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Headache as the term clearly implies involves pain or discomfort of the head, as well as around the face. But headaches arent that simple. They vary in location, intensity, and frequency.
And they come in three primary types migraine, tension. and cluster and a few other variations such as premenstrual andsinus each with differing treatment strategies. Some headaches occur as the result of an underlying medical condition, while others are the main problem.
Tension headaches, the most common headache type, result from stress, anxiety, depression, and muscle tension.
Migraine headaches involve moderate to severe throbbing and pulsating pain, which worsens with movement. Theyre accompanied by additional symptoms such as nausea and vomiting, lightheadedness, sensitivity to light, and other visual effects.
Unlike other types of headaches, migraines occur in phases. Two phases may precede the actual headache:
- The premonition phase, hours or days before, presents as a change in mood or behavior
- The aura phase, immediately before, may include vision and speech changes, hallucinations, numbness, and muscle weakness
The headache resolution phase follows the migraine headache. Some migraine sufferers feel refreshed in this phase. Others feel fatigued, irritable, and unfocused.
Headache specialist Richard Kim, MD, describes migraine headache symptoms.
Click play to watch the video or read video transcript.
Both Migraine And Cluster Headache Can Get Better With Age
Puberty is often the time when girls first have migraine attacks, and theyre most common between ages 18 and 44, according to Migraine Research Foundation.
About 2 out of 3 women with migraine will have significant improvement in their migraine attack frequency when they go through natural menopause, especially for women who have migraine with aura, according to American Migraine Foundation.
The average age of onset of cluster headache is between 20 and 40, according to American Migraine Foundation. People may not age out of cluster headaches entirely, but the amount of time between bouts of cluster headaches usually increases, leading to fewer headaches, according to the Migraine Trust.
What Kind Of Pain Is It
The symptoms of a headache, Finkelstein says, are straight forward. They are not debilitating, but they can cause enough discomfort that will slow people down. Usually, however, people are able to carry on with their days and dont lose their ability to function.
Specifically, a headaches symptoms typically include dull, aching head pain and a sensation of tightness or pressure across the forehead or on the sides and back of the head. People may also experience tenderness of the scalp, neck and shoulder muscles, the Mayo Clinic outlines.
Headaches are classified into two categories: episodic and chronic.
Episodic tension headaches can last anywhere from 30 minutes to a week. They usually happen less than 15 days a month for at least three months.
Chronic headaches can last for hours and may be continuous. If they occur 15 or more days in a month for at least three months, theyre often considered chronic.
Migraines, however, are far more painful, Finkelstein said.
When migrainers develop a headache, its moderate to severe in nature, their function is disabled and they often experience other signs that typical headache patients dont experience like nausea, vomiting, light and sounds sensitivity, Finkelstein explains. Migraines are primary headaches in other words, there is no other underlying reason for the headaches.
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How Do You Know If You Have A Migraine Or Another Type Of Headache
The only way to be sure what kind of a headache you have is to see a doctor, but you can help your doctor make a diagnosis by keeping tabs on your symptoms with a headache diary.
You should record things like:
- what your headache feels like
- what other symptoms come along with it
- how long your headache pain and other symptoms last
- how often your headache strikes
A doctor can take a cohesive look at your headache patterns, your family history, and the results of any required tests and examinations to help you figure out what kind of headache you haveâso you can get treatment.
So how can you tell if you have migraine attacks versus a different type of headache? Without the help of a doctor, it can be difficult to tell the difference between, say, chronic migraine, and another serious condition. Thatâs why itâs important to talk about your condition with a doctor.
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
Weakness On One Side Of The Body
When an arm goes limp, it can be a sign of a migraine.
Some people experience muscle weakness on one side of the body before a migraine attack. This can also be a sign of a stroke, however, so consult a doctor to rule out any other causes.
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Causes And Triggers Of Migraine Versus Cluster Headaches
Genetics play a significant role in migraine. If one or both of a persons parents have migraine, theres a 50 to 75 percent chance that they will, too, according to the American Migraine Foundation.
Genetics are believed to less strongly influence the occurrence of cluster headaches but are suspected to be involved in about 10 percent of people with cluster headache, according to the National Organization for Rare Disorders .
The underlying cause of cluster headache is not known. The direct cause of pain is thought to be a result of blood vessels dilatating and creating pressure on the trigeminal nerve, says NORD.
