you performed, what foods you ate. Moreover, if there was any weather-related activity. Many times, migraines are the result of unusual or severe weather conditions.
- Avoid the triggers
Another effective migraine treatment is to avoid triggering factors such as lack of sleep, skipped meals, and certain medications. One example of a drug that may induce migraines is prednisone, often prescribed to treat lupus and other autoimmune diseases.
Exercise is also considered one of the most effective ways to cure headaches. Doing workouts for at least 30 minutes or more per day can reduce the number of migraines by up to 40 percent. Specialists usually recommend low-impact exercises like walking, jogging, or cycling to help prevent migraine headaches.
- Relaxation practices
Relaxation techniques can help treat head pains in conjunction with other effective treatments. Controlled breathing exercises, yoga, and biofeedback are simple relaxation techniques that can help reduce the number of headaches when combined with other therapies.
- Adequate sleep
Regular sleep is another significant way to treat migraines. Some people experience headaches as a result of not getting enough sleep. If this is the case, making sure that the person gets at least six hours of sleep per night can prevent migraine headaches.
- Hot water bath
Another well-working at-home migraine treatment is by taking a hot shower or a bath. The water from the shower will help relax the muscles and ease some of the pain. A person can also fill up a sink with warm water, submerge their head into the water, and lie down in bed with a heating pad or heating pillow to relax any tense muscles.
Numerous home remedies can help ease the pain and discomfort of a migraine headache. Exercise is one of the most effective ways to prevent or reduce migraines from occurring. Moreover, relaxation techniques in combination with well-working treatments such as rest and regular sleep can lend you a hand in lowering the risk of headaches.
What are the effective medications for migraines?
If a patient has a treatable medical condition, specialists may try several medications before settling on one or two that may be effective and offer the fewest side effects. Effective preventive treatment for migraines requires significant changes to lifestyle habits and possibly medication. In other words, no quick fix! That said, there is hope, and your doctor is the best resource.
The drugs used to prevent migraines are called prophylactic medications or preventive medications. Prophylactic migraine therapy does not cure migraines. However, it can reduce the number of attacks or stop them altogether for several months or longer. Patients who have chronic daily headaches more than 15 days a month may need preventive therapies for migraine treatment.
Triptans tighten or constrict blood vessels around the brain. These drugs are considered so effective for migraines that patients can use them as often as needed during an attack (up to two doses in 24 hours). Moreover, options may include the following-
- Almotriptan (Axert)
- Eletriptan (Relpax)
- Frovatriptan (Frova)
- Naratriptan (Amerge)
- Rizatriptan (Maxalt, Maxalt-MLT)
- Sumatriptan (Imitrex, Sumavel DosePro, and others)
- Zolmitriptan (Zomig, Zomig-ZMT)
These medications are only available in oral forms; no triptan is available as a nasal spray. In addition, this migraine treatment does not work for everyone or all episodes of headache attacks. The possible side effects can be-
- Flushing or redness of the face and neck (hives, skin rash)
- Nausea and vomiting
Be careful that doses higher than 100 mg may cause chest pain and tightness, heart palpitations, and shortness of breath. People who have had a heart attack should not take triptans.
They are available in combination with NSAIDs, such as naproxen. The combination of Rizatriptan and naproxen (Maxalt-MLT) may be more effective than either medicine alone for migraine attacks.
Anticonvulsants prevent or reduce the severity of seizures in some people. Commonly prescribed drugs are clonazepam (Klonopin), topiramate (Topamax), and valproic acid (Depakote). Side effects of anticonvulsants may be as or more troublesome than those associated with triptans-
- Dizziness, drowsiness
- Impaired concentration
- Nausea and vomiting
- Weight gain
Topiramate can cause dental problems such as tooth decay and loss, the FDA says. In rare cases, this migraine treatment can also cause a potentially life-threatening syndrome that produces a diverse set of symptoms, including a decreased level of consciousness, seizures, and altered mental status.
Older classes of drugs used for migraines include antidepressants and anti-seizure medications. Amitriptyline (Elavil) is a tricyclic antidepressant that can prove to be effective in preventing migraine attacks. However, patients on this drug often experience side effects such as-
- Dizziness, drowsiness
- Blurred vision and other eye problems
- Nausea and vomiting
One antidepressant, venlafaxine (Effexor and others), can cause seizures and should be avoided if there is any history of migrainous seizures. Other side effects associated with such medications include-
- Nausea and vomiting
- Increased blood pressure
Anti-seizure medications also have a role in migraine treatment. Although they are not as effective as triptans for aborting a migraine attack, they can prevent attacks. These drugs may cause side effects that are similar to those of antidepressants. However, they may also cause-
- Increased risk of suicidal thoughts and behaviors (antidepressants do not seem to increase this risk)
Atypical antipsychotics are another class of drugs that may help put off migraines. The FDA has approved one atypical antipsychotic, topiramate (Topamax), for migraine prevention. Patients on this drug may experience side effects that are similar to those listed for other anticonvulsants.
Erenumab is part of a new class of medications called calcitonin gene-related peptide (CGRP) receptor antagonists, designed to target CGRP. A molecule can play a significant role in headaches by causing inflammation and widening blood vessels in the brain. It is accessible as an injection under the skin (subcutaneously). A 2017 study of episodic migraines found that patients who received erenumab experienced three or four fewer migraine days per month than the placebo group did.
As with other types of medication used for migraine treatment, side effects may include:
- Muscle aches
How can you prevent migraines?
Migraine is a brain disease that triggers attacks of intense headaches, causing you to become sensitive to light and sound. If you are tired, have just undergone surgery, or if weather conditions change, your risk of having migraines increases.
The first step in preventing migraines is to avoid these triggers as much as possible – for example, if you have light sensitivity, wear sunglasses. It is important to note that you cannot avoid all the triggers.
The following factors can often trigger migraine headaches-
- Weather conditions (e. g., high humidity or atmospheric pressure changes)
- Strong smells (e.g., perfume, paint, diesel engine exhaust)
- Lights (an example would be the light emitted by computer screens)
- Medications that contain estrogen (hormone replacement therapy) or are used to treat seizures such as topiramate and older so-called “triptans” such as Imitrex
Some people also experience a headache following the use of caffeine. However, this does not mean that you should avoid coffee. Caffeine may actually work in migraine treatment by preventing episodes of headache if taken in small amounts (e.g., 100mg).
The component is present in tea, cola, and chocolate. It is significant not to exceed the recommended dosage. Moreover, the following tips may help put off migraine headaches-
- Avoid what triggers your attacks
- Take over-the-counter painkillers such as aspirin or paracetamol
If you smoke, use a natural aid. Raw tobacco contains more than twice as much nicotine as cigarettes made from it. Nicotine acts on neurotransmitters involved in the triggering of migraine attacks.
Here are some tricks for you to try-
- Take a shower with tepid water or cold compress during an attack
- Apply ice packs to the forehead and neck
- Rest your head and eyes by closing them and lying down for a while
- Use relaxation techniques such as focusing on your breathing or progressive muscle relaxation
- Drink plenty of water and eat regularly
- Take your migraine treatment as prescribed