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.”
Theories About Migraine Pain
Older theories about migraines suggested that symptoms were possibly due to fluctuations in blood flow to the brain. Now many headache researchers realize that changes in blood flow and blood vessels don’t initiate the pain, but may contribute to it.
Current thinking regarding migraine pain has moved more toward the source of the problem, as improved technology and research have paved the way for a better understanding. Today, it is widely understood that chemical compounds and hormones, such as serotonin and estrogen, often play a role in pain sensitivity for migraine sufferers.
One aspect of migraine pain theory explains that migraine pain happens due to waves of activity by groups of excitable brain cells. These trigger chemicals, such as serotonin, to narrow blood vessels. Serotonin is a chemical necessary for communication between nerve cells. It can cause narrowing of blood vessels throughout the body.
When serotonin or estrogen levels change, the result for some is a migraine. Serotonin levels may affect both sexes, while fluctuating estrogen levels affect women only.
For women, estrogen levels naturally vary over the life cycle, with increases during fertile years and decreases afterwards. Women of childbearing age also experience monthly changes in estrogen levels. Migraines in women are often associated with these fluctuating hormone levels and may explain why women are more likely to have migraines than men.
What Is The Main Cause Of Migraines
The exact cause of migraines remains a mystery. However, several factors are associated with migraines. Some of the factors are:
- Migraines happen due to changes in the blood supply to the brain accompanied by inflammation, according to the neurovascular theory.
- Migraines may be due to changes in the level of a chemical in the brain called serotonin. Low levels of serotonin cause the vessels that supply blood to the brain to swell up. This leads to pain and other symptoms of a migraine.
- Genes also play a role in causing migraines. Around 70% of migraine patients report their parents, grandparents or siblings suffer from migraines.
- The higher occurrence of migraines in women suggests the role of hormones in causing migraines.
Other factors causing migraine events are:
- Exposure to bright or fluorescent lighting
- Strong odors
- Fasting or skipping meals
- Red wine
- Certain foods and food additives , citrus fruits, aged cheese, meats with nitrites)
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What Is A Migraine Attack And How Do You Manage It
Migraine is the leading cause of disability in people aged 15 to 49, yet this brain disease is often misunderstood and misdiagnosed. Heres what you need to know.
I was a teenager when I had my first migraine attack. I was sitting in my sunny living room and I started to see spots. Bright and iridescent, they gradually morphed into a swirling pattern that spread across the left side of my vision. I couldnt see past it, and I had no idea what was happening to me.
The episode soon passed, but it was followed by a throbbing headache. My mom instantly recognized the signs of migrainesomething she was all too familiar with.
Over the years, I had the odd migraine attack, but nothing I couldnt manage with a nap and some ibuprofen. But after I had kids, my attacks increased, and I developed some concerningand confusingsymptoms.
I became painfully sensitive to noise and had bouts of tinnitus , but ear exams showed nothing. I had dizzy spells and thought my thyroid medication needed adjusting, but my bloodwork was normal. I was often exhausted, but I blamed it on parenting. Ditto for my anxiety and depression, which were at an all-time high.
Then I started getting pins and needles in the side of my face, along with tingling in my arm, tightness in my chest, and heart palpitations. After two visits to the ER and a full cardiology workup, I was assured that my heart was healthy. I was relieved, but mystified. What was going on with me?
What Is The Cause Of Hemiplegic Migraine
Hemiplegic migraines often have a genetic component. However, they are often triggered by head trauma1, whether it be mild or severe.
In those individuals that may be suffering from Hemiplegic Migraine and have no underlying pathology or disorder that can be recognised, another known cause may be due to a sensitised brainstem2.
A SENSITISED BRAINSTEM will perceive non-threatening stimuli and create pain to be felt where the sensory information was originally detected. This hyper-excitability of the pain sensation is due to the heightened arousal and sensitive brainstem. A sensitive brainstem will relay the sensory information to the brain, but will heighten the sensation so that the brain perceives the information as painful.
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What Questions Should I Ask My Healthcare Provider
- Will my child grow out of their migraines?
- What medications do you recommend for me?
- What should I change about my lifestyle to prevent my migraine headaches?
- Should I get tested?
- What type of migraine do I have?
- What can my friends and family do to help?
