Understanding Migraine

Who gets migraine?

Migraine affects over 28 million people in the U.S., and is most often seen in adults between the ages of 25 and 55. Women are nearly 3 times more likely to suffer from migraine than men.

Is migraine hereditary? 

Many experts believe migraine can be hereditary. Studies show that individuals with a family history of migraine are more likely to suffer from the disease.

How often do migraine attacks occur? 

Migraine is not a daily headache and can occur at any time. Most migraine sufferers have at least 1 attack a month.

How long does a migraine last? 

If left untreated, migraines in adults can last from 4 hours to 3 days.

Types of migraine? 

There are several types of migraine. The most common are:

  • Migraine without aura - This is the most common type of migraine and includes throbbing headache pain, usually combined with sensitivity to light and sound.

  • Migraine with aura - This type of migraine is immediately preceded by aura. Up to 3 out of every 10 people who suffer from migraine experience aura before an attack. Aura develops gradually preceding an attack and generally lasts less than an hour. It usually involves visual changes, such as seeing bright lights, jagged lines, or experiencing blind spots.

What are the symptoms of migraine? 

Symptoms can vary from person to person and from 1 attack to another, even in the same person. Some of the most common symptoms are:

  • Throbbing pain, usually on one side of your head. It is moderate to severe in intensity, gets worse with activity, and can keep you from your daily routine

  • Sensitivity to light

  • Sensitivity to sound

  • Nausea

What causes migraine? 

While the exact cause of migraine is not known, most experts agree that migraine pain is caused by swollen blood vessels around the brain and certain nerves in the brain.

However, certain "triggers" may bring on an attack. The most common are:

  • Fatigue - from too much physical activity, lack of sleep, or too much sleep

  • Stress - periods during or after stressful situations

  • Some foods and beverages - particularly foods containing nitrites or monosodium glutamate (MSG); foods and beverages containing aspartame, an artificial sweetener; chocolate; aged cheeses; and alcoholic drinks

  • Caffeine withdrawal - caused by dramatically cutting back or stopping your caffeine intake altogether. Common foods containing caffeine are coffee, tea, and some soft drinks.

  • Menstruation - relating to changes in hormone levels at the time of a woman's period

  • Weather changes

How does migraine differ from other types of headaches? 

In general, headaches are divided into 2 groups: primary and secondary.

  • Primary headaches are the most common type of headaches, resulting from temporary or recurring changes in your brain's chemical, physical, or electrical makeup. Primary headaches include the following:

  • Migraine Headache - An intense, throbbing pain that is often accompanied by nausea and sensitivity to light and sound. Most migraine sufferers get at least 1 attack a month. Migraine headaches can happen at any time and, if left untreated, can last from 4 hours to 3 days.

  • Tension Headache - Characterized by a feeling of pressure and tightening, plus mild to moderate pain on both sides of the head. It usually occurs several times per month and can last from several minutes to several days.

  • Cluster Headache - Occurs in "clusters" over a period of a few weeks to several months, and involves severe pain around or behind one eye. It can last from a few minutes to over 2 hours and occur up to 8 times a day. Other symptoms may include tears, a stuffy or runny nose, flushing, and swelling of the eyelid on the same side as the pain.

  • Secondary headaches are the result of a physical disease or disorder, such as a brain tumor, head injury, sinus infection, or internal bleeding. If your doctor suspects that you have any of the symptoms of secondary headaches, he or she can do special tests, such as a CAT Scan or MRI to determine your condition, so you can be treated immediately.

Is there a way to tell when a migraine attack is about to occur?

Most migraines come on without warning. However, some migraines are preceded by early warning signals called prodrome and aura. Some migraine sufferers may experience one or both of these.

  • Prodrome (also known as premonitory symptoms) may begin hours before the onset of migraine or up to 2 days in advance. The most common symptoms are:

  • Increased activity

  • Decreased activity

  • Feeling sad

  • Craving for certain foods

  • Repetitive yawning

  • Aura develops gradually immediately preceding an attack, and generally lasts less than an hour. Up to 3 out of every 10 people who suffer from migraine experience aura before an attack. The most common symptoms include:

  • Visual changes 

  • Seeing flashing lights

  • Seeing jagged lines

  • Blurred vision or blind spots

  • Difficulty in focusing

  • Sensory or motor changes 

  • Numbness or tingling of the lips, face, or hands on 1 or both sides

  • Weakness in the arms or legs, usually on 1 side of the body

  • Speech or language changes 

  • Inability to understand words

  • Loss of speech or inability to speak normally

What else can you do to manage your migraine? 

You and your doctor are partners in managing your migraines. In addition to exploring effective drug treatments, there are many things you can do on your own and with your doctor's guidance to help manage your migraine.

  • LIFESTYLE

  • Know your triggers. Once you know what triggers your migraine, you can learn to manage your symptoms and be better prepared for your next migraine. To help identify your triggers, keep a record and write down what you were eating, drinking, and doing, as well as what was happening before your migraine. The most common triggers are:

  • Fatigue - from too much physical activity, lack of sleep, or too much sleep

  • Stress - periods during or after stressful situations

  • Some foods and beverages - particularly foods containing nitrites or monosodium glutamate (MSG); foods and beverages containing aspartame, an artificial sweetener; chocolate; aged cheeses; and alcoholic drinks

  • Caffeine withdrawal - caused by dramatically cutting back or stopping your caffeine intake altogether. Common foods containing caffeine are coffee, tea, and some soft drinks.

  • Menstruation - relating to changes in hormone levels at the time of a woman's period

  • Weather changes

  • Follow a regular sleep routine. Try to go to bed and wake up at the same time every day. Keeping to any routine may help reduce migraine, but your sleep routine is especially important.

  • DIET

  • Eat meals on a regular basis. Dieting or not eating can also bring on an attack. Having your meals at regular times each day may lessen the chance of migraine.

  • Avoid foods and beverages that may trigger a migraine attack. Like many migraine sufferers, you may be sensitive to certain substances found in foods and food additives that may be migraine triggers. Your doctor can help you identify and avoid foods that may be migraine triggers.

  • The most common triggers are foods containing nitrites or monosodium glutamate (MSG); foods and beverages containing aspartame, an artificial sweetener; chocolate; aged cheeses; and alcoholic drinks.

  • Migraines may also be triggered by caffeine withdrawal brought on by dramatically cutting back or stopping your caffeine intake altogether. Common foods containing caffeine are coffee, tea, and some soft drinks.

  • PHYSICAL ACTIVITY

  • Exercise often. Regular exercise can not only keep you fit, but can also reduce stress. Ask your doctor to suggest an exercise plan that's right for you.

  • Progressive relaxation Stress can set off a migraine headache and often shows up in your body as a stiff neck, clenched jaw, tight shoulders, or tense brow. Using progressive relaxation, you focus on relaxing the muscles in each part of your body in a step-by-step manner. By becoming more aware of the difference between tense and relaxed muscles, you can learn to relax your muscles and control your body's reaction to stress.

  • Deep breathing exercise Tense muscles are often a sign of stress, which can trigger your migraine. By following certain breathing techniques, you can increase the amount of oxygen in your bloodstream and muscles, helping them to loosen and relax:

  • Sit down in a quiet place, close your eyes, and inhale slowly and deeply through your nose to the count of 10. 

  • Allow your stomach and abdomen to expand, but try not to let your chest raise up. 

  • Then exhale through the nose, also to the count of 10. Focus on your breathing and your counting. 

  • Clear your mind of other thoughts. 

  • Repeat 5 to 10 times.

National Cancer Institute