Migraine Attacks Often Cant Be Prevented
Many people who experience migraines see improvement in their symptoms when they take steps to make life more regular, consistent, and predictable, Cowan says. This includes sleeping, eating, and exercising on a regular schedule. But the benefits of these behaviors are limited for many people.
I do all those self-care routines, and I still experience chronic migraines, says Kessel, who worries that overemphasizing the benefits of preventive steps may further stigmatize those who dont benefit much from them. If I didnt sleep on a regular sleep schedule, would my migraine attacks be worse? Probably. But I still have this condition, she says. Its not the cure.
Jacobson notes that while a small percentage of people who experience migraines can identify a single food that triggers their attacks, most people have multiple triggers, many of which cant be avoided. If you have a hormonal trigger and youre a woman, she says, or a barometric trigger like a cold front coming in, you cannot always avoid it.
Can Migraines Be Prevented Or Avoided
Medicine to prevent migraines may be helpful if your headaches happen more than 2 times a month. You may want to consider this medicine if your headaches make it hard for you to work and function. These medicines are taken every day, whether you have a headache or not.
Preventive medications for migraines can include prescription drugs often used to treat other ailments. Anti-seizure medicines, antidepressants, medicines to lower blood pressure, and even Botox injections are some of the preventive medications your doctor may prescribe. Calcitonin gene-related peptide inhibitors can also help prevent migraines. They do so by blocking a gene-related peptide in your sensory nerves. This peptide is known to increase during a migraine attack, so blocking it can help prevent migraines.
There are also a number of non-medical treatments designed to help minimize migraine pain and frequency. One is an electrical stimulation device, which has been approved by the FDA. It is a headband that you wear once a day for 20 minutes to stimulate the nerve linked to migraines. Another non-medical treatment is counseling aimed at helping you feel in more control of your migraines. This counseling works best when paired with medical prevention of migraines, as well.
Botulinum Toxin Type A
In June 2012, NICE recommended the use of a medicine called botulinum toxin type A by headache specialists to prevent headaches in some adults with long-term migraine.
Botulinum toxin type A is a type of nerve toxin that paralyses muscles.
It’s not exactly clear why this treatment can be effective for migraine.
NICE recommends that this treatment can be considered as an option for people who have chronic migraine that has not responded to at least 3 previous preventative medical treatments.
Under the NICE guidelines, botulinum toxin type A should be given by injection to between 31 and 39 sites around the head and back of the neck.
A new course of treatment can be given every 12 weeks.
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Whats A Migraine What Does A Migraine Feel Like
A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that its the sixth most disabling disease in the world.
Why Are Migraine Triggers Important
A few people are aware of at least some of their triggers. Others are confused when a suspected trigger sometimes results in an attack, but not every time. Understanding your migraine triggers can help you unravel the mystery of why you get migraine attacks. Imagine that your body has a migraine threshold, which allows you to tolerate the effect of migraine triggers without ill effect until this threshold is crossed. Varying triggers occur over a period of time and act by building up in combination, until they cross your migraine threshold. At this point a migraine attack occurs.
This explains why apparently similar situations do not always result in a migraine attack.
Your migraine threshold can fluctuate and the number or importance of triggers can vary. An example to illustrate this might be that missing a meal, or less obvious triggers such as flickering sunlight or a lack of sleep, may not always bring on an attack. However, if any or all of these are combined with a period of stress or hormonal changes, an attack may occur. By identifying and addressing your triggers, you may reduce the frequency of attacks and use less medication. Many patients find it possible to prevent migraines by modifying their lifestyle and preventing interaction of their migraine triggers.
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It Can Wreak Havoc On Your Work Family And Social Life
A lot of people who get migraines experience rifts in relationships that may never heal, says Jacobson. Many people have lost their families, she says. I have spoken to so many who have had to ship their kids to the grandparents. So that adds to the depression and the anxiety of it, because you just never know if youre ever going to get better.
Just as bad, Jacobson says, is the risk of losing your job a story shes heard many times. When someone calls in sick repeatedly, supervisors will say, What is wrong with you? Just come in. No, youre not allowed to take off one more day. And its not just bosses but fellow employees who contribute to the problem, according to Jacobson. People feel angry that they have to cover for , she says. Nobody else believes a migraine.
And people who get migraines often lose friends over time. When you cancel plans with people, they think youre making it up, or that you just dont feel like going, Jacobson says, even though in reality, you would do anything to be out at the beach, or be with your kids, or be with your friends. And its very, very depressing to have to lie in a dark room instead.
But one pleasant surprise that many parents experience, according to Jacobson, is that their kids turn out all right. When youre going through it, you feel like a terrible mom or a terrible dad, she says, but most of the time, your kids end up being really empathetic and understanding.
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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What Tests Are Used To Find Out If I Have Migraine
If you think you get migraine headaches, talk with your doctor. Before your appointment, write down:
Your doctor may also do an exam and ask more questions about your health history. This could include past head injury and sinus or dental problems. Your doctor may be able to diagnose migraine just from the information you provide.
You may get a blood test or other tests, such as CT scan or MRI, if your doctor thinks that something else is causing your headaches. Work with your doctor to decide on the best tests for you.
Living With Migraines Takes Courage And Resilience
Imagine how hard it is to drag yourself out of bed, in pain, day after day, and fight a disease that others think is stress induced or imagined, says Dumas. It takes courage to keep fighting.
Kessel is encouraged by people who show up at Miles for Migraine events with a determination to spread awareness about their condition. If you want a cure for this disorder, you need to start advocating for yourself, she says. You need to get up and make some noise about your condition, and come out of the closet and not be silent.
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Alternative And Complementary Therapies
In addition to medications, lifestyle changes can help you avoid certain triggers, potentially preventing some migraine attacks. Practicing relaxation exercises, such as yoga and meditation, may ease migraine pain.
While the evidence isnt definitive, some people with migraine have found that home remedies and alternative therapies such as acupuncture and biofeedback are effective. Consult with your healthcare provider to find an approach that works for you.
According to MedlinePlus, you should see your doctor if there are changes in your headache pattern, if treatments youve been using stop working, if your headaches are more severe when youre lying down, or if you have bothersome side effects from your medication.
You should call 911 if you have problems with speech, vision, movement, paralysis, or loss of balance, particularly if youve never had these symptoms before with a migraine. If your headache starts suddenly, it may be an emergency.
What Are Common Triggers For Migraine
Certain foods, in particular cheese, chocolate, alcohol, citrus fruits, dairy produce, and many others have been implicated in triggering migraine. However, the true link with migraine is uncertain as craving for specific foods can occur as part of migraine, before the headache starts the premonitory stage.
Also, because several factors are necessary to trigger an attack it follows that if other factors can be identified and minimized, then food triggers will be less important. If you suspect that any foods do trigger an attack, cut them out of your diet for a few weeks before reintroducing them.
Delayed or missed meals often result in a relative drop in blood sugar, triggering migraine. This is usually the most important trigger in children particularly when they are going through a growth spurt or involved in strenuous exercise. It explains why many children come home from school with a bad headache they just havent had sufficient to eat, often enough. But insufficient food may also be an important migraine trigger in adults.
Mild dehydration can have an impact on people who have migraine. It is recommended that you should drink at least 8 glasses of water per day. This is in addition to any other drinks you may have. Fizzy drinks can contain the sweetener aspartame, which some people link to their migraines.
Change in routine
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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.
When Should I Seek Help For My Headaches
Sometimes, headache can signal a more serious problem. You should talk to your doctor about your headaches if:
- You have several headaches per month and each lasts for several hours or days
- Your headaches disrupt your home, work, or school life
- You have nausea, vomiting, vision, or other sensory problems
- You have pain around the eye or ear
- You have a severe headache with a stiff neck
- You have a headache with confusion or loss of alertness
- You have a headache with convulsions
- You have a headache after a blow to the head
- You used to be headache-free, but now have headaches a lot
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How Is Migraine Diagnosed
Theres no single test that can lead to a diagnosis of migraine. Rather, your doctor will take your medical history, as well as obtain your family history of migraine, and perform a physical and neurological exam. Your healthcare provider may order certain blood tests and imaging tests to rule out other causes of headache. Keep a detailed log of your symptoms to help with diagnosis.
Reducing The Severity Of A Migraine Attack
In addition to preventing your attacks through the above steps, there are acute medications you can take that can reduce the severity of the attack. These include over-the-counter or prescription analgesics, triptans, and ergot alkaloids.
I tell all my patients, Our goal with you is to get you down to one to two headaches per month that you can make go away within an hour, and until we get to that goal, were going to keep working with you, Dr. Hershey says. Once you get to the goal, then its your job to help maintain that.
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Dehydration And Caffeine Withdrawal
About one-third of people who get migraine attacks note dehydration as a trigger.
Obviously, you cant drink water while youre asleep, so its possible that waking up dehydrated is a reason why people are more prone to getting migraine attacks in the morning.
The wee hours of the morning also tend to mark a full day since your last caffeine fix. Coffee and other forms of caffeine dilate the blood vessels in your brain, relieving tension. And caffeine withdrawal has been connected to migraine attacks.
Migraine happens in several different stages. You may wake up with the pain of a migraine attack, but that doesnt mean you didnt experience the other phases of migraine in the hours or days before the pain.
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.
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Are There Different Kinds Of Migraine
Yes, there are many forms of migraine. The two forms seen most often are migraine with aura and migraine without aura.
Migraine with aura . With a migraine with aura, a person might have these sensory symptoms 10 to 30 minutes before an attack:
- Seeing flashing lights, zigzag lines, or blind spots
- Numbness or tingling in the face or hands
- Disturbed sense of smell, taste, or touch
- Feeling mentally “fuzzy”
Only one in five people who get migraine experience an aura. Women have this form of migraine less often than men.
Migraine without aura . With this form of migraine, a person does not have an aura but has all the other features of an attack.
When To Get Medical Advice
You should see a GP if you have frequent or severe migraine symptoms.
Simple painkillers, such as paracetamol or ibuprofen, can be effective for migraine.
Try not to use the maximum dosage of painkillers on a regular or frequent basis as this could make it harder to treat headaches over time.
You should also make an appointment to see a GP if you have frequent migraines , even if they can be controlled with medicines, as you may benefit from preventative treatment.
You should call 999 for an ambulance immediately if you or someone you’re with experiences:
- paralysis or weakness in 1 or both arms or 1 side of the face
- slurred or garbled speech
- a sudden agonising headache resulting in a severe pain unlike anything experienced before
- headache along with a high temperature , stiff neck, mental confusion, seizures, double vision and a rash
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Genetic And Environmental Factors
The reason youre getting migraine could be because your parents or close family members have the genes, Dr. Hershey says. However, there are a few simple things you can do to reduce your chances of experiencing a migraine attack. We cant change our genes, but we can change the environmental influence on those genes, Dr. Hershey says. Oftentimes, by taking better care of themselves, people can lessen that impact of migraine.
Taking better care of yourself is one way to prevent migraine attacks. To do so, there are four main healthy habits patients with migraine should maintain, Dr. Hershey says: