What Triggers Migraines and How Can You Manage Them?
By Pamela Howard, MD
If you’ve been experiencing migraines more than usual lately, you’re not alone. Seasonal changes (yes, even here in mild and pleasant Texas) are one of the many triggers of this impairing head pain. What makes migraines different from regular headaches is the associated symptoms that go along with them. If other ailments like nausea, sensitivity to lights or noise, or dizziness accompany your throbbing head, there’s a good chance you’re suffering from a migraine. The good news is that there are lifestyle changes you can make to reduce the chances of encountering this unpleasant affair.
What Does a Migraine Feel Like?
Migraines are headaches that typically cause severe throbbing or pulsing sensations, which classically are localized to one side of the head but can cause pain anywhere from the neck to the top of the head. Migraines usually become progressively worse over time before reaching a peak. They can last anywhere from 4 to 72 hours but can rarely last months or even years, which is called chronic migraine.
In addition to severe head pain, migraine sufferers can also experience nausea, diarrhea or vomiting. Some migraines can even cause these symptoms without the associated head pain, making them difficult to diagnose. These are called acephalgic migraines, of which vestibular migraine is the most common.
Stages of a Migraine
Migraines happen in stages, though not every patient will experience them all. The “prodrome” stage happens pre-migraine, usually a day or two before the head pain starts. This stage can include:
- Loss of appetite
- Stiff neck
- Increase in urination
- Excessive yawning
- Food cravings
After the prodrome stage comes auras. Only a third of people with migraines experience auras. Visual changes such as zig -zag shapes, spots, or tunnel vision are most common, but tingling or numbness in the hands can occur. Auras typically occur 10-30 minutes before a migraine starts and are linked to mental fatigue and disorientation. Other symptoms include:
- Loss of vision
- Hearing sounds that aren’t there
- Trouble speaking
- Weakness on one side of the body (can be mistaken for a stroke)
Then, mercilessly, comes the headache attack. Migraines can last a few hours or even a few days and often are so debilitating they cause the patient to retreat to a dark, quiet room to wait it out. After the attack period, some patients might experience a postdrome phase, leaving them feeling drained, exhausted, moody, and sensitive to light and sound. Overall an unpleasant and drawn-out experience!
What are the Common Triggers of Migraines?
From environmental factors to hormone cycles, migraines result from both internal and external factors or a combination of the two. Though anyone can experience migraines, they’re most common in young women.
Migraines typically rear their ugly heads right before a woman’s period starts because this is when estrogen and progesterone levels are at their lowest. They can also occur mid-cycle and be caused by hormonal birth control. Sometimes, birth control pills can make migraines better, but for many patients, it makes them worse. While menopause may not be a welcome change for many women, the silver lining is that migraines occur less frequently in this phase of life.
While most people associate turning seasons with allergy or sinus headaches, changes in barometric pressure can provoke migraines. Weather-related triggers also include changes in humidity and temperature, storms, or dusty and dry environments.
The list is seemingly endless for migraine triggers. Bright, flickering lights, the hot, beating sun, a lack of sleep, loud noises, certain foods, alcohol, and stress can all cause migraines. A simple argument with a spouse or a bad day at work is also to blame – and unfortunately, sometimes immediate action to rectify the stressor (like taking a vacation) can also prompt head pain. This is called a “holiday headache.”
Migraine attacks may be an unfortunate downside for those who have gotten used to working from home. Because work-from-home employees naturally lose out on steps and activities associated with commuting, they often spend more time at their desks. If they don’t have an ergonomic chair or ideal desk setup, their posture can be negatively affected. This is known as the “slumped shoulder syndrome,” caused by the weight of your head putting stress on your neck.
When it comes to migraines, caffeine is a double-edged sword. Consuming caffeine or withdrawing from it can cause a migraine attack; however, some patients may benefit from drinking caffeine to stave off symptoms. This is because caffeine has vasoconstrictive properties that help alleviate pain from blood pressure increases that surround nerves.
How Can You Manage Migraines?
Migraines are high maintenance – they prefer their host to be incredibly boring. That means going to bed at the same time every night, getting enough high-quality sleep, eating healthy, avoiding processed foods, exercising regularly, and staying hydrated are all critical for keeping migraines at bay.
When patients are triggered by events outside of their control, like storms or changes in humidity, some medications can help assuage the pain. Over-the-counter supplements such as magnesium, vitamin B2, CoQ10, and Butterbur can mitigate migraine pain. Ibuprofen and aspirin may also help with mild migraines.
For patients that experience severe migraine-related symptoms like excessive vomiting, we recommend visiting our clinic for a proper diagnosis and treatment plan. At Advanced Pain Care, we initiate treatment with a variety of medication options. If medication doesn’t work, we will progress to other treatment options such as nerve blocks.
Migraine pain should not control your life! Frequent headaches are not normal and should not be treated as such. Those experiencing chronic migraines (15 or more a month) should not rely on over-the-counter medications like ibuprofen (as they are not meant to be taken on a regular basis) and instead come in to visit one of our experienced doctors. If you’re struggling with migraine pain that won’t go away, it will be our pleasure to help you find relief!