What Are The Causes Of Migraine
Chronic migraine typically evolves from episodic migraine because of increasing attack frequency and several other risk factors that have been implicated with migraine pain progressing into persistent pain.
Classification between different kinds of headaches and chronic migraine is important because patients often get misdiagnosed and are prescribed the wrong medication. Once classified as chronic migraine, the treatment protocol is different, as they do not respond to regular medicines. Patients might need specialised treatments and a lot of high-end treatments.
People with chronic migraine might notice that certain things trigger their symptoms. Triggers differ from person to person, and they can include anything from environmental changes to specific foods or because of ones lifestyle. The other triggers may include stress, depression or anxiety, hormonal changes, lack of sleep, hunger, alcohol consumption etc. Changes in hormones could be among the reasons that women have more headaches than men do. Oestrogen is one of the common hormones related to higher migraine prevalence in women experiencing menstruation.
Oestrogen regulates the female reproductive system, and it also happens to control chemicals in the brain that impact the sensation of pain. A drop in oestrogen levels can cause a headache, which can further lead to a more severe one i,e chronic migraine, if not controlled on time.
Best Exercises For Chronic Migraines
Should you work out if youre prone to migraines? The answer, according to research, is a decided yes.
In addition to the fact that exercise is good for your overall health and well-being, it may also play a significant role in reducing the frequency and intensity of migraine attacks, according to the American Migraine Foundation .
A review of 44 studies on migraine and exercise published in September 2018 in The Journal of Headache and Pain found that regular exercise may have a preventive effect in reducing the number of migraines and the frequency and intensity of headaches.
Whats The Outlook For People With Chronic Migraine
The hope for people with chronic migraine is to control the headache. With a good treatment plan, it is reasonable to believe that the number and severity of migraine headaches can be reduced. Many patients with chronic migraine may revert to episodes of migraine over time.
For patients with chronic migraines that have not responded to previous treatments, there are other options. Some patients need more aggressive hands-on techniques such as nerve blocks and trigger point injections. Other patients particularly those with medication overuse headaches – need to rid their body of previous medications in a monitored setting, such as an infusion suite. In the infusion suite, patients receive intravenous medications that stop migraines and treat the nausea and vomiting.
For patients with the most difficult migraines to treat those not responding to any treatments, in whom detoxification efforts have not been totally effective, and patients are still using medications not helpful to improving their headache a team approach is required. The team, consisting of healthcare professionals from neurology, psychiatry, psychology, nursing, physical therapy and social work, meet together with the patient and the patients family over a series of weeks to develop a plan of care and monitor progress. Patients with difficult to treat migraines should ask their doctors to refer them to facilities that offer such multi-team, patient-centered programs.
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Treatment Of Chronic Migraine
There are three broad approaches to treating chronic migraine: lifestyle and trigger management, acute treatments , and preventive treatments . While many patients find that lifestyle adjustments such as regularizing meals and sleep can reduce the frequency of their attacks, some form of medication or other treatment is almost invariably necessary in patients with chronic migraine. The National Institute for Health and Care Excellence have recently published guidance on the diagnosis and treatment of migraine, and further consensus guidelines have been published by the British Association for the Study of Headache, the American Headache Society and American Academy of Neurology, and the European Headache Federation .
Summary Of Chronic Migraine
Migraine is considered chronic when people have 15 or more headache days per month, with at least 8 of those days meeting criteria for migraine. Chronic migraine can be a very disabling condition. Development of chronic migraine has been associated with a number of potentially treatable risk factors. Chronic migraine treatment should primarily focus on prevention through use of medication and non-medication preventive strategies as well as addressing identified risk factors.
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Take A Detailed History
Accurate history taking is vitally important in the diagnosis of migraine. It is important to give patients time to describe their attacks fully , and also to clarify the history with specific questions aimed at filling out the gaps in what the patient has told you spontaneously. The diagnosis of migraine lies in the history, and that the purpose of examination is primarily to look for other problems that may be exacerbating an underlying tendency to migraine. This may in most cases be restricted to fundoscopy, inspection and palpation of the head and neck structures, and a brief screening cardiovascular and neurological examination, unless, on the basis of the history, serious intracranial or systemic pathology is suspected.
It is then useful to ascertain what treatments, current and previous, have been tried, and at what point these treatments are taken. Patients should be asked to bring a list of medications tried in the past, including doses, and be asked why these treatments were abandoned . The use of alternative or complementary therapies should also be sought.
While superficially there seems to be a lot of information required, it is almost invariably the case that patients will volunteer much of this information without being specifically asked, and it usually does not take too much time to fill out the gaps if a structured approach to the history taking is followed. If there is uncertainty, then encouraging the patient to keep a headache diary can be very useful.
