Migraines Articles

Cheat Sheet / Updated 03-27-2016

Besides a side-splitting headache, a variety of symptoms can occur when you have a migraine. Identifying common migraine signs will help: determine triggers (causes), create a plan to prevent migraines, and recognize warning signals that require medical attention. Steer clear of migraine myths so they don't hinder your diagnosis and treatment

Article / Updated 03-26-2016

As if migraines aren't big enough mischief-makers as it is, they also like to sing show tunes and take on different personas. So here we turn to migraine variants — the exceptions and odd lots that make finding your way to migraine diagnosis and treatment quite a challenging proposition. Abdominal migraines Abdominal migraines, which are sometimes diagnosed in children, are unusual because they cause pain in the stomach and lead to nausea and vomiting (sometimes without a headache). A child who complains of recurrent pain in his stomach may be experiencing abdominal migraines. Children who suffer from abdominal migraines are likely to have migraine headaches in adulthood. Abdominal migraines are usually treated with anticonvulsant drugs. Basilar migraines The basilar migraine was once known as the basilar artery migraine, or BAM. It was considered a problem that was found primarily in young women and adolescent girls, but it occurs in both sexes and all ages. Basilar migraines are extremely rare, but they have the potential to be a serious health hazard in that they can lead to a transient ischemic attack (TIA) or stroke. Symptoms to watch for are double vision, partial vision loss, terrible vomiting, dizziness, loss of balance, slurred speech, lack of coordination, numbness (on one or both sides of the body), weakness, and confusion. These symptoms typically go away at the onset of the actual headache, although they may last for days after the pain disappears. If you experience any of the symptoms that signal basilar migraines, see a doctor as soon as possible. Transient ischemic attacks, which can result from basilar migraines (although they rarely do), are essentially "mini-strokes." TIAs result from disruptions of the blood flow to the brain. Although a stroke can mean permanent disability, TIAs don't cause lasting damage. Any neurologic problems associated with TIAs, such as weakness in one arm and slurred speech, are resolved within 24 hours. Hemiplegic migraines Hemiplegic migraines are often caused by an inherited gene, but they occur in people with no family history of migraines. With hemiplegic migraines, you experience temporary paralysis or arm and leg weakness on one side of your body. The paralysis or weakness is then followed, usually within an hour, by bad head pain. The paralysis or weakness does not always go away when the headache disappears. These headaches often originate during childhood. Ocular migraines Ocular migraines are rare migraines that feature a repeated vision disturbance (temporary, partial, or complete vision loss in one eye) that lasts less than one hour. After the vision disturbance subsides, you're left with a dull ache behind the affected eye, and your entire head may ache, as well. If you suffer from ocular migraines, you need to be evaluated by a doctor (an ophthalmologist) to exclude other possible causes for your vision loss. Ophthalmoplegic migraines Ophthalmoplegic migraines are no longer believed to be migraines. They are now thought to be a type of neuritis (inflammation of a nerve). These headaches are associated with pain around the eyeball and the temporary weakness or paralysis of eye muscle(s). It's a condition that's usually diagnosed in children. The common symptoms of these migraines are a drooping eyelid, a dilated pupil, and double vision. Ophthalmoplegic migraines, which can last for days or months, require a thorough exam and testing to rule out conditions that are more serious. Status migrainosus The term status migrainosus refers to a migraine attack that goes on for more than 72 hours and leads to problems such as dehydration. If you have status migrainosus, you should go to the emergency room, where you will be treated with IV fluids and pain medication. Women-only migraines Certain migraines are uniquely attached to the hormonal swings that females experience. Migraines are commonly linked to menstruation. Some women get migraine headaches when they're on oral contraceptives. And in the case of women who are going through or are past menopause, hormone therapy migraines can be problematic. (Some older women have hormone-replacement-therapy-related headaches, while other women who have had migraines in the past no longer have them after menopause.)

