Migraine involves intense, throbbing headaches, often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. These headaches are never pleasant, but if they occur almost daily, they can seriously disrupt your life.
If you experience 15 or more headache days each month, you’re likely dealing with chronic migraine. Every year, about 2.5 percent of people with episodic migraine transition to chronic migraine.
You don’t have to settle for living most of your days in pain. Bring these questions to your doctor so you can get started on treatment to reduce the frequency and intensity of your symptoms.
The exact cause of migraine headaches is unclear, but genetics and environmental factors may play a role.
Most people with migraine have the episodic kind, meaning they get headaches less than 14 days each month.
In a small number of people, the number of migraine days gradually increases. Your doctor will diagnose you with chronic migraine if you’ve had these headaches for 15 or more days a month for at least three months.
A few factors can make you more likely to develop chronic migraine, including:
- obesity
- depression
- anxiety
- other pain
disorders - extreme stress
- overusing your pain
medications - snoring
Everyone’s migraine triggers are a little different. For some people, a lack of sleep sets off their headaches. Others get them from eating processed foods.
Here are some common migraine triggers:
- hormonal changes
- a lack of sleep or
too much sleep - hunger
- stress
- strong smells
- bright lights
- loud noises
- food additives like
MSG or aspartame - alcohol
- weather changes
To help your doctor pinpoint your triggers, keep a diary of your symptoms. Write down what you were doing right before each migraine started. Share your diary with your doctor at each visit.
Constant severe headaches could make you fear the worst-case scenario, like a brain tumor. But in reality, headaches are rarely a sign of a serious condition, especially if they’re your only symptom.
Symptoms that can be a sign of a serious condition include:
- uncontrolled
vomiting - seizures
- numbness or
weakness - trouble speaking
- stiff neck
- blurred or double
vision - loss of
consciousness
If you experience any of these along with your headaches, call 911 or get medical help as soon as possible.
These changes are called migraine aura. They’re a collection of sensory symptoms that some people experience just before a migraine. You may see zigzag patterns in your vision, hear strange noises, or feel unusual sensations like tingling in your body.
Aura may stem from changes to brain cells and chemicals. About 20 to 30 percent of people with migraine get aura right before their headache. These symptoms usually subside in about an hour.
You may only be seeing your primary care doctor for migraine management. But if you’re experiencing migraine more often and it’s impacting your daily life, you may want to start visiting a specialist.
A neurologist can complete a detailed exam to rule out other possible causes of your headaches. Then, you can get started on treatment to help reduce the frequency of your migraine attacks.
Preventive treatments can help stop your migraines before they start. You can take these medications every day.
Some of the medications for chronic migraine treatment include:
- beta blockers
- angiotensin
blockers - tricyclic
antidepressants - anti-seizure drugs
- calcium channel
blockers - calcitonin
gene-related peptide (CGRP) antagonists - onabotulinum toxin
A (Botox)
Your doctor can recommend one of these depending on how severe and frequent your migraines are.
Other drugs relieve migraine pain once it starts. You can take these medications as soon as your symptoms begin:
- aspirin
- acetaminophen
(Tylenol) - NSAIDs such as
ibuprofen (Advil, Motrin) - triptans
- ergots
Discuss your options with your doctor to see which option would work best for you.
Medication isn’t the only way to tackle migraines. Once you identify your triggers, lifestyle changes can help you avoid and prevent migraine attacks.
- Get a good night’s sleep. Sleep deprivation
is a common migraine trigger. Go to bed and wake up at the same time every
day to get your body used to a routine. - Don’t skip meals. Blood sugar drops
can set off migraines. Eat small meals and snacks throughout the day to
keep your blood sugar steady. - Stay hydrated. Dehydration can
also lead to headaches. Drink water or other fluids throughout the day. - Practice relaxation techniques. Try deep
breathing, yoga, meditation, or massage to relieve stress. - Avoid foods that are triggers. Processed meats,
MSG, caffeine, alcohol, and aged cheeses can all lead to migraine.
A few supplements have been studied as an alternative approach to migraine treatment, including:
- magnesium
- feverfew
- riboflavin
- coenzyme
Q10 (CoQ10)
There’s some evidence that these help, but check with your doctor before you try any supplement. Some of these products can cause side effects or interact with other medications you take.
Experiencing migraine attacks for half a month or more isn’t normal, and could mean you have chronic migraine. Your symptoms are preventable and treatable, so make sure you bring up all of your concerns with your doctor.
Your primary care team is your go-to resource for your overall health, including migraine, sleep issues, and mood episodes. They can diagnose migraine and may prescribe lifestyle changes and medication. They usually refer patients to specialists only if symptoms don’t improve with these treatments.
A neurologist or other headache specialist evaluates head pain disorders and recommends a treatment plan to reduce the frequency and severity of migraine symptoms. They may prescribe medications, lifestyle changes, and other therapies.
A psychologist who specializes in pain management may use biofeedback, relaxation training, cognitive behavioral therapy, or other techniques to reduce muscle tension and headache pain.
An occupational therapist evaluates your ability to perform daily activities and meet your goals. They may adjust your tasks and environment to help you live better with migraine. This can include developing self-care routines and limiting migraine triggers at work, school, or home.
A physical therapist uses hands-on treatments to reduce muscle tension and pain in your back, neck, jaw, or head. They can teach you exercises and stretches that may help reduce the frequency and severity of migraine symptoms. They may also recommend optimal positions for sleeping, working, driving, and more to reduce muscle strain that could contribute to migraine.
Insomnia and other sleep disorders are more common in people with migraine and may aggravate symptoms. A sleep medicine physician diagnoses sleep disorders. A behavioral sleep medicine specialist helps you adjust your habits, behaviors, and environments to improve sleep.
Mood disorders, such as anxiety and depression, are more common in people with migraine and may worsen symptoms. A psychologist, clinical social worker, or licensed mental health counselor can treat mental health conditions with psychotherapy. A psychiatrist can prescribe medication if needed.