In Rare Cases Constant Headaches Could Be A Sign Of A Brain Tumor
Googling your headache symptoms may result in a self-diagnosis of brain tumor. A brain tumor is a growth of abnormal cells on your brain, and they can be either cancerous or benign the Mayo Clinic says. Rest assured: They’re rare, so chances are you don’t have one. But its a possibility, and something you don’t want to miss, Dr. Hutchinson says. “If a patients had a regular headache pattern and it hasnt changed, it’s usually not a red flag,” she says. But if headaches are a new thing for you, are the most severe you’ve ever experienced, or are changing or worsening over time, these are signs your doctor may order a brain scan. But if you’re ever worried about what’s causing your headaches, it’s worth discussing with your doctor.
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You Drink Too Much Caffeine
Caffeine causes vasoconstriction in your blood vessels, meaning they get a little narrower. If you drink coffee or other caffeinated drinks every day, your body gets used to it, Dr. Hutchinson explains. So when you skip it one day, your blood vessels don’t become constricted and can make your head hurt. It becomes a vicious cycle, slugging back a mug to find relief, and just further deepening your need for caffeine. Additionally, the Mayo Clinic says that adults can safely consume up to 400 milliliters of caffeine per day , butkeeping in mind that everyones tolerance is differentafter that, your body might begin to rebel.
Fix it:“It’s unrealistic to tell all headache patients to avoid caffeine,” Dr. Hutchinson says. Instead, she recommends moderationa maximum of two caffeinated drinks in one dayto avoid that withdrawal headache when you go without.
How Is Chronic Migraine Treated
Treatment of chronic migraine is focused on managing lifestyle choices and headache triggers, managing migraine attacks and providing preventive treatments to reduce migraine attacks.
Lifestyle changes include:
- Beginning treatment for any existing mood disorder or sleep problem.
The typical treatment plan for managing migraine attacks includes:
- Treating migraine attacks early when pain in mild begin with a simple pain killer and slowly increase the dose as needed to the max tolerated dose, unless the headache is severe at the start or will become severe. In such cases add a triptan to the above medication to improve efficacy. Avoid use of opiates if possible. Your doctor will devise a treatment plan to avoid worsening chronic headache by overusing medications.
- Treat associated side effects, such as nausea.
- Consider other treatment techniques, including transcranial magnetic stimulation and transcutaneous supraorbital nerve stimulation.
Preventive treatment is aimed at reducing the number of headaches. Preventive treatments include:
- Beta blockers, such as propranolol , atenolol and metoprolol
- Angiotensin blockers, such as candesartan
- Tricyclic antidepressants, such as nortriptyline , amitriptyline
- Anticonvulsants, such as topiramate , sodium valproate
- Calcitonin gene-related peptide , such as galcanezumab , fremanezumab , erenumab
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How Is Chronic Migraine Diagnosed
Your doctor will take a detailed medical history. The doctor will ask about:
- Your pattern of migraine pain, including when and how migraines begin if they are episodic or continuous how long the migraine lasts if there are any triggers or factors that make the migraine worse.
- Your description of the pain, including its location, sensation, and severity.
- Other symptoms that accompany the pain, such as auras, lack of energy, stiff neck, dizziness, changes in vision or in senses, and nausea/vomiting.
- Your current and previously tried treatments, including when the medications are taken, dosages, outcome and side effects and use of alternative or complementary therapies.
- Your medical history including other health problems , family history of headache, current non-headache medications, and lifestyle choices .
Headaches In Early Pregnancy
Nearly all women have occasional headaches, but having a headache in pregnancy is not fun. And, managing headaches is especially tricky in the first trimester when you should avoid many medicines. Whether your headache is from tension or is a full-blown migraine, there are some things you should know.
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Can Using Birth Control Pills Make My Migraines Worse
In some women, birth control pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe. But in other women, the pills may worsen their migraines. In still other women, taking birth control pills has no effect on their migraines.
The reason for these different responses is not well understood. For women whose migraines get worse when they take birth control pills, their attacks seem to occur during the last week of the cycle. This is because the last seven pills in most monthly pill packs don’t have hormones they are there to keep you in the habit of taking your birth control daily. Without the hormones, your body’s estrogen levels drop sharply. This may trigger migraine in some women.
Talk with your doctor if you think birth control pills are making your migraines worse. Switching to a pill pack in which all the pills for the entire month contain hormones and using that for three months in a row can improve headaches. Lifestyle changes, such as getting on a regular sleep pattern and eating healthy foods, can help too.
How To Treat A Headache
Because there are so many different types of headache, there are lots of different ways they can be treated.