Article / Updated 03-26-2016

So you go to see your doctor, and — oops! — you discover that she's just not "into" headache diagnosis. If you're not happy with her response to your concerns, shop around for another doctor. Find a doctor who'll agree to team up with you on a treatment plan. Some primary care doctors are old hands at treating headaches, while others may want to refer you to a headache specialist for diagnosis and treatment. You can also check out doctors on your own. If your doctor smirks or rolls her eyes when you describe your headache problem, you know you're in trouble. The signals probably won't be that obvious though. So you have to look for subtle clues that let you know that diagnosing and treating headaches just isn't your doc's cup of tea. (You show up with a nice case of strep throat, and she's totally in the groove — but headaches aren't her bag.) Truth is, some doctors aren't very knowledgeable about headache diagnosis and treatment, while others just think in terms of "too many headaches, too little time." Doctors often prefer that you get help from a specialist in the head-pain field — a neurologist, pain-management expert, or internist who has made treating headaches her special passion. However, physicians who don't treat headaches themselves can usually recommend a doctor who specializes in headache diagnosis and treatment. (This specialized doctor's home base may be a headache clinic.) The first doctor you visit may recommend a treatment plan that actually works. But if it doesn't help — or you're worried that you may have a complex problem that requires a specialist — ask your primary care doctor for a referral to a specialist. Don't be shy. Just ask your doctor if she thinks that you should see a headache specialist. Keeping the faith even if your doctor is a disbeliever Okay, you weren't thrilled with what your doctor said. You got a pat on the arm and were instructed to "take some acetaminophen," even though you clearly explained that you tried that approach already. If your doctor is skeptical about your headaches, find a headache specialist to diagnose and treat you. Don't let your doctor's lack of interest keep you from looking further for relief for your headaches. You're definitely doing the right thing by seeking additional opinions. You shouldn't feel any more reluctant to seek help for your headaches than you would if you had a gaping wound or chest pains. If you feel like you need to see another doctor, or if your doctor refers you to a specialist, don't take it as a sign that you have an awful disease lurking inside you. Actually, the chances of you having a serious health problem are fairly unlikely. You may have high blood pressure, which definitely requires monitoring and medication, or you may just need the right migraine medication and some lifestyle changes. Giving up on finding help is a bad idea. Help is out there, but it just may take a little effort to find it. Spotting signs that you need to look elsewhere for a doctor What do you do if your doctor seems marginal about treating headaches? She wants to help you, but she doesn't appear to be overflowing with headache knowledge. Or she is clearly leaning toward sending you to someone whom she considers better equipped to diagnose your problem. You need to be able to identify the components of a deal-breaker, the indications that point you to the exit door so that you can do some more doctor shopping. If you notice even one of these signals, keep looking for a doctor to treat your headaches: Your doctor makes a dismissive comment: "Well, after all, this is just a headache — not exactly anything earthshaking. . . ." or "Women have a lot of headaches due to hormone changes. . . ." Your doctor looks bored when you describe your symptoms, as if she has heard all this a million times before. Your doctor seems eager to refer you to a specialist. Your doctor looks confused when you describe your headache symptoms. Your doctor comes from the bite-the-bullet treatment school and wants you to go to bed and tough it out until the headache goes away (obviously, this healthcare provider has never had migraines herself). Your doctor doesn't discuss your medical history or answer your questions. (This bit of advice refers to doctors who are treating migraines, but be advised that this is not a good sign of a helpful healthcare provider in any domain!) Your physician seems eager to finish up and suggests a pain medication right away. Your diagnosis is still up in the air after a visit or two. You may want to shop around for a headache specialist if your primary care physician tells you that she doesn't feel comfortable trying to diagnose and treat your severe headaches, or if an existing medical problem leads you to believe that you may benefit from seeing a headache specialist. You may also need a headache specialist if you take over-the-counter medications almost every day, and you don't get any new solutions when you visit your doctor. If you see disinterest or reluctance on the part of your doctor to work with you on migraine management, don't hesitate to ask for a referral to a headache specialist. The specialist will probably be a neurologist or internist who specializes in treating migraines.