Alcohol may trigger both types of headaches, but migraine attacks may also be triggered by hormonal fluctuation and relaxation after stress, says Richard Lipton, MD, a professor and vice chairman of neurology at the Albert Einstein College of Medicine and director of the Montefiore Headache Center, both in New York City.
Light Noise Or Smells Trigger Or Worsen Pain
In the throes of a migraine attack, the migraine sufferer tends to seek refuge in a dark, quiet place. Bright lights and loud noises can trigger a migraine or intensify the pain. The same is true of certain odors.
“Once you’ve already got a migraine, smells can seem more intense and make it worse,” Dr. Calhoun says. “But a smell can also trigger a migraine in someone who didn’t have one before walked past the perfume counter.”
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How Do I Know If Its A Migraine Or A Stroke
With a stroke, symptoms usually come on suddenly. With a migraine, they happen gradually the headache usually starts small and gets more painful. A stroke is more likely to have what are called “negative” symptoms such as you might lose sight in one eye or lose feeling in one of your hands or feet.
Where Is Migraine Pain Located
A migraine is usually an intense pounding headache that can last for hours or even days. The pounding or pulsing pain usually begins in the forehead, the side of the head, or around the eyes. The headache gradually gets worse. Just about any movement, activity, bright light, or loud noise seems to make it hurt more.
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What Are Some Migraine Risk Factors And Triggers
Some things make you more likely to get migraine headaches . Other things may bring on a migraine .
Common migraine risk factors include the following:
- Family history: You are much more likely to have migraines if one or both of your parents had migraines.
- Sex: Women are more likely than men to have migraines.
- Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.
Common migraine triggers include the following:
- Food and drink: Certain food and drink may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines.
- Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy.
- Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work, but your body can also be stressed if you exercise too much or dont get enough sleep.
- Senses: Loud sounds, bright lights , or strong smells may trigger migraines.
- Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.
- Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children.
Foods that may trigger migraines:
- aged, canned, cured, or processed meat
- aged cheese
- soy sauce
Why Headaches Can Be So Costly For Us All
If you can avoid going to hospital unnecessarily when you have a headache, youll benefit yourself and Australias health-care system.
Every time you present to an emergency department, it costs you hours of your life, and the community an average of A$561.
If headaches interfere with your life, please prioritise your health. See a doctor, get a management plan for them and save yourself a painfully long wait in emergency.
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What Medicines Help Relieve Migraine Pain
For mild to moderate migraines, over-the-counter medicines that may help relieve migraine pain include:
- an acetaminophen, aspirin, and caffeine combination
People who have more severe migraines may need to try abortive prescription medicines. A medicine called ergotamine can be effective alone or combined with other medicines. Dihydroergotamine is related to ergotamine and can be helpful. Other prescription medicines for migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan, eletriptan, and frovatriptan.
If the pain wont go away, stronger pain medicine may be needed, such as a narcotic, or medicines that contain a barbiturate . These medicines can be habit-forming and should be used cautiously. Your doctor may prescribe these only if they are needed and only for a short period of time.
What Are The Symptoms Of Migraines
The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like its affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.
Other symptoms of migraine headaches include:
- Sensitivity to light, noise and odors.
- Nausea and vomiting, upset stomach and abdominal pain.
- Loss of appetite.
- Feeling very warm or cold .
- Pale skin color .
- Euphoric mood.
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What Causes Migraines
Doctors dont know exactly what causes migraines. It appears that migraine headaches may be caused in part by changes in the level of a body chemical called serotonin. Serotonin plays many roles in the body, and it can have an effect on the blood vessels. When serotonin levels are high, blood vessels constrict . When serotonin levels fall, the blood vessels dilate . This swelling can cause pain or other problems. Another aspect that is being studied is that migraine headaches go along with a spreading pattern of electrical activity in the brain.
Some research suggests there could be a heredity factor for migraines, meaning they may run in families. Researchers have identified some genes associated with migraines. They are unsure, though, why these genes seem to impact some people more than others. The American Migraine Foundation reports that if one of your parents has migraines, there is a 50% chance that you will, too. If both of your parents have migraines, your chances jump up to 75%. Ultimately, migraines seem to be caused by a combination of factors: genetic, environmental, and lifestyle.
Women are more likely to have chronic migraines . This is likely linked to hormones. Hormones fluctuate each month around the time of your period. They can also fluctuate if you are pregnant or going through menopause.
