Headaches, like people, come in all shapes and sizes. Possibly the best known type of headache is the migraine, which is believed to affect about three million Canadians. Migraine can strike anyone at any time of life, but it is three times more common in women and usually appears for the first time during early adulthood. About 80% of sufferers have a family history of migraine.
A migraine is not just another headache. Migraine is a condition that causes severe, recurring pain that is often accompanied by nausea and vomiting. During an attack, it is very difficult for the person to function normally, and many people find that they must lie down in a quiet, dark place until the pain eases up. When untreated, most attacks last between four hours and three days. The frequency varies from person to person, and some people experience several headaches a month while others may go a year or more between attacks.
Scientists are unsure about the exact cause of migraines, but many believe they are due to malfunctions in the nervous system that are triggered by imbalances in brain chemicals. One thing is certain, though, and that is that a change in blood flow in the brain is a key element of a migraine headache.
There are a number of different types of migraines. The two main varieties are migraine with aura (formerly called classic migraine) and migraine without aura (formerly called common migraine). About 20% of migraine sufferers have migraine with aura. What sets these two types apart is a combination of unusual sensations called an aura that appears about 15 to 30 minutes before the pain. These sensations generally include blurred or double vision, the appearance of
flashing coloured lights or zigzag patterns, and tingling or numbness in the limbs. In rare cases, weakness or language and speech problems may occur.
When the migraine occurs, it is likely to produce:
- moderate to severe pain—frequently on one side of the head only—that is
strong enough to hinder regular daily activities
- head pain that pulses or throbs
- pain that worsens with physical activity
- nausea, sometimes with vomiting
- sensitivity to light and sound.
While the underlying cause of migraine requires further study, we do know some of the things that can trigger an attack. Stress is one of the major migraine triggers, but what is unusual is that the headaches often occur during the let down phase that follows a stressful event or period rather than at the most stressful point. A good example of this is the weekend migraine that follows a particularly stressful week at work. Lowering the stress level by learning to relax may help reduce the severity of these headaches. Exercise and techniques such as biofeedback or meditation that help reduce stress provide relief to some migraine sufferers.
Many women find that changing hormone levels during menstruation and ovulation may also lead to migraines.
Environmental factors such as bright lights and sun glare can produce a migraine. So can smells—both pleasant ones, such as perfume and flowers, and unpleasant ones like paint thinner and cigarette smoke. A change of weather, season, altitude, or barometric pressure are other common triggers. Changes in sleep patterns can also bring on a migraine. Some people find that intense physical exertion (including sexual activity) may be a problem as well.
What you eat can also affect the frequency or intensity of a migraine. Foods that are known to cause trouble include:
- aged, cured, and processed meats (such as hot dogs and cold cuts)
- aged and processed cheeses
- dairy products such as buttermilk and sour cream
- alcohol, especially beer and red wine
- pickled, fermented, and marinated foods
- food additives such as monosodium glutamate (MSG) and aspartame.
While the list above includes many of the common migraine triggers, the triggers are not the same for everyone. Your headaches may not be triggered by the things listed, but they may be linked to any number of other factors in your life. Because of this, keeping a headache diary can play an important role in controlling migraines.
A headache diary is a simple record of what foods you eat and when you eat them, what activities you participate in, the time of day a headache strikes, your emotional state when you get a headache, and where you were and what you were doing when the headache struck. After a while, you will probably begin to see a pattern. For example, you may discover that drinking coffee or going to the movies triggers your migraines. That points to the obvious solution of avoiding caffeine and movie theatres. Sometimes the trigger can’t be avoided completely, but we can adjust our activities to limit our exposure to these triggers.
Unfortunately, sometimes drugs used to treat other conditions turn out to be migraine triggers. If this turns out to be your problem, you will need to discuss it with your doctor and pharmacist. They may be able to suggest a different medicine that won’t cause this problem.
The first step in treating migraine headaches is to identify your triggers and avoid them as much as possible. When that isn’t possible, there are medicines that can help. Migraine medications fall into two categories: drugs that prevent headaches from occurring and drugs that stop a headache once it has begun. The decision about what type of treatment is right for you will depend on the frequency and severity of your headaches, the degree of disability the headaches cause, and any other health conditions you may have.
Generally, preventive medicines are used in people who have two or more debilitating headaches a month, who take pain relief medications more than twice a week, and whose pain is not relieved by medication.
In addition to medication, some people find some relief from resting in a dark room and applying ice to the painful area. Some find biofeedback and relaxation techniques helpful.
Some headache sufferers turn to complementary and alternative medicine for relief. Acupuncture, biofeedback, massage, and supplements are among the techniques that may provide relief. Some research shows that oral magnesium supplements and high doses of vitamin B2 (riboflavin) may be helpful, but the study results are not conclusive. Because complementary treatments can have effects on other health conditions and therapies, it is important to discuss their use with your doctor before trying them.
Headache is such a common problem that many people suffer in silence because they don’t think anything can be done. That simply isn’t true. Help is available for recurring headaches, all you have to do is ask for it. If you have any questions about headache treatments, please consult your London Drugs pharmacist.