Anyone who has experienced a headache, and the pain that goes with it, knows how uncomfortable it can be. There are different types of headaches, but one of the worst is a migraine. Lynn Rankin, MD, UnityPoint Health neurologist, discusses migraine symptoms and triggers, pain management and when to contact your doctor.
The Difference between Migraines and Other Headaches
Tension-type headaches are the most common, which can be caused by stress, posture at work, excessive alcohol and lack of sleep. Headaches can also result from allergies, caffeine withdrawal, eyestrain, hangovers, hunger and more. But, migraine headaches are much more involved.
- Typically last 4-72 hours
- Usually experienced on one side of the head
- Pounding or throbbing sensation
- Worsen with simple exertion
- Associated with several other symptoms (nausea, vomiting, sensitivity to light and sound, motion or smells)
“Migraine headaches affect roughly 12 percent of the population, with a female to male ratio of 3:1,” Dr. Rankin says. “They are typically most problematic for young and middle-aged adults but affect all ages, including children as young as 3-years-old. Most patients have a family history of migraines, but not all, and sometimes, migraines begin after a major hormonal event or concussion.”
Other co-morbid conditions can be associated with migraines as well. For the approximately 10 percent of migraine sufferers who experience headaches over 15 days a month, conditions, such as fibromyalgia, irritable bowel syndrome, anxiety, depression and/or obesity, may be present.
Excedrin® released a campaign, “The Migraine Experience,” using virtual reality to allow others to experience what migraine sufferers go through during an episode. These powerful clips display just how extreme migraine symptoms can be.
Pain Management for Migraines
Management for migraines includes medication and non-medication approaches. Non-medication management always starts with identification of triggers and keeping a regular routine. Dr. Rankin suggests keeping track of headaches in a journal or app, which can be helpful to identify and manage migraine triggers.
“The importance of understanding the amount of rest required and habits, like keeping a regular bedtime and wake-up schedule, cannot be over emphasized. Regular mealtimes are also important, as is regular exercise, although during a migraine attack, rest is recommended,” Dr. Rankin says.
To help relieve discomfort, Dr. Rankin suggests several home remedies for headaches:
- Apply a cold pack to the eyes or head (for tightness in the neck, moist heat is recommended)
- Rest in a dark room
- Some patients find benefit from essential oils and meditation
- An activity regimen that includes yoga
“Managing migraine triggers is also important. Some examples include wearing FL-41 tinted glasses, wearing wide brimmed hats in bright sunlight, hydrating well before exercise, avoiding alcohol, avoiding preservatives and monosodium glutamate (MSG) in the diet, avoiding hunger and keeping caffeine intake low,” Dr. Rankin says.
Family members can also try and help loved ones during a migraine and headache episode. There are several ways you can help comfort them through the pain.
“Offer to bring a cold pack to the migraine sufferer or obtain their medication. Keeping the home environment quiet and free of odors can be helpful, too. Of course, expressing love and support is always helpful,” Dr. Rankin says.
When to See a Doctor for Headaches
If you notice any significant changes in your headaches, including new visual or neurological symptoms, it’s time to see your provider. UnityPoint Health supports the Choosing Wisely initiative, which aims to increase conversations between patients and providers to make the best health care decisions together. A national campaign, its educational focus hopes to result in reduced waste in the health care system and risk to patients from unnecessary tests or procedures.
“In the case of headache, the Choosing Wisely campaign emphasizes that a brain imaging study is not necessary for long-standing recurrent headaches diagnosed as tension-type or migraine headaches. A CT or MRI scan would be normal. I am a neurologist with left temporal migraines and have never had a scan, even though I have experienced disabling migraine with vomiting, requiring hospital care in the past,” Dr. Rankin says.
The majority of headaches will prove to be primary headaches that do not require any further imaging, but when occasional headaches start to interfere with school, work or family life, you should start keeping a headache journal and make an appointment.
“Over the counter (OTC) medications are unlikely to be harmful if taken occasionally for headaches, but when used over 2-3 days a week, these medications can actually cause rebound headaches, stomach or liver issues. Frequent use of OTC medications should prompt a call to your doctor,” Dr. Rankin says.
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