More Than an Aspirin Headache

Coping with migraine misery

/ Author:  / Reviewed by: Joseph V. Madia, MD

If you've never had a migraine headache, you may not have known the stomach-churning pain that can make all your senses go mad.

Here's how sufferers from an online support forum describe the misery of migraines.

"Sometimes it feels as if my brain is too big for my skull, like it wants to break through the bones, because there is not enough room in my head."

"Or it feels like there is an ice pick poking through my left eyeball that just won't stop."

"Sometimes I feel like if I could just rip my eyeball out maybe it would stop the pain. Yes, I know it wouldn't, but I'm not always rational in the throws of a head banger (my term for severe migraine.)"

"If I was to describe the feeling of light, it's like a virtual stab wound. I can feel it enter my eye and hit something that triggers a cascade of reactions. Light makes me angry!"

"And everything is way too loud, like the volume got turned all the way up, so I can hardly focus on what anyone is saying. I just hear the noise."

"I frequently get wicked nausea with migraines. When I was in my 20s I would throw up - 9 or 10 times."

What is a migraine?

Migraines are what's known as "vascular headaches." This means the arteries both inside and outside the brain change.

Migraine pain can be occur in the face, back of the head, sinus area, jaw or neck. It's frequently felt around the eyebrows, eyes and in the temple area.

During an attack, touching the head in any way, such as combing hair or shaving can be painful.

Who gets migraines?

The National Headache Foundation estimates that some 30 million Americans have migraines. Here are some facts and figures:

  • Women are about three times more likely to suffer from migraines than men.
  • Migraines are most commonly experienced between the ages of 15 and 55.
  • Children suffer from them as well.
  • About 75 percent of sufferers have a family history of migraine.
  • Less than half have an official diagnosis of migraine, so they aren't being treated for them.
  • Migraines are often misdiagnosed as either a sinus headache or tension related headache.

dailyRx spoke to MaryAnn Mays, M.D., a Neurologist in the Center for Headache & Pain at Cleveland Clinic, about how migraines affect children. "Most children respond favorably to treatment with improvement in their  headaches," Dr. Mays said.

She added, "About 1/4 to 1/3 of children will go into remission, but the rest may continue to have migraines for the rest of their lives. The prognosis seems a little better for boys than girls, but this result varies from study to study," Dr. Mays said.

What causes migraines?

It's now believed that most migraines are caused by some sort of inherited brain irregularity. The pain results when brain cells cause the release of chemicals that irritate and lead to the swelling and narrowing of blood vessels in the brain. The blood vessels then send signals to the brainstem, which processes pain information.

During stressful times, the brain releases chemicals that activate changes in the blood vessels that cause migraine. Anxiety, excitement, worry and fatigue can lead to increased muscle tension which makes the headaches worse.

What are the symptoms of migraines?

Not everyone experiences migraines the same, and episodes can have varied characteristics, including:

  • Intense pain - often on one side of the head
  • Pulsating or throbbing pain
  • Pain that's severe enough to interfere with daily activities
  • Sensitivity to light, sounds or odors
  • Loss of appetite
  • Vision problems
  • Dizziness
  • Nausea and vomiting
  • More pain with exertion such as climbing stairs

And migraines can last for as little as a few hours or as long as up to a week.

As one sufferer put it, "If it only lasted for 3 or 4 hours I wouldn't bat an eyelid, but it goes for 3 days."

It's not uncommon for sufferers to get migraines once a week or twice a month. Some may have them every few days, while others might have only one or two a year.

What are the different types of migraines?

There are two types of migraines that are distinguished by the symptoms experienced with the headache begins:

"Classic" migraine is one with an aura
"Common" migraine is without aura.

Auras, which often signal the onset of a headache, are sensory disturbances that can include any of the following:

  • Distorted or blurred vision
  • Blind spots
  • Bright flashing lights or dots
  • Temporary loss of vision
  • Jagged or wavy lines
  • Ringing in the ears
  • Changes in smell, taste or touch

What brings on migraines?

Most people come to realize that certain things trigger the onset of a headache. Dr. Mays says stress is the number one migraine trigger.

Other triggers can be any number of individual factors or a combinations of things, such as:

  • Sensitivity to chemicals and preservatives in food and beverages
  • Food additives such as nitrates found in processed meats and MSG
  • Missing meals
  • Fatigue or sleep problems
  • Bright lights
  • Weather changes
  • Psychological issues
  • Menstrual cycles
  • Tension of any kind

Keeping a diary of events leading up to headaches and recording things that seemed to trigger them can be helpful. Avoiding these situations or things may help avoid the onset of headaches.

How are migraines diagnosed?

Unfortunately, there are no definitive tests to diagnose migraines. Imaging scans - CT and MRI - might be used to rule out tumors. Other than these tests, though, diagnosis comes from looking at specific headache symptoms and patterns of occurrence. A family history of migraines will also be considered.

When should you seek help for migraines?

If you have ongoing headaches that are debilitating, you will want to see a doctor. Dr. Mays explains the best way to go about getting the right treatment.

"It is reasonable to seek help initially from your family doctor. If the headaches become too difficult to treat then that doctor will refer you on to a specialist," she said.

"If you are getting weekly headaches, starting with a specialist who is a headache medicine specialist or a neurologist would be recommended as well. Most headache patients do not require any more diagnostic testing than a good history and examination," said Dr. Mays.

How are migraines treated?

There are a number of medications that are used to relieve the various symptoms of migraine.

Over-the-counter medications

Three over-the-counter products are approved by the U.S. Food and Drug Administration (FDA) to treat migraine:

  • Excedrin Migraine (a combination of aspirin, acetaminophen and caffeine)
  • Advil Migraine
  • Motrin Migraine Pain

Other over-the-counter medications commonly used are nonsteroidal anti-inflammatory drugs (NSAIDs) - ibuprofen (Advil, Motrin), aspirin (Anacin, Bayer) acetaminophen (Tylenol) and naproxen (Aleve)

Dr. Mays cautions, "Avoid self treating your headaches. If you are overusing analgesic medications - that is more than 2 days a week - you actually may be making your headaches worse. It is called medication overuse headache, and it is one of the most frequent causes of more disabling, daily headaches," Dr. Mays said.

Prescription medications

Again, there are a number of medicines that can be prescribed to treat migraine symptoms, and prvent them from occurring. Among the most popular drugs are known as triptans and include:

Other prescription migraine medications include:

  • Cafergot and Migergot (ergotamine/caffeine)
  • Compro (prochlorperazine)
  • D.H.E. 45, Migranal (dihydroerotamine)
  • Reglan (metoclopramide)

Natural management techniques

There are a number of ways manage migraines without medications. Dr. Mays says, "Many of my patients have reported better headache control when they are eating a healthy diet, low in carbs and those avoiding processed foods." Other methods she says are:

  • Staying hydrated
  • Getting adequate sleep
  • Regular exercise, particularly yoga or Pilates to strengthen core muscles
  • Physical therapy
  • Massage
  • Acupuncture
  • Biofeedback

According to Dr. Mays, "Recognizing stress and managing it is essential."


Living with migraines isn't easy. As one online forum participant put it, "I wish more people asked to describe the pain we feel - not because I want them to feel sorry for me, but I want a chance to explain why at times I am irritable, or impatient, or cannot do certain things."

If you suffer from migraines, you will want to be under the care of a physician who can give you access to prescription-strength relief.

Review Date: 
September 11, 2011