Understanding migraines could help find relief, best treatment sooner
LA CROSSE, Wis. ― Nearly 1 in 4 U.S. households includes someone who experiences migraines. Most experience migraines once or twice a month, but more than 4 million people have chronic daily migraines with at least 15 migraine days per month, according to the Migraine Research Foundation. Every 10 seconds, someone in the U.S. goes to the emergency department complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks.
"Migraine headaches can cause severe throbbing pain or a pulsing sensation, usually on one side of the head, often accompanied by nausea, vomiting and extreme sensitivity to light and sound," says Daniel Anderson, D.O., a neurologist at Mayo Clinic Health System in La Crosse. "A migraine usually lasts from four to 72 hours, if untreated. Migraines might occur rarely or strike several times a month, and the pain can be so severe that it interferes with your daily activities."
Migraine is three times more common in women than men, and it affects more than 10% of people worldwide, according to the National Institute of Neurological Disorders and Stroke. Migraines can begin at any age, though they often first occur during adolescence.
"For some people, a warning symptom known as an aura occurs before or with the headache," adds Dr. Anderson. "An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face, or in an arm or leg, and difficulty speaking. A migraine aura also can occur without an associated headache."
The term "ocular migraine" often is used interchangeably to refer to two conditions: migraine aura that involves visual disturbance, which usually isn't serious, and retinal migraine, which could signal something serious and warrants prompt medical attention. A retinal migraine is a rare condition occurring in a person who has experienced other symptoms of migraine. Retinal migraine involves repeated bouts of short-lasting, diminished vision or blindness. These bouts can precede or accompany a headache.
"Migraine triggers can include hormonal changes in women; stress; sleep changes; and certain foods, food additives and medications. Some people who have migraines appear to be more sensitive to changes in the weather, including bright sunlight, extreme heat or cold, barometric pressure changes, and windy or stormy weather," adds Dr. Anderson.
There may be a link between migraines and the gut. Research suggests that people with frequent headaches may be more likely to develop gastrointestinal disorders. And research has shown that people who regularly experience gastrointestinal symptoms, such as reflux, diarrhea, constipation and nausea, have a higher prevalence of headaches than those who don't have gastrointestinal symptoms.
Acute treatments can provide patients with the relief they seek from migraine and headache pain. Dr. Anderson says health care providers will find the best treatment for patients by going over family history, and reviewing medications and other comorbid conditions, before selecting the best treatment plan. At times, patients can overuse medications, which can unknowingly worsen symptoms by exceeding medication limits.
"Living with migraines can be a daily challenge," says Dr. Anderson. "Medication is a proven way to both treat and prevent migraines, but medication is only part of the story. It's also important to take good care of yourself, including diet, exercise and stress management."
Learn more about how combining medication with behavioral measures and lifestyle can be the most effective way to handle migraines.
Watch a Zoom interview about migraines with Dr. Anderson.
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Rick Thiessee-mail: thiesse.ricky@mayo.edu
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