Migraine Headaches

 What are migraines and how can I prevent them?

As a Neurologist with a specialty in Headache Medicine;  This is what I tell patients with migraine headaches

What are migraines?  Migraines are a primary headache disorder of recurrent attacks of moderate to severe pain.  The pain is often described as a throbbing or a pulsing pain which is typically located on one side of the head.  This can be accompanied by light and noise sensitivity, upset stomach, and visual changes (aura).  Migraines may present in different ways and maybe misdiagnosed by as tension headaches or sinus headaches.

What causes migraines? For many years it was believed that migraine attacks were due to changes in the blood vessels in the brain.  It is now believed that migraines are probably genetically induced hypersensitivity of the neurons in the central nervous system. This results in the brain neurons being more sensitive to their environment and thus has a lower threshold for developing a headache. Hormones, foods, noises, smells, lights, and stress all play a part in causing headaches.

How are migraines diagnosed? Migraines are diagnosed clinically by talking with your doctor. There are no x-rays or blood tests that will diagnose migraines. Generally, no tests are needed when migraine is suspected.

Who gets Migraines? Migraines affect 12 % of the U.S. population. Men and women of any age can get migraine headaches. However, migraines are most common in women in their teens to menopause.  Migraines often run in families.

Why did I get migraines? Every person has a headache threshold.  For a lucky few, it may take a sledgehammer to give them even a mild headache.  However for those with frequent headaches, something as simple as a missed meal may lower their headache threshold enough to start a disabling migraine.  Everyone has different migraine triggers to increase their headache threshold. The way I like to describe migraine is to think of it like a cup; once the cup is full = migraine.  Some people start with a cup that is already almost full and only one other trigger such as hormonal issue can make the cup full and thus trigger a migraine.  Other people have very little in the cup to begin with so it takes multiple triggers before the cup is full, and thus harder to trigger a migraine.

What are some common migraine triggers?

  1.     Sleep pattern changes, either too much or too little
  2.     Increased stress in everyday life
  3.     Menstrual cycles or hormonal changes (for women)
  4.     Weather changes/fronts
  5.     Foods; There a lot of foods that has been reported to trigger migraines in some people.  Some of the most commonly reported causes include
    1. Caffeine
    2.  Aspartame
    3.  MSG from Chinese food
    4.   Nitrates and nitrites
    5.   Red wines and alcohol
  6.  Dehydration

For more information on migraine triggers see recent blog post on triggers.

Conservative ways to prevent/decrease migraines:

  1. Get good restorative sleep; try to wake up and go to sleep at about the same time every day.  If you snore please seek medical evaluation and treatment for this, it may be sign of obstructive sleep apnea which can cause headaches, and also other medical problems such as high blood pressure, heart attack, and strokes.
  2. Stress reduction; obviously it is hard to get rid of all the stress in your life, but you need to find ways to better deal with the stress.  Such as: talking about problems, relaxation, messages, and exercise.
  3. Make exercise a routine part of your life.  Migraine may worsen when you exercise with a headache.  Recent studies however show that participants who routinely exercise had a decrease in the frequency and severity of their migraines.  I recommend exercising 5-6 times a week.  Exercise also help to decrease other migraine triggers such as anxiety and stress. It can improve sleep, decrease weight, increases natural pain reducing chemicals, and increases natural endorphins (feel good chemicals) in the brain.  For more information see “Exercise to prevent your migraines” post.
  4. Practice relaxation exercises on a daily basis. Whether it is through biofeedback, deep breathing, mediation, guided relaxation, cognitive-behavioral treatment, yoga, or Tai Chi, these practices can help decrease the hyperexcitation of the brain, thus decreasing likelihood of getting a migraine, help you deal with the migraine better, and help you deal with other outside stressors.
  5. Weight loss: Obesity is associated with an increase in frequency of migraines in people with migraines.  It is unclear why, some feel it is due to the higher levels of inflammation in the body.
  6. Hydration:  Drink at least eight 8 ounces of water daily, this may need to be increased in the summer months, if exercise regularly, or drink dehydrating fluids such as caffeine or alcohol.
  7. Limit or stop drinking caffeine: If suddenly stop drinking caffeine may get caffeine withdraw headache.  If must drink caffeine try to drink less than two servings a day.
  8. Eat regularly: do not skip meals, especially breakfast. I also recommend eating smaller more frequent meals.  (See addition information in “Migraine Diet” blog)
  9.  Maintain a headache diary: this helps you keep track of any possible triggers (lack of sleep, food, hormones, stress) that might have trigger but also shows if migraine frequency is improving or worsening.

Medical treatment for migrainesThere are medications that can decrease the frequency of your migraines and also medication to take when you have a migraine.  For more information please discuss with your Neurologist.

This site is purely informative and should not be considered medical advice. It is not intended to be used to diagnosis or treat any disease.  Please consult your physician before starting any fitness program or new supplement.