If your headaches are frequent, keeping a diary that lists when you get headaches might help you figure out what triggers them. If theres an obvious cause, like a tight neck, dehydration, or having too much caffeine, you might be able to avoid headaches by changing your behaviour or lifestyle.
When you have a headache, the below steps can help relieve the pain.
- rest and relax in a quiet space with good ventilation
- put a cool cloth or ice pack on your head
- splash your face with cold water
- if you have a tension headache, massage your neck, jaw, shoulders and head
- talk to your pharmacist about what pain medication you can take this might change depending your health, if you are taking any other medications and the type of headache you have.
Try these tips for preventing headaches:
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So What Does It Mean If You Have Constant Headaches
Technically, for your headaches to be considered chronic, they need to go on for 15 days or longer per month, for at least three consecutive months, SELF reported previously. That being said, if you have recurring headaches for, say, two weeks, that doesnt mean you should discount your painyou should still see your doctor.
The causes of constant, headacheswhether tension or migrainerange from totally minor to pretty major. Here are 10 things your headaches could be telling you about your health.
What Can I Do About Headaches
Steps to manage headaches include the following:
Avoid any known headache triggers, including allergens and certain foods, like monosodium glutamate, cured meats, and strong cheeses.
Smoking is never a good idea in pregnancy. You should also avoid secondhand smoke.
Try to eat well and drink plenty of fluids, especially if you are prone to morning sickness.
Reduce your stress level. Try a massage or cold pack to help with tension headaches.
If your headache is a migraine, rest in a cool, dark room with no noise, and try using warm or cold compresses or an ice pack.
There is good news, however. Most women have fewer headaches during pregnancy, especially after the first trimester. And those with a history of migraines often find there is improvement during pregnancy.
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Start Your Personal Migraine Diary
Try one of our community’s favorite migraine diary apps. Set a goal, that, no matter how long the pain goes on, you’re going to have a useful record you can review with your headache specialist in 30 or 60 days.
Just completing it makes you feel like a winner. And you will definitely discover something about yourself that you didn’t realize before.
New Daily Persistent Headache
If you suddenly get frequent headaches, you may have NDPH. The symptoms of NDPH can mimic tension headaches or migraines, but NDPH occurs in people who dont have a history of headaches. Often, people with NDPH can remember exactly when the onset happened. Your doctor may need to run tests to make sure these headaches arent secondary that is, a symptom of a serious underlying condition.
Although daily headaches might not be the result of a dangerous problem, they can affect your quality of life and shouldnt be considered normal.
Progressive symptoms of more severe or frequent headaches, or any headache that is also associated with other neurological symptoms, should be evaluated by a physician, says Jonathan J. Russin, MD, a neurosurgeon at Keck Medicine of USC and assistant professor of clinical neurological surgery at the Keck School of Medicine of USC. Even using these criteria, the majority of headaches will not represent an underlying problem. An exception is a thunderclap headache, which refers to the sudden onset of the worst headache of your life. This type of headache should always be evaluated by a physician whether it is associated with other symptoms or not.
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When Should You See A Doctor About A Headache
Headaches not only cause you pain, but can result in loss of productivity and income. If you have ongoing headaches, its important to see your doctor to try and figure out the cause, rather than just put up with the pain. Keep in mind that most headaches do not point to a serious illness, extra worry about your headache might make it worse!
See your doctor if your headaches are frequent, youve had a headache for more than a few days, or your headaches are causing you stress or worry.
Rarely, a headache might be a sign of a serious medical condition. You should seek immediate medical attention if you:
- have a sudden, very severe headache, and its the first time its happened
- are experiencing any of the signs of stroke including a dropped face on one side droopy mouth or eye cannot lift one or both arms or have slurred or garbled speech
- have a headache accompanied by a stiff neck and fever
- have signs of severe dehydration or heat stroke
- may have been poisoned by ingesting, inhaling or touching a substance, or being bitten or stung by a poisonous animal or plant
- or have injured your head from a fall, blow or bump.
Can Stress Cause Migraines
Yes. Stress can trigger both migraine and tension-type headache. Events like getting married, moving to a new home, or having a baby can cause stress. But studies show that everyday stresses not major life changes cause most headaches. Juggling many roles, such as being a mother and wife, having a career, and financial pressures, can be daily stresses for women.
Making time for yourself and finding healthy ways to deal with stress are important. Some things you can do to help prevent or reduce stress include:
- Eating healthy foods
- Being active
- Doing relaxation exercises
- Getting enough sleep
Try to figure out what causes you to feel stressed. You may be able to cut out some of these stressors. For example, if driving to work is stressful, try taking the bus or subway. You can take this time to read or listen to music, rather than deal with traffic. For stressors you can’t avoid, keeping organized and doing as much as you can ahead of time will help you to feel in control.