- Are my migraines considered chronic?
A note from Cleveland Clinic
Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.
How Do You Treat A Migraine Hangover
For those who typically suffer migraine postdrome, it may be easier to preempt them by treating your migraine attack itself while it is happening. Of course, thats not always possible. The postdrome may be reduced or eliminated when the migraine attack is properly treated, says Newman. Migraine-specific acute medications treat the head pain and the associated symptoms. If these medications are taken early in the attack, they can prevent or reduce the postdrome symptoms for many people.
Options for treatment will vary, and youll need to speak to a doctor about a long-term treatment plan if you have frequent migraines. In general, over-the-counter pain relievers or prescription-strength triptans can reduce or dull migraine pain, while anti-nausea drugs may be prescribed to manage symptoms of digestive upset, according to the Mayo Clinic.
If you are experiencing a migraine postdrome, be gentle with yourself. The American Migraine Foundation recommends getting additional rest, staying hydrated, and doing light activities, like stretching. The AMF also notes that after a severe migraine attack you may be eager to resume your normal activity, but ignoring symptoms of postdrome may increase your risk of having another full-blown migraine attack.
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What Are Some Ways I Can Prevent Migraine
The best way to prevent migraine is to find out what triggers your attacks and avoid or limit these triggers. Since migraine headaches are more common during times of stress, finding healthy ways to cut down on and cope with stress might help. Talk with your doctor about starting a fitness program or taking a class to learn relaxation skills.
Talk with your doctor if you need to take your pain-relief medicine more than twice a week. Doing so can lead to rebound headaches. If your doctor has prescribed medicine for you to help prevent migraine, take them exactly as prescribed. Ask what you should do if you miss a dose and how long you should take the medicine. Talk with your doctor if the amount of medicine you are prescribed is not helping your headaches.
How Are Migraines Treated
Migraine headaches are chronic. They cant be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.
- Abortive medications are most effective when you use them at the first sign of a migraine. Take them while the pain is mild. By possibly stopping the headache process, abortive medications help stop or decrease your migraine symptoms, including pain, nausea, light sensitivity, etc. Some abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.
- Preventive medications may be prescribed when your headaches are severe, occur more than four times a month and are significantly interfering with your normal activities. Preventive medications reduce the frequency and severity of the headaches. Medications are generally taken on a regular, daily basis to help prevent migraines.
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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
What Is Hemiplegic Migraine
Hemiplegic Migraine has an unusual and often alarming presentation that can mimic stroke, multiple sclerosis, epilepsy or metabolic disorders. Hemiplegia is a condition where one side of the body is weakened or paralysed. Technically, Hemiplegic migraine is a subcategory of Migraine with Aura. During a hemiplegic migraine attack, sufferers will experience weakness or paralysis of one side of the body, as well as more typical migraine aura symptoms such as visual, sensory, or speech disturbances1,2.
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Enhancing Healthcare Team Outcomes
A hemiplegic migraine is a very rare migraine headache accompanied by unilateral weakness. It can be very upsetting to the patient and their family. Typically an interprofessional approach involving a nurse experienced in headache education working with a clinical headache specialist to educate the patient and family will result in the best outcome.
Throbbing Pain On One Or Both Sides Of The Head
Pulsating pain is a classic sign of migraines. The throbbing is often felt on one side of the head.
In an online survey of patients with migraines, the National Headache Foundation found that 50% “always” have throbbing on one side, while 34% say they “frequently” have this symptom.
Migraine pain often burrows behind the eye.
People will blame it on eye strain and many will get their eyes checked, but that won’t make their headaches any better, Dr. Messina says.
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What Can I Do To Prevent Migraines
One of the best ways to prevent migraines is to try to avoid the things that might trigger your attacks. Most people benefit from trying to get stable sleep, eating regular meals, drinking plenty of fluids to keep hydrated, and trying to manage stress. Taking regular exercise may also help prevent migraines since it helps with breathing, improving blood sugar balance and maintaining general wellbeing. Although you should take care not to engage in very strenuous activity that your body is not used to as this can sometimes act as a migraine trigger.
Keeping a diary of your migraines can be a useful way to record when and where you experience attacks, check for any patterns, and try to identify your triggers. Take the diary when you see your GP so you can communicate your symptoms with them and they can find the best way to help you.
