My Head Is Killing Me!

Do any of these scenarios sound familiar to you? You’re not alone. Migraine headaches are incredibly common, with about 12% of women and 6% of men experiencing them. You are part of a large community dealing with this condition.

Migraines are painful, throbbing headaches that last from four to 72 hours. When you have a migraine, it may be so unbearable that you aren't able to live your everyday life. But remember, migraines can be treated. And even though they can feel bad, they don't cause long-term damage. There is hope for relief.

Experts are still determining what causes migraines. They believe that changes in brain cell activity may lead to nerve inflammation, which causes pain. Migraines often run in families, so genetics may play a role for some people. Some things, called triggers, can cause a migraine to start.

Triggers for migraine headaches are different for each person. Triggers include changes in daily routine, foods, hormones, medicines, lights, odors or other things in the environment. The most common migraine triggers are:

• Stress (either during a stressful time or right after stress subsides).
• Menstrual cycle in women and hormonal changes.
• Changes in your routine, such as how much you exercise or how much you sleep.
• Fasting or skipping meals.
• Changes in the weather, heat, or high humidity.
• Bright lights, glare, or reflected sunlight.
• Foods such as chocolate, nuts and artificial sweeteners.
• Alcohol—all alcohol, or one type of alcohol in particular, like beer or wine.
• Odors such as perfume, paint, dust, candles, scent diffusers and certain flowers.

Other migraine triggers include:

• Strong emotions, such as depression or anxiety
• Pushing yourself too hard when you exercise.
• Monosodium glutamate (MSG).
• Nitrates, which are found in cured meats such as hot dogs, bacon, and cold cuts.
• Preservatives.
• Tyramines, which are found in pickled or marinated foods, aged cheeses, and yeast