Migraines affect roughly 28 million Americans and women are more likely than men to suffer from them. Some migraines are preceded or accompanied by sensory warning symptoms or signs (auras), such as flashes of light, blind spots or tingling in your arm or leg. A migraine is often accompanied by nausea, vomiting, and extreme sensitivity to light and sound and can be completely debilitating to those who suffer from them.
Symptoms:
-Moderate to severe pain, which may be confined to one side of the head or may affect both side
-Head pain with a pulsating or throbbing quality
-Pain that worsens with physical activity
-Pain that interferes with your regular activities
-Nausea with or without vomiting
-Sensitivity to light and sound
When untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently.
When to go to the ER:
-An abrupt, severe headache like a thunderclap
-Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
-Headache after a head injury, especially if the headache gets worse
-A chronic headache that is worse after coughing, exertion, straining or a sudden movement
-New headache pain if you’re older than 50
Causes:
Although much about the cause of migraines isn’t understood, genetics and environmental factors seem to both play a role. Migraines may be caused by changes in the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals, including serotonin (which helps regulate pain in your nervous system) also may be involved. They are thought to be triggered by : hormonal changes (women), stress, food (beer, red wines, ages cheeses, caffeine, MSG), sensory over stimuli (looking at bright lights for long periods of time i.e. computer screens), changes in wake-sleep patterns, physical overexertion, medications (certain medications can cause migraines- be aware when starting a new med).
Treatments:
Usually, HCPs will order you prescription meds (which I will discuss) but a major study just came out showing that taking 900-1000mg of Aspirin at the first signs of migraines will diminish all pain by 24 hours and symptoms of migraines will be diminished within as soon as 2 hours after taking the aspirin. It is also suggested that you take a dose of 10mg of Metoclopramide (Reglan) to ward off any nausea. For alternative therapies, any people have found relief with acupuncture, massage therapy, and biofeedback (relaxation techniques- check out this book for more info Migraines Be Gone: 7 Simple Steps to Eliminating Your Migraines Forever). There is some evidence that the herbs feverfew and butterbur may prevent migraines or reduce their severity. A high dose of riboflavin (vitamin B-2) also may prevent migraines by correcting tiny deficiencies in the brain cells. Coenzyme Q10 supplements may be helpful in some individuals. Medications known as triptans are used to treat migraines too. The triptans attach to serotonin receptors on the blood vessels and nerves that surround them, constrict the blood vessels, and reduce the inflammation. This stops the headache. The triptan with the longest history of use is sumatriptan (Imitrex). Sumatriptan is available in the US as an injection, oral tablet, and nasal inhaler. Zolmitriptan (Zomig) and rizatriptan (Maxalt) are newer triptans that are available as oral tablets and as tablets that melt in the mouth. Naratriptan (Amerge), almotriptan (Axert) and frovatriptan (Frovalan) are available only as oral tablets. The most common side effects of triptans are facial flushing, tingling of the skin, and a sense of tightness around the chest and throat. Other less common side effects include drowsiness, fatigue, and dizziness. These side effects are short-lived and are not considered serious. The most serious side effects of triptans are heart attacks and strokes, which is why many HCP’s are leaning towards prevention and treatments with alternative therapies. Some HCP’s still treat the acute pain with narcotics, but due to addiction that can occur, it’s not the optimal treatment.
If you are one of the millions of Americans suffering from migraines, please try some of these alternative therapies, and let me know how they work for you. Is there something different that you do that might help others? And, if you think that you have migraines, but aren’t sure, keep a dairy of your headaches, symptoms, when they occur, what makes the better and worse, and discuss this with your HCP- they may do a CT Scan, MRI, or lumbar puncture (draw some fluid off of your spine) to rule out other causes of your headaches (and totally based on your symptoms and presentation).
You and your HCP can figure out the most appropriate treatment for you, and bring up these alternative therapies, if it is something you are interested in trying!
Yours in Good Health,
B