When Should I Seek Immediate Help Or Contact My Healthcare Provider
- You are experiencing the worst headache of my life.
- You are having neurologic symptoms that youve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
- Your headache comes on suddenly.
- You have a headache after experiencing a head injury.
Schedule a visit with your healthcare provider if:
- The number or severity of your headaches increase or your headache pattern changes.
- Your medications no longer seem to be working or youre experiencing new or different side effects.
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How Can I Tell If I Have A Migraine Or Just A Bad Tension
Compared with migraine, tension-type headache is generally less severe and rarely disabling. Compare your symptoms with those in this chart to see what type of headache you might be having.
|Aura before onset of headache||x|
Note: Rebound headache may have features of tension and/or migraine headache. Adapted from a table produced by the American Council for Headache Education.
Although fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by certain foods, changes in the body’s hormone levels, and even changes in the weather.
There also are differences in how types of headaches respond to treatment with medicines. Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.
You can’t tell the difference between a migraine and a tension-type headache by how often they occur. Both can occur at irregular intervals. Also, in rare cases, both can occur daily or almost daily.
What Is The Prognosis For People With Migraines
Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.
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What Are Migraine Triggers
In many, but not all people it is possible to identify and avoid migraine triggers.
Migraine likes a regular routine.
Irregular or skipped meals should be avoided. People with migraine should take a fibre-containing breakfast within an hour of getting up, before leaving home for work or school. Eat little and often.Some people think dehydration can trigger migraine. This is easy to avoid.
Try to have a regular body clock, with the same or similar time for sleep and for getting up every day. Avoid shift work, or try to stay on the same shift all the time. On weekends or days off, stick to the same daily ritual as in the working week.
The let-down from stress is another reason for migraine at the weekend. Try to keep stress levels relatively constant, or change gradually.
Keeping physically fit makes you more resistant to migraine . Unaccustomed exercise can trigger migraine try to exercise regularly at the same time every day build up fitness gradually.In women, a falling oestrogen level can trigger migraine at menstruation or after childbirth. The oestrogen containing contraceptive pill can sometimes worsen migraine .
Change in the weather can trigger migraine: but this is unavoidable.
One of the commonest causes of worsening migraine, is too many painkillers! See the fact sheet on Medication Overuse.
Travel is a common migraine trigger. Many of the above triggers can contribute to migraine on holiday.
How The Blind Are Unlocking Migraine Sufferers’ Sensitivity To Light
One of the biggest symptoms of a full-blown migraine is sensitivity to light, and it can also be a trigger. In order to try to find out just why that’s such a major part of migraines for so many people, researchers from Harvard took a look at what was going on when two groups of people, all blind, suffered from migraines.
One group was made up of people who were completely blind due to various types of diseases and disorders of the eye, while the other group suffered from degenerative diseases and were only considered legally blind. The first group could detect no light at all , while the second group could. When they exposed the first group to light that triggered sensitivity in sighted suffers, none reported that their migraines got any worse. The second group reported an increase in pain, and that helped to narrow down just what was going on in their brains. The optic nerve is what gives your brain signals regarding light, and it was only the patients that had intact optic nerves who described the sensitivity to light.
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What Does A Migraine Feel Like
Migraines are not felt the same way by everyone. The usual symptoms of a migraine are:
- A severe, throbbing headache that increases with movement.
- Pain is usually limited to one side of the head, around the forehead and around the eyes. However, it can be felt anywhere around the head or neck.
- Pain builds up between one to two hours, progressively increasing and becoming more diffuse.
- A migraine headache can last for four hours to three days.
- Nausea occurs in 80% of the cases.
- Almost half of the people with a migraine complain of vomiting.
- Sensitivity or discomfort to light and sound.
The typical features of a migraine aura are:
- Aura can occur before, during or after the onset of a headache.
- An aura can also occur independently, with no relation to the headache.
- An aura usually builds up over five to 20 minutes and lasts less than an hour.
- Most commonly, visual symptoms occur during the aura. The person may report seeing flashes of light, colorful or bright shapes, shimmering spots, or loss of vision.
- Hearing various kinds of sound.
- Difficulty talking.
- Weakness or numbness of the face or one side of the body.