Nearly every adult has had a headache at some time, and we can usually get through those days with an over-the-counter pain reliever and some quiet time. For the 12 percent of people in the United States who get migraines, though, it’s not that simple. These severe headaches can send people into darkened rooms for hours or days until symptoms subside.
What is a migraine?
These intense, pounding headaches are thought to result from changes in the level of a body chemical called serotonin that affect blood flow in the brain. Migraine pain is often on just one side of the head, and bright lights, loud noises and physical activity can make it worse. They also can cause nausea and vomiting. Migraines usually start slowly and gradually get worse, and can last from a few hours to several days.
For about 15 percent of people who get migraines, they start with a warning sign called an aura. This is a group of symptoms that can include temporary blind spots, blurred or tunnel vision, eye pain, or seeing flashing lights or lines. Some people experience unusual smells, tastes or feelings such as tingling or numbness.
Who is likely to get a migraine?
Women are three times as likely as men to have migraines. Your family history is also a factor – people with a parent or parents who have migraines are much more likely to also have them. Migraines usually begin between the ages of 10 and 40, and can occur a few times a year or every day.
For people who get these headaches, certain triggers can bring them on. That can include:
- Certain foods such as chocolate, aged cheeses, foods with MSG, cured meats and fermented or pickled foods
- Missing meals
- Tobacco smoke
- Loud noises or bright lights
- Drinking alcohol
- Too much or too little sleep
- Withdrawing from caffeine
- Changes in hormone levels, such as during a woman’s menstrual cycle
There is no specific test to determine whether a headache is a migraine. However, your symptoms and your family history most likely will be enough for a diagnosis. If not, a complete physical exam can rule out other conditions that could be causing your headaches. Your doctor also may recommend blood tests or imaging tests. A headache diary, which keeps track of what you are eating and doing when your headaches occur, also can help with diagnosis.
What are the treatments?
The best way to deal with migraines is to avoid them. A headache diary can help by revealing what triggers your headaches so you can adjust your lifestyle. For example, keeping a regular schedule for eating, sleeping and exercise can minimize migraines. People who have frequent migraines that disrupt their lives can take medicine every day to prevent them.
Other medicines can help relieve migraines once they start. For mild to moderate migraines, an over-the-counter pain reliever may help. However, check with your doctor if you need to take these often – some OTC pain relievers can irritate your stomach or damage your liver if you take too much.
If your migraines are severe, your doctor may prescribe one of several medicines that can be effective. Some people take both preventive medicines and those to treat migraine symptoms. You also can try strategies such as a cold or hot compress over your forehead or behind your neck, and lying down in a dark, quiet room.
When should I see a doctor?
If you think you may be having migraine headaches, make an appointment with your doctor. He or she can determine what type of headache you are having and recommend the best treatment.
Some headaches are symptoms of another problem that needs immediate treatment. Call 911 if a severe headache starts suddenly, seems like the worst one of your life, or if you also have confusion, trouble speaking, loss of vision or numbness or weakness in your face, arm or leg.