When To See A Doctor
If your tension headaches are chronic, or ongoing, I always tell my patients to err on the side of caution and schedule a visit. Depending on the severity and length of your symptoms, your doctor may prescribe medicines to prevent tension headaches from recurring.
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Famous People Who Have Migraine With Aura
Celebrities are not immune to the effects of Migraine with aura. A few notable Migraine with aura warriors include:
- â Famous author of Through the Looking Glass and Alice’s Adventure’s in Wonderland, Lewis Carroll was a well-known person with Migraine. In fact, the size distortions that Alice experiences down the rabbit hole are thought to be related to Migraine and are now called “Alice in Wonderland Syndrome.”
- Artist Vincent van Gogh – Art enthusiasts have speculated that the halos, swirling patterns, and colors of paintings like Starry Night and Trees in the Garden in Front of the Entrance to Saint-Paul Hospital are representations of van Gogh’s Migraine auras.
- Artist George Seurat- Famous French post-Impressionist artist George Seurat, well known for the artistic technique pointillism, is said to have experienced Migraine with aura. Some medical researchers even refer to scotoma, or scintillating aura, in Migraine as the Seurat Effect.
- Actress and Singer Kristin Chenoweth â Migraine warrior, famed actress, and singer Kristin Chenoweth shares her experience with Migraine at the Migraine World Summit. She explains how knowing she wasn’t alone was sometimes the best medicine for dealing with a condition that is largely invisible and often stigmatized.
Are Migraines Small Strokes
Migraines have not been shown to cause stroke, but if you have migraine with aura you have a very slightly higher risk of stroke. This guide explains more about migraine, and lists some useful organisations. Stroke and migraine both happen in the brain, and sometimes the symptoms of a migraine can mimic a stroke.
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Migraine Vs Headache Diagnosis
Although there are no specific tests for migraine headaches, your doctor may order tests to exclude other conditions or problems that are triggering your headaches. This may include blood work or different brain imaging, such as CAT scan or MRI. In rare cases, your doctor may order a spinal tap to exclude causes of more serious, severe headaches.
Monitoring the duration of your headache can provide important information that can help diagnosis the type of headache you are experiencing. Migraine headaches may last a few hours to three days, while tension headaches may last only 30 minutes or linger for up to a week.
- Keep a headache diary to help identify triggers that lead up to the onset of the headache, for example, menstrual cycles for women, hormone treatments, and alcohol intake.
- Keep track of when a headache begins, the severity of the pain, any associated symptoms, how long the headache lasts, and any medications that you have taken.
- If there does not seem to be any clearly identifiable cause for your headaches, maintain a diet diary, and keep track of any foods or drinks that you may have consumed the day before a headache to identify possible triggers.
Could A Headache Caused By Covid
Headache is one of the most commonly reported symptoms of COVID-19, the viral illness caused by SARS-CoV-2, according to the Centers for Disease Control and Prevention .
The Journal of Headache Pain published a survey in October 2020 that looked at the characteristics of headaches that occurred as a result of COVID-19. People reported having headaches in which the pain was pulsating, pressing, and even stabbing.
The survey reported that men were more likely than women to have COVID-19-related headaches. The headaches were reported to be bilateral , often lasted longer than 72 hours, and commonly occurred along with gastrointestinal symptoms and loss of taste and smell.
If you experience a sudden headache and you suspect it may be COVID-19-related, contact your healthcare provider right away.
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What Are The Stages Of A Migraine
The Migraine Research Foundation says that migraine is a neurological disease that affects 39 million people in the U.S. Migraines, which often begin in childhood, adolescence or early adulthood, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.
How A Migraine Feels Compared To A Headache
One of the biggest differences between a headache and a migraine is the sensations you feel. People who have headaches often feel:
- Pressure and pain in varying frequencies and intensities
- Pain extended to the neck or face
People with migraines often experience similar signs, along with additional symptoms such as:
- Throbbing pain
- Neck stiffness
- Seeing colored spots or floaters
Typically, migraines bring on more symptoms than headaches, and those symptoms can be more severe. However, it really depends on what’s causing your headache. Severe headaches could also lead to more intense symptoms.
If you aren’t exactly sure if youre experiencing migraine pain or headache pain, call your doctor or head to and explain the pain. They’ll help you determine if you’re experiencing a headache or a migraine.
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