Managing Migraines: It Can Be Done

Although there is no cure for migraines, many medications can treat or prevent them. And you may be able to reduce their frequency by identifying and avoiding triggers.
Managing Migraines: It Can Be Done - Articles


Chances are that you’ve experienced a headache at some point in your life—that throbbing or pain in your head that makes it difficult to concentrate or do anything until it goes away. Rest assured, you’re in good company—according to the National Headache Foundation nearly 78 percent of all adults will experience a tension headache at some point in their lives. Many of those people and countless others also will experience headaches as the result of an illness or infection, a blow or some other trauma to the head, or exposure to a host of environmental factors (air pollution, sudden weather or light changes, exposure to secondhand smoke, strong perfumes, or household chemicals).

In most cases, the symptoms associated with these headaches will be mild to moderate and can be alleviated through a variety of self-treatment techniques and/or medications (including aspirin and other over-the-counter remedies). However, for the 45 million Americans who suffer from chronic, recurring headaches—particularly the 29.5 million Americans who suffer from migraines—the pain can be debilitating and can bring daily activities to a screeching halt.

Unfortunately, researchers have not identified a cure for migraines just yet; but, many medications are available to treat or even prevent some migraines. Better yet, you may be able to reduce the frequency of your migraines by identifying and avoiding triggers that cause them in the first place.

What Are Migraines?

Migraines are headaches that often begin as a dull ache and develop into a throbbing, severe pain. Each migraine can last anywhere from four hours to three days.

Typically, migraine sufferers will feel pain around their eyes or temples; however, they may also feel pain in the face, sinus, jaw, or neck area. Once the attack is full blown, most people become sensitive to anyone or anything touching their head, and simple activities such as combing your hair or shaving may be painful or unpleasant.

In addition to the headache, migraine sufferers typically will experience some of the following symptoms in a variety of combinations and severity:

  • Heightened sensitivity to light, noise, and odors
  • Nausea and vomiting
  • Loss of appetite
  • Sensation of being very warm or cold
  • Paleness
  • Fatigue
  • Dizziness or blurred vision
  • Diarrhea

Approximately 20 to 30 percent of all migraine sufferers will experience an “aura,” or a physiological warning sign, before the headache pain occurs. Visual disturbances such as wavy lines, dots, or flashing lights and blind spots will begin to occur approximately 20 minutes to an hour before the actual onset of a migraine. Some people also will experience tingling in their arms or face or have difficulty speaking.

Who Gets Migraines?

The National Headache Foundation estimates that 29.5 million Americans suffer from migraines, with women being affected more than three times as often as men. Nearly one-fourth of all women with migraines suffer four or more attacks a month. Migraines are most commonly experienced by individuals between the ages of 15 and 55, and 70 to 80 percent of all migraine sufferers have a family history of the chronic illness.

It’s important to note that children are not immune to migraines—statistics indicate that 5 percent of all children 15 and under have had migraine attacks.

What Causes Migraines?

Unfortunately, the exact cause of migraines is unknown. For many years, scientists believed that migraines were linked to expanding and constricting blood vessels on the brain’s surface; however, they now believe that migraines are caused by inherited abnormalities in certain areas of the brain.

Although there is no known specific cause for migraines, there are a wide range of external factors that are known to “trigger” migraines in chronic sufferers. Although they vary from person to person, the most common known triggers include the following:

  • Emotional stress—This is one of the most common triggers of migraines because migraine sufferers are generally found to be more emotional and highly affected by stressful events. During these events, certain chemicals in the brain are released to combat the situation (known as the “flight or fight” response). The release of these chemicals can provoke blood vessel changes that can cause migraine headaches.
  • Sensitivity to specific chemicals and preservatives in foods—Certain foods and beverages (e.g., aged cheese and alcoholic beverages), food additives such as nitrates (found in pepperoni, hot dogs, and lunch meat), and monosodium glutamate (or MSG, which is commonly found in Chinese food) may be responsible for triggering up to 30 percent of all migraines.
  • Caffeine—Excessive caffeine consumption or withdrawal from caffeine can cause headaches when the caffeine level abruptly drops. On the other hand, caffeine itself can be helpful in treating acute migraine attacks.
  • Changing weather conditions—Storm fronts, changes in barometric pressure, strong winds, or changes in altitude can all trigger migraines.
  • Menstrual periods—It has been estimated that 70 percent of all migraine sufferers are female. Of those, between 60 and 70 percent report a menstrual relationship to their migraine attacks.
  • Skipping meals
  • Changes in normal sleep patterns or excessive fatigue
  • Intense physical exertion
  • Exposure to bright light or excessive noise

Certain medical conditions are also more commonly associated with migraines, including asthma, chronic fatigue syndrome, hypertension, Raynaud’s phenomenon (occurs when blood vessels narrow, causing pain and discoloration, usually in the fingers), stroke, and sleep disorders.

How Do I Treat a Migraine?

A variety of over-the-counter and prescription medications are available to treat or even prevent some migraines. In order to determine which one is right for you, consult a headache specialist or another healthcare provider who is familiar with migraine treatments.
Also, as is the case with any medication, be sure to follow the label instructions and your doctor’s advice carefully.

Can Migraines Be Prevented?

Yes. Although there is no known “cure” for migraines, you can reduce the frequency of your migraine attacks by identifying and then avoiding your migraine triggers. You can keep track of your migraine patterns and identify triggers by keeping a headache diary.

You can make the following simple life-style changes to reduce the frequency of your migraines:

  • Monitor and adjust your diet. Using your headache diary to keep track of what you ate before an attack may help you identify foods that cause your migraines and allow you to make dietary changes that enable you to avoid these triggers in the future. Eating regularly to avoid low blood sugar and eating a healthy diet low in fat and high in complex carbohydrates may also help reduce the frequency of your migraine attacks.
  • Get adequate rest. Getting enough sleep is important for everyone but is especially important for those who suffer from migraines.
  • Exercise regularly. Regular moderate exercise is certainly helpful for relieving stress. However, it is important to warm up gradually and not overdo it since sudden, vigorous exercise might actually cause or aggravate a migraine attack.
  • Relax. Stress management and coping techniques, along with relaxation training, can help reduce the frequency and severity of your migraine attacks.
  • Avoid nicotine and caffeine.

If lifestyle changes do not seem to reduce the frequency and severity of your migraines, you may want to talk to your healthcare provider about prescribing medications that can help prevent the attacks. In general, individuals should only consider using these medications on a daily basis when one or more of the following conditions are present:

  • Recurring migraines significantly interfere with normal activities, even with treatment.
  • Attacks are severe and disabling.
  • Drugs used for migraine attacks are ineffective.
  • Drugs used for treatment are being overused.
  • Side effects of treatment are overly severe.
  • Migraine attacks typically occur more than two or three times a month.
  • You suffer from a rare form of migraines. It is important to determine which type of migraines you suffer from because some of the standard drugs for common migraines are not effective with rarer forms of migraines.

It should be noted that many preventive drugs have potentially serious side effects and that, even with their use, only 10 percent of all patients become completely headache free. Therefore, you should consider using preventive medication only if the lifestyle changes you have made do not produce results.

Where Can I Obtain Additional Information?

A wealth of information and support is available to those suffering from migraines. For additional information, contact any or all of the following organization.

National Organizations and Agencies

State Organizations and Agencies

Jefferson Headache Center: 215-955-1234

Other Migraine-Related Links