Article / Updated 03-26-2016

Several types of massage can be helpful in relieving the pain of migraine headaches. But there aren't enough studies to show how effective — or ineffective — these therapies are. Typically, migraine sufferers who benefit from massage use it as one component of their pain-relief plan, along with medications, lifestyle changes, and so on. You may want to give some of the following massage options a try: Craniosacral therapy: With this type of therapy, you lie back as a therapist gently massages your skull bones and your scalp. Your nerve endings get some touchy-feely attention, which soothes the nerves and lessens the pain waves they send. Neuromuscular massage: This therapy, which is also known as trigger-point therapy, is a muscle-relaxing treatment that applies moderate pressure to your body's trigger points (spots in a muscle that, when stimulated by pressure or touch, are painful). Some believe that it can reduce nerve compression and relieve pain in tense or overworked muscles. Reflexology: This therapy is based on the pressure and massage of points on the soles of the feet. The healing art of reflexology is often used to relieve stress and pain. For some headache sufferers, it's a godsend. It works on the idea that there are zones in the feet that correspond to all areas of the body. Therapists manipulate these zones, helping to benefit the corresponding areas throughout the rest of your body. Deep-tissue massage therapy: People get massages to get rid of pain and discomfort or to just give themselves a relaxing treat. A massage therapist uses pressure, movement, and stretching to render your body more pliable and comfortable. For headaches, a therapist will usually use therapeutic, deep-tissue techniques. Deep-tissue massages may serve to improve circulation and help reduce muscle tension. When performing a deep-tissue massage, a massage therapist focuses on specific areas of the body to relieve pain and release stress. Many believe that massage can reduce muscle pain and ease muscle tension and stiffness. Deep tissue refers to the use of deep finger pressure and slow strokes on areas of the body that are suffering from muscle tension or aches. Because deep-tissue massage works well on tense shoulders and necks, it can sometimes provide relief from headache symptoms. (If you aren't sure whether your physical condition is amenable to massage, check with your doctor before having a massage. Massage isn't recommended if you have varicose veins, a recent fracture, sprain, or nerve injury, or if you've recently had chemotherapy or radiation.) Acupressure: For headache relief, acupressure techniques are used to apply gentle finger pressure to various points on your head. It is believed that this therapy can help headache sufferers by calming muscle tension and enhancing blood circulation. In a more ethereal sense, some think that acupressure promotes self-healing of the body by re-establishing energy balance. At any rate, this therapy is painless. So if you want to try it, check with your physician. (He'll probably give you a go-ahead.) You can figure out how to perform a simple form of acupressure in minutes. Apply gentle and continuous fingertip pressure with two fingers for two to three minutes. Use one hand to work the top of your skull, and the other hand to apply pressure to the spot between your eyebrows. Of course, there are many other acupressure moves — you can get a book on the subject or have an acupressure practitioner take you through the steps. Rolfing: This therapy is one of many variations on the theme of massage. Its roots go back to the belief that most of us become all choked up with muscle contractions, which throws our bodies off balance. By applying deep pressure to your muscles, a Rolfing practitioner may be able to ease your headache pain by ratcheting down the tautness of your muscles. For some people, Rolfing reduces pain. For others, Rolfing is too vigorous for their taste. Rolfing is not for the person who's put off by aggressive body manipulation. (Basically, Rolfing is massage that is taken to a tougher intensity level. It's not a surefire headache remedy, by any means.) The pressure of any type of massage may cause some discomfort, but if you experience a great deal of pain, tell the therapist to stop. You may need to see your doctor for an evaluation. Check with a local school of massage for the names of qualified therapists in your area. And when you're interviewing therapists, ask to see proof of membership in the American Massage Therapy Association (AMTA). Therapists with membership in this association have completed a training program approved by the Commission on Massage Training Accreditation/Approval, hold a state license that meets AMTA standards, and have passed an AMTA exam or the National Certification Examination for Therapeutic Massage and Bodywork. You can also find trained massage therapists on the AMTA Web site.

Article / Updated 03-26-2016

A rebound headache is a headache that you end up with just because you go in search of a little relief from the constant pounding in your noggin. You feel bad, so you take a pill — you feel worse, so you take another, and so on, and so on, and scoobie-doobie-do. Basically, you wind up with a headache because you're overusing medications. Exceeding label or physician instructions when taking medications can result in rebounding into another headache. Other spin-offs of medication overuse include a more excruciatingly painful headache, addiction to medications, and other adverse side effects. Prolonged use of even over-the-counter medicines can cause liver and kidney damage. In the wild-and-woolly migraine arena, rebound headaches have to rank right up there at the top of the pain-wielding, mind-blowing, frustration-inciting extravaganza. Sometimes rebound headaches are migraines, and sometimes they're not. To help prevent future rebound headaches, you may be able to take a migraine-preventive medication or use lifestyle changes without medication. First, however, you must get past the vicious cycle of rebounding — you overmedicate repeatedly before realizing that you're perpetuating your pain. Your doctor can help you taper off your overmedicating, nonproductive ways. If some of the following signs apply to you, you're probably having rebound headaches (but be sure to see your doctor for evaluation of your problem to confirm that it's a headache and not something more serious): You suffer from headaches daily or every other day. Your pain intensifies about three hours after your last dose of medication. Your pain medications don't work as well as they used to. You take more medication, but your headaches are worse. You rely on more pills, and you take them more often. You take medication even for mild headaches, and you often try to ward off a headache by using a medication. You take pain relievers three to four days a week, and you average more than three tablets per day. (This depends on the kind of medication you're taking, so you'll need your doctor's advice.) Your pain runs the gamut from mild to moderate to horrible. Usually, the pain is a dull ache that you feel on both sides of your forehead and, sometimes, on the top or back of your head. Your headaches occur much more frequently. Because you're in pain, you may use medications too often. The theory behind the rebound headache is that the overuse of drugs makes the headache rebound after your body has absorbed all of the medication. Painkillers are supposed to relieve pain, of course, but if you overuse prescription or nonprescription drugs, they can turn on you and actually cause headaches. Essentially, an over-the-counter drug or a prescription medication that's taken too often can give rise to a brain-craving for more of the medicine. The episode begins when the brain gets some initial relief from pain, likes the effect, and then decides it will send out to room service for more of the same. Your brain continues to signal "pain" in its search for more of the drug, and you have to take increasing dosages to get relief. Therefore, your medication becomes less and less effective, and you create a cycle of increasing misery. If you rush to the emergency room with a killer migraine, the doctor will want to know what you took and when you took it last, so be prepared to supply this information. The emergency room physician needs to know if you overused medication and have a rebound headache. She doesn't want to treat you with a medication you overused, or with a medication that's not going to jibe with a drug you took recently. The typical medications that appear in the rebound scenario are aspirin and acetaminophen, alone or in combination with caffeine-containing products. Other drug culprits often implicated in rebounding are Caffeine Codeine Combination drugs such as Fiorinal and Midrin Drugs containing barbiturates Ergotamine tartrate Opiates Abortive drugs (such as the nonsteroidals ibuprofen and naproxen), triptans (Imitrex, Zomig, Amerge), and DHE (dihydroergotamine) may also induce rebounding, but they're less likely to do so.

