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Treating Migraine Headaches Starts With Prevention

Today's Medicine
Published: May 20, 2019

 

If you’ve never experienced a migraine, it can be difficult to understand.

You’re probably familiar with tension headaches – an aching pain or pressure that is relatively mild. A migraine, on the other hand, is intense. The pain can be so incapacitating that you can’t go to school or work. It’s more than just a severe headache.

Over 37 million Americans suffer from migraines, according to the American Migraine Foundation. One in four households has a member who suffers from one of the types of migraines. Women are three times more likely than men to experience the neurological condition, and children also can develop it.

Fortunately, it’s something primary care providers see frequently and are comfortable treating.

 

Migraine symptoms

A migraine attack is often preceded by what’s called an “aura,” a sensation such as a funny smell or a visual disturbance like seeing wavy lines or lights. Not all migraine sufferers experience an aura beforehand.

After the migraine begins, symptoms can include:

  • Sensitivity to light or sound
  • Vision problems
  • Nausea or vomiting
  • Pulsing pain on one or both sides of the head

A migraine attack can last from a few hours to a several days. A person with symptoms for more than 15 days a month may be suffering from chronic migraines.

Migraine sufferers usually begin to experience them in their teenage years, but they can begin in childhood or middle age. It’s especially important that you see a doctor if you experience migraine-like symptoms later in life because it could be a sign of another illness.

Rarely, migraines can include symptoms that may be confused with a stroke – such as numbness or tingling in the face, or weakness on one side of the body. These “complex migraines” aren’t common, but their symptoms can be serious and scary. If you have no history of migraines and experience these symptoms, get help immediately.

 

What causes migraines?

Since I can’t see migraines, what a patient tells me is key in diagnosis. Information about any aura symptoms, frequency of headaches and family history (there’s a strong genetic link) are helpful. Common patterns and triggers include:

  • Stress
  • Certain foods
  • Caffeine
  • Alcohol
  • Lack of sleep
  • Menstruation
  • Overuse of painkillers

 

Prevention and treatment

Taking preventive measures is an important part of treating migraines. While there are steps you can take on your own, seeing a primary care provider may be necessary. Common treatment options include:

Prevention: Try keeping a journal to identify what’s triggering your migraines. Are there any common denominators? Once you pinpoint something, work on avoiding it and adjusting your lifestyle. Getting regular exercise and plenty of sleep can help.

Find a quiet place: Many people experiencing migraines find relief after lying down in a calm, quiet, dark area. If someone you know is having a migraine, respect their need for time in that kind of environment.

Over-the-counter medication: Analgesics like acetaminophen and ibuprofen are a common way to treat migraines. However, it should be noted that overuse of these and other drugs can lead to more headaches

Prescription medication: Patients often seek a doctor’s advice when the measures above fail. Triptans – a class of drugs developed to treat migraines – may be an option in these cases and can be very effective when taken early in the onset of a headache.

Prevention therapy: This approach may benefit people experiencing migraines most days of the week. Prevention therapy may include lifestyle changes, medication to treat migraines and medication to prevent or suppress them.

New medications: Some patients inquire about newer injectable drugs meant to prevent chronic migraines. I advise patients to first try preventive strategies and traditional medications we know more about.

Specialists: It’s rare, but a patient may need to work with a neurologist for further care and therapies.

Strong pain medicine: There is sometimes a need for drugs like opioids or morphine, but we try to avoid this form of treatment at all costs. It’s important that you work with your primary care provider to develop a treatment plan before untreated migraine pain leads you to an emergency room or urgent care facility in need of strong drugs. 

 

Your doctor can help

You don’t have to fight this battle alone. While migraines are a common medical problem, your story is unique, and your primary care provider can help you take control.

More resources

Brian Couse

About the Author:

Dr. Brian Couse is a family medicine physician at Methodist Physicians Clinic Red Oak. He enjoys practicing in a small-town setting while making a difference in people’s lives.

“When patients call in, they know that we’ll be there for them,” he said.
 

See More Articles by Brian Couse