Migraines

What is a Migraine?

A migraine is a headache condition that causes extreme pain and discomfort. It most commonly occurs on only one side of the head. Some people also report experiencing other symptoms in addition to the headache, such as nausea, vomiting, and even vision complications. 

You might be curious and wonder, "How long can a migraine last?" Well, there is no set answer. A migraine attack may last anywhere from several hours to days. It is debilitating and excruciatingly painful.

Another common question people ask is, "What's the difference between a headache and a migraine?" Generally speaking, headaches cause discomfort in the head, face, and upper neck. The pain caused by a migraine is generally more severe and may present with other symptoms like nausea and vision disturbances. They tend to be much more debilitating, causing sufferers to miss work or other commitments.

There are two main types of migraines: with aura and without aura. An aura refers to visual symptoms like seeing lines and flashes. Migraines are a neurological disorder that, without treatment, can significantly affect your quality of life, making even simple daily tasks difficult to accomplish during an attack.

Pathophysiology and Risk Factors

Headaches usually result from traction or irritation of the brain meninges and blood vessels. These factors also play a major role in the pathophysiology of migraines. 

In more serious cases, head trauma or tumors may stimulate pain receptors, leading to headaches or migraines. Doctors also suspect that in some people, imbalances in brain chemistry may contribute to this condition. While numerous things can cause migraines, the following factors can put you at higher risk of developing them:

  • Genetics - If someone else in your family already experiences migraines, you may be at a higher risk of experiencing them. 
  • Age - You're most likely to get your first migraine as a teen, but it can develop at any time. Migraines are the most intense around age 30, and, later in life, they often begin to dwindle. 
  • Gender - Women are approximately three times more likely to suffer migraines than men.
  • Hormonal changes - Shifts in estrogen can trigger an attack.
  • Stress - This puts your brain into "fight or flight" mode and can trigger the condition.
  • Skipping meals or not eating enough - When you skip a meal, your blood sugar drops, potentially triggering migraines. 
  • Alcohol/Caffeine - Both alcohol and caffeine are triggers of migraines. Some sufferers find it easier to avoid both altogether.
  • Sensory overload - Some sensory stimuli such as flashing lights, bright lights, loud, intense smells may lead to migraines.
  • Sleep pattern changes -  This can lead to feeling tired, which predisposes many people to migraines.
  • Physical strain - Physical activity is excellent for your body and your brain. Still, too much or too demanding exercise can be a trigger. 
  • Weather - Changes in the air pressure can cause a migraine.

Symptoms

Symptoms of migraines vary widely between people. However, many sufferers report their condition occurs in roughly the following four stages:

Prodrome 

This stage can last hours to days before the onset of the pain. A few notable symptoms are sensory sensitivity (light, sound, etc.), fatigue, shifts in mood, bloating, and severe thirst.

Aura

Not every person experiences this stage (those with migraines without aura do not). The symptoms in this stage stem from the nervous system and affect your sight. Some people report seeing flashes or objects in their field of vision. Aura can also include seeing black dots, experiencing tunnel vision, feeling tingling or numbness, having difficulty speaking clearly, and ringing in the ears. This stage can last from five minutes to an hour.

Attack

A migraine attack can begin with a slow, dull ache and develop into a full-blown pounding headache. The head pain is severe. Approximately 80% of people who experience migraines also experience nausea. An attack can last anywhere from a few hours to several days.

Postdrome

This stage of the attack can include fatigue, muscle pain, food cravings, or decreased appetite. It can last up to a day following the initial pain.

If you are suffering from these symptoms or believe you may be experiencing migraines, see one of our online providers now to discuss treatment options.

Diagnosis

While you may suspect you have migraines, if you are experiencing repeated, severe headaches, your doctor will be able to diagnose you formally. They will begin by asking about your medical history and symptoms. It is essential to be clear and forthcoming about your pain level and how it affects your daily life. 

While a physical exam can be helpful, it is often not enough to diagnose this condition since there are no visible signs. Therefore, your doctor may also order additional tests like bloodwork or magnetic resonance imaging (MRI) or a computed tomography (CT) scan to rule out other causes of your headaches.

Treatment

Your treatment plan will depend on the frequency and severity of your migraines. If you know what triggers your attacks, your physician will likely work with you to develop a plan to avoid them. This may include lifestyle modifications like eating more regularly, remaining hydrated, and getting consistent sleep.

To control your pain during an attack, your doctor may recommend over-the-counter migraine medications or prescription pain relievers. If you regularly experience migraines, a daily preventative medicine can also be ordered to help decrease the number of headaches you may develop per month. Finally, physical therapy or chiropractic care can sometimes help relieve symptoms by releasing muscle tension or correcting spinal misalignments that compress nerves or blood vessels.

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Prevention

Migraines can cause severe throbbing or stabbing pain and other symptoms such as nausea or vision changes. While this can be debilitating, especially during an attack, migraines are generally not considered dangerous.

Migraines do not cause brain damage or other physical harm. Still, the severity of their symptoms can negatively affect your mental health. Luckily, with proper care, the pain and other manifestations can be effectively treated. Preventative therapy can also decrease the number of migraine attacks you experience and improve your quality of life. If you suffer from migraines, speak with one of our online doctors now to see how your condition can be managed.

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Dr. Robert Chow
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