Article / Updated 03-26-2016

Whether internal or external, anything that sets a migraine attack in motion is a trigger. Take a look at the following categories of common migraine instigators so you can track potential triggers for your headaches and steer clear of them in the future: Environment: Weather changes, high altitude, bright lights, fluorescent lighting, strong odors Food and drink: Alcohol, MSG, aged cheese, nitrites, skipped meals Hormones: Menstruation, menopause, hormone replacement therapy, birth control pills Sleep: Irregular sleep patterns, excessive or too little sleep, sleep disorders Odds and ends: Stress, fatigue, certain prescription drugs

Article / Updated 03-26-2016

If you're sick of dealing with migraines you need to develop a plan to prevent them. The steps to getting and staying as migraine-free as possible are: See your doctor for evaluation and treatment. Identify triggers and avoid them. Find medications that work and use them properly. Find a type of exercise that doesn't cause migraines for you and do it regularly.

Article / Updated 03-26-2016

Whether you've been dealing with migraines for some time or you've never experienced one, make yourself aware of the symptoms that require medical attention. Severe headaches should not be taken lightly, if you experience any of the following symptoms, see a doctor as soon as possible: A headache accompanied by a stiff neck, fever, or rash. A headache that strikes like a thunderclap - very suddenly and very painfully. Worst-ever headache. First-ever headache after age 50. Headaches getting worse and more frequent. Headaches brought on by exertion. You faint, lose your vision, or have coordination problems with a headache. You have a family history of brain aneurysms and you're having headaches. You recently had a head injury, and now you're having headaches. You're having bad headaches, and you have certain medical conditions such as cancer, AIDS, diabetes, high blood pressure. You have weakness in your arm(s) and/or leg(s), numbness, slurred speech, breathing difficulty, and/or vision problems.

Article / Updated 03-26-2016

Falling into the trap of migraine myths can prevent people from being diagnosed and treated properly. Migraines are valid problems. Migraine myths abound and some of the following are the more common misconceptions and the real story: Your doctor would have already told you if you actually had migraines. Not necessarily! Sometimes migraines can be hard to diagnose. You need to tell your health care provider the specific symptoms associated with your headaches. Your migraines are all in your head. Not so! A migraine is a biological illness that can cause great deal of pain. Doctors know what causes migraines. No, they don't! But many headache experts believe that a disturbance in brain chemicals is the source of migraine development. If you're a migraineur, every headache you get is a migraine. Nope! Migraine sufferers can have other kinds of headaches as well. Children don't get migraine headaches. Yes, they do! Apparently, even some babies suffer from migraines. You can't be having migraines because you don't have auras (the visual disturbances, such as zigzag or flashing lights). Not true! Many people who have migraines don't experiences auras. You're stuck with suffering head pain from migraines because they're rarely treated successfully. Wrong! Most migraine sufferers who seek help discover medications and lifestyle changes that really help ease their suffering and make headaches less frequent.

Article / Updated 03-26-2016

Headaches aren't the only symptom of migraines. Migraines are an umbrella for multiple symptoms, and everyone experiences a migraine a little bit differently. How do you know you have a migraine? The following are the hallmarks of a migraine headache: A drooping eyelid (more common in cluster headaches but it can happen in migraines) Bloodshot eyes Cold hands and feet or feeling hot all over Flushed or pale face or a very red face Frequent, regular headaches Moderate to severe pain Pain lasts several hours to three days Tender scalp Throbbing pain on one or both sides of the head Feeling better after sleeping Associated symptoms include nausea, vomiting, visual disturbances, sensitivity to loud noises and light, and feeling depressed.