Migraine Headaches: Ways to Deal With the Pain

What causes migraine headaches?

Migraine headaches seem to be caused in part by changes in the level of a chemical made in the brain called serotonin. Serotonin plays many roles in the body, and it can have an effect on blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems.

Many things can affect the level of serotonin in your body, including your level of blood sugar, certain foods and changes in your estrogen level if you're a woman.

What does a migraine feel like?

The pain of a migraine headache can be intense. It can get in the way of your daily activities. Migraines aren't the same for all people. Possible symptoms of migraines are listed in the box below.

You may have a "premonition" several hours to a day before your headache starts. Premonitions are feelings you get that can signal a migraine is coming. These feelings can include intense energy, fatigue, food cravings, thirst and mood changes.

Are there different kinds of migraine headaches?

Yes. The most common are classic migraine and common migraine.

Classic migraines start with a warning sign, called an aura. The aura often involves changes in the way you see. You may see flashing lights and colors. You may temporarily lose some of your vision, such as your side vision.

You may also feel a strange prickly or burning sensation, or have muscle weakness on one side of your body. You may have trouble communicating. You may also feel depressed, irritable and restless.

Auras last about 15 to 30 minutes. Auras may occur before or after your head pain, and sometimes the pain and aura overlap, or the pain never occurs. The head pain of classic migraines may occur on one side of your head or on both sides.

Common migraines don't start with an aura. Common migraines may start more slowly than classic migraines, last longer and interfere more with daily activities. The pain of common migraines may be on only one side of your head.

Possible symptoms of migraines

How long do migraines usually last?

Migraines can last from 4 to 72 hours. They may happen only once or twice a year, or as often as daily. Women are more likely to have migraines than men.

What can set off a migraine?

Things that can set off migraines include the following:

Foods that may trigger migraines:

How are migraines treated?

There are 2 types of medicines for migraine treatments. One type focuses on relieving the headache pain. This type of treatment should be started as soon as you think you're getting a migraine. The other type includes medicines that are used to prevent headaches before they occur.

Can nonprescription medicines help relieve the pain?

Yes. Nonprescription medicines that can help relieve migraine pain include aspirin; acetaminophen (one brand name: Tylenol); an acetaminophen, aspirin and caffeine combination (one brand name: Excedrin Migraine); ibuprofen (one brand name: Motrin); naproxen (brand name: Aleve); and ketoprofen (brand name: Orudis KT).

What about prescription medicines?

People who have more severe pain may need prescription medicine. A medicine called ergotamine can be effective alone or combined with other medicines. Dihydroergotamine is related to ergotamine and can be helpful.

Other prescription medicines for migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan, eletriptan and frovatriptan.

If the pain won't go away, stronger medicine may be needed, such as a narcotic, or medicines that contain a barbiturate. These medicines can be habit-forming and should be used cautiously.

Can medicine help prevent migraines?

Yes. Medicine to prevent migraines may be helpful if your headaches happen more than twice a month or if your headaches make it hard for you to work and function. Examples of medicines used to prevent migraines include propranolol, timolol, divalproex and some antidepressants.

Talk to your doctor about which medicine is best for you. Nonprescription and prescription medicines that are used often or in large doses may cause other problems.

What else can I do to prevent migraines?

Try to avoid foods or other things that seem to cause migraines for you. Keep a journal to help you identify triggers. Get plenty of sleep and drink plenty of fluids. Try to relax and reduce the stress in your life. Also try to get regular exercise. Aerobic exercise can help reduce tension as well as keep your weight in check. Obesity can contribute to migraines.

Tips on reducing the pain