What Causes Migraines?
Migraine Management
Holiday Headaches
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If you suffer from headache or migraine, you are not alone. More than 90% of the population has had at least one headache in their life 48 million Americans suffer recurring headaches Migraine is one of the most common debilitating medical conditions in women In women 30-45 years old (childbearing age), up to 40% report having a migraine, approximately three times more common than in men Migraine is often hereditary and peak onset occurs in childhood. Women with migraine (more so than men) report that relationships with family, friends, and co-workers are affected. Interference with social activities is more common than absence at work or school. The indirect costs of migraine to U.S. employers are about $13 billion annually, most of which are due to migraine-related absenteeism and reduced productivity. In a general population survey, women had more severe, longer lasting headaches than men and more disability. Women, however, are twice as likely as men to consult a healthcare professional for migraine treatment. |
What does a migraine feel like? Why are the lights flashing?
Moderate to severe, throbbing pain often on one side of the head
Worsened by routine activity such as walking or climbing stairs
Lasts 4-72 hours
The pain is often accompanied by nausea, vomiting, and sensitivity to light and noise
A subjective sensation or movement called an aura precedes 15% to 20% of migraine attacks. The most common are visual disturbances such as flashing lights, blind spots, or zigzag lines lasting less than one hour and typically resolving before the head pain begins.Laboratory tests and brain imaging are not usually required in headache patients unless there is something unusual in the history or the physical exam (e.g. weakness in one arm, numbness in the leg, etc.).
People who inherit the predisposition to migraine, have a more sensitive nervous system than people not prone to migraine. When that sensitive nervous system encounters certain triggers, a cascade of events occur in the brain including excitation of brain neurons, release of pain-provoking chemicals, enhanced nerve signaling and dilation of blood vessels on the surface of the brain. These events result in the pain and associated symptoms of migraine.
What are the common triggers of migraine?
"Changes" that easily disrupt the balance of the nervous system
Internal changes : hormones, stress, medications, other illnesses
External changes: sleep disturbances, weather patterns, strong odors, bright lights, loud noise
Certain foods such as chocolate, aged cheeses, alcohol, caffeine and flavorings such as MSGSerotonin
Migraines are related to chemical imbalances in the brain. One chemical, called serotonin carries messages between the nerve cells and affects three things: pain perception, sleep patterns and moods. Certain medical conditions associated with serotonin are more common in women with headache including depression, anxiety, fibromyalgia, and irritable bowel syndrome.
Estrogen
Estrogen is closely related to serotonin, and changes in estrogen levels appear to be the major factor for the gender differences in headache. Migraine is impacted by estrogen changes in women. Its onset often coincides with the hormonal changes of puberty. Up to 70% of female migraine sufferers have headaches with their menstrual periods. Menstrually associated migraines occur in the 2 days before or the first 3 days of the menstrual period. Migraine at this time of month is due to a drop in estrogen. Migraine frequently improves during pregnancy but returns soon after delivery. Changes in headache pattern often accompany changes or starting to take oral contraceptives (OCs) or hormone therapy. During the hormonal fluctuations associated with peri-menopause, many women have worsening of their migraines. After menopause, migraine frequency in women declines.
Migraine headache frequency can wax and wane throughout a lifetime. Although migraines cannot be cured, they can be controlled. Headache management involves two important parts: treating each headache episode and preventing future headaches.
What can you do when a migraine hits?
Place cold or warm compresses on the head or neck
Massage the temples or neck muscles
Lie down in a dark, quiet room
Over-the-counter pain relievers may be effective for milder symptoms
Prescription medicationPrescription Medication
In the past 15 years, migraine treatment has been revolutionized by the triptans, a group of prescription medications designed to treat the underlying imbalances in the brain occurring during an attack. They dont cause drowsiness or addiction. In addition to quickly relieving migraine pain, these medications can also relieve the associated symptoms of nausea and sensitivity to light and noise.
Prevention
While not all headaches can be prevented, there are several ways of reducing the likelihood of developing a headache.
Tips to Keep Migraines from Returning
Identify situations or foods that seem to be related to the onset of a headache and avoid these triggers (e.g. chocolate, caffeine, stress, etc.)
Exercise
Regular sleep patterns
Healthy diet
A daily prescription medication may help reduce headache frequency in someStress can be a migraine inducer as well as cause of tension or "regular" headache. Don't let the stress of the holidays bring on a headache. Your usual migraine triggers may now occur in abundance. Try these tips for Headache-free Holidays:
Try to go to sleep and get up at the same time daily - skimping on your sleep may make it seem like you are getting more done, but can cause a migraine that will put you further behind on your to-do lists.
Are alcohol or certain foods a migraine trigger for you? Remember that at the holiday buffets and parties. Only you can decide whether 'just a little' taste is worth the migraine that might result. And dont skip meals to allow for those extra holiday goodies. Try to keep a healthy diet during these tempting times.
Make gift buying easy and enjoyable make a list (or two), stick to your budget and dont wait until the last minute.
Schedule some personal time to exercise, read a good book or even take a nap by the fireplace.
Work with your health care provider to develop a headache treatment plan for you. Keep your medications with you at all times in case a migraine tries to ruin your holiday plans.
Perhaps the most important way to deal with holiday stress and the accompanying headaches is planning ahead and setting manageable expectations. Make lists to keep track of what you need to do and remember you dont have to "do it all"!Resources:
The National Headache Foundation. www.headaches.org
Read more at Headache Associates
