There are many kinds of headaches. Migraine headaches may involve:

  • Severe pain on one or both sides of the head

  • Upset stomach

  • Sensitivity to lights and sounds

  • Changes in vision

The pain of a migraine headache is described as intense, throbbing, or pounding and can be felt in the forehead, temple, ear, jaw, or around the eye. Migraine often starts on one side of the head but may spread to the other side.

Pre-Migraine Symptoms

Some people notice vague symptoms before the migraine starts. These can include:

  • Mental fuzziness

  • Mood changes

  • Fatigue

  • Retention of fluids

Neurological Symptoms

Some people may have neurological symptoms called an aura up to an hour before the headache starts. You may see flashing lights, zigzag lines, or may lose vision for a short time.
Other symptoms of aura may include:

  • Trouble talking

  • Weakness of an arm or leg

  • Tingling of the face or hands

  • Confusion

Headache Phase

During the headache phase of a migraine, you may have diarrhea, increased urination, nausea and vomiting. The pain of a migraine can last several days.

Migraines can strike as often as a few times a week, or as rarely as once every few years. It can happen at any time.

Chronic Migraine

Sometimes, migraines can happen daily or almost daily. This is called chronic migraine. Some people have migraines at the same times such as around menstruation or every Saturday morning after a stressful week of work.

Causes

There are many theories about what causes a migraine. Complex changes happen in the brain during and between migraine attacks. Often, migraines may run in families. Headache triggers are different for each person. Some people do not know of any triggers, while others list one or more triggers. What may trigger a migraine one time may not trigger one every time.

Common Triggers

  • Stress

  • Hormonal changes

  • Certain foods

  • Alcohol

  • Too much or too little sleep

  • Skipping meals

Medicine overuse headaches may also happen when you use either caffeine or short-acting pain medicines more than two days a week.

Treatment

There are many treatment options for migraines. Success often involves both lifestyle changes and medicines.

The goals of treatment are to:

  • Decrease the number and severity of your headaches.

  • Allow you to be active, get back control of your life.

  • Enjoy life as fully as you can with as few side effects as possible.

Treatment Methods

  • Medicines

  • Biofeedback training

  • Stress management

  • Getting rid of caffeine

  • Getting rid of certain foods

  • Aerobic exercise, such as swimming or vigorous walking

  • Yoga

Types of Medicines

  • Preventive medicines that prevent and decrease the number and intensity of the attacks.

  • Abortive medicines that treat a headache once it has started.

Preventive Medicines

If you have migraines more than twice a week or 1-2 headaches per month that effect your daily life, you should be take a preventive medicine. These medicines include:

  • Propranolol

  • Amitriptyline

  • Valproate

  • Topiramate

  • Others

You need to take these medicines every day for them to work. It may take a few weeks for them to start working, so be patient. For some patients with chronic migraine (daily or near daily headaches) treatment may include Botox injections.

Abortive Medicines

For less frequent migraines, you can take medicines at the first sign of a headache to stop it or ease the pain. Using these medicines too often can cause medicine overuse headaches.

One of the medicines often used to stop a migraine is called a triptan. Another is ergotamine tartrate. For best results, you need to take these during the early stages of a migraine.

Caffeine can also be an abortive medicine for headaches, but daily caffeine use can make headaches worse. At times, you may need to stop using caffeine to help your headaches get better.

Over-the-Counter Medicines

Other pain medicines can sometimes help to stop a migraine. These include over-the-counter medicines such as aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®). You should always get your doctor’s advice before you use these to treat migraines.

Opioid Pain Medicine

Sometimes opioid medicines are prescribed but these can cause headaches to be worse.

Side Effects

Many headache medicines can have side effects. But like most medicines they are fairly safe when used with care and under your doctor's orders. Make sure you know the side effects of your medicines. Your doctor can help answer any questions.

Other Pain Relief Methods

During a migraine headache, a cold pack may give short term relief.

Biofeedback and Relaxation Training

Medicine for migraines is often combined with biofeedback and training on how to relax. Biofeedback is a way to give people better control over body functions such as blood pressure, heart rate, temperature, muscle tension, and brain waves.

You can practice biofeedback at home with a portable monitor. But the goal of treatment is to do biofeedback without a machine to help you. You can then use biofeedback anywhere at the first sign of a headache.

Diet

Many people with migraines are helped by changing their diet. Talk to your doctor about whether a diet change could help.

Planning Your Treatment

Your doctor will help you set up a treatment plan for your headaches. Write it down and keep a copy with you. If you need to see a different doctor about your headaches, your treatment plan will help you get the best care.

To Find Out More

American Council for Headache Education

1-800-255-2243

www.achenet.org

National Headache Foundation

1-800-843-2256

www.headaches.org

National Institutes of Health Neurological Institute

1-301-496-5751

www.ninds.nih.gov