Migraine is more than head pain. It is a neurological disease that can be inherited (passed down) from a parent to a child. Neurological disorders affect the nervous system, which includes the brain and pain fibers from the tissues surrounding the brain. Migraine disrupts the way the brain processes pain, light, sound, and smell. This leads to discomfort from normal input such as sunlight or music. It causes migraine attacks that usually last hours to days. For some people with migraine, the headache can be continuous.
Migraine attacks are usually accompanied by nausea. They can also cause other neurological symptoms such as changes in sight, dizziness, numbness, weakness, and difficulty speaking. For some, these symptoms can be even more disabling than the headache.
What causes migraine?
Migraine has no known cause, but the condition can be passed down from a parent to a child. While there are triggers that can bring on headache attacks in migraine, those are not the cause of the condition.
How common is migraine?
About 36 million people in the US have migraine. It affects men and women of all ages and across every socio-economic (educational and income) group. About 4 out of every 100 people have some form of daily headache, with migraine accounting for the largest part of that.
Migraine is more common in women than in men. About 18% of women have migraine compared to 6% of men. Worldwide, migraine is the 2nd leading cause of disabled days in men and women. It causes more disabled days than stroke, epilepsy, and multiple sclerosis.
How is migraine diagnosed?
There is no test to diagnose migraine. A doctor can usually tell if the headaches you are having are migraine by asking about your symptoms and family history, and by examining you. If the doctor thinks that there could be another cause of your headaches, he or she may do tests to try to learn what it is.
How can I get care for migraine or headache disorder?
Maybe you get a lot of headaches, or your headaches stop you from doing your normal activities. Maybe you’ve already been diagnosed with migraine. In every case, it’s important to know that there are healthcare providers who can help you.
For many people, the diagnosis is made by the primary care physician (PCP). He or she can often provide the necessary care. In fact, some PCPs have additional training in migraine disease and other headache disorders. If your PCP is unable to manage your migraine, he or she may refer you to a neurologist or a headache specialist. Neurologists are doctors who specialize in treating the nervous system, which includes the brain. They all have additional training in treating headache disorders.
Some neurologists are also headache specialists. Your PCP will likely know of a neurologist or headache specialist in your area who may be able to help you.
What should I do to prepare for my first doctor visit for my headaches?
If possible, keep a headache diary for as many days as possible before your visit. Whether or not you keep a diary, you should be prepared to answer the following questions:
- When did you get your first headache?
- Do you have family members who get headaches? (Their headaches do not have to be as severe as yours.)
- How often do you get headaches?
- How long do they usually last?
- How intense are they on a scale of 1 (not very intense) to 10 (extremely intense)?
- What is the location of your headaches?
- What kind of pain do you usually have? (For example, sharp, dull, aching, throbbing, pounding, searing)
- Are there triggers that usually bring on your headache? (For example, bright lights, loud sounds, alcohol, weather, lack of sleep)
- What do you do when you get a bad headache? Are there things you avoid doing?
- What medicine(s), including over-the-counter medicines, do you currently take for the headaches (including the dose and how many days per week you are taking them)?
- What medicines have you tried in the past?
What are the most common treatments for migraine?
For some people with migraine, avoiding triggers, using over-the-counter pain medicine, and complementary medicine or behavioral treatments such as meditation, stress reduction, biofeedback, and guided imagery will be enough. For more severe or frequent migraine, the doctor may prescribe prescription medicines.
There are two groups of medicines that can be used to treat migraine: acute medicines and preventive medicines.
Acute medicines are used to treat a headache while you are having it. It can treat the pain and other symptoms associated with migraine. Examples include prescription triptans (sumatriptan, rizatriptan, naratriptan, frovatriptan, zolmitriptan, almotriptan, eletriptan) and prescription and over-the-counter non-steroidal anti-inflammatory medications (naproxen, ibuprofen, diclofenac). Acute treatments should be taken no more than 2 days per week in order to avoid making the headaches worse over time.
Preventive medicines are taken every day with the goal of reducing the frequency and intensity of headache over time. If you are having headaches more than 8 days a month (or fewer if they are severely disabling), your doctor may prescribe a preventive medicine. There are several classes of preventive medicines that are used to prevent migraine. If your doctor prescribes a preventive medicine, it will likely take some time to find the right dose. In addition, these medicines can take several months to have their full effect. This is referred to as a trial period.
While there are dozens of preventive medicines on the market, a lack of funding for research means that no new migraine-specific preventive medicines have been developed in decades. What’s more, no new migraine-specific acute medicines have been developed since the triptan class in the late 1980s.
A new class of medicines, called anti-CGRPs, will be available in 2018. In addition, new medical devices have been developed over the past few years, and more are expected to come to market.
AHDA – Alliance for Headache Disorders Advocacy
The Alliance for Headache Disorders Advocacy is comprised of nonprofit organizations who are vitally concerned about the health of patients with headache disorders including migraine disease, cluster headaches, chronic daily headache, new daily persistent headache, tension-type headaches. All headache disorders.
The AHDA is dedicated to advocacy efforts that can result in better treatment for all headache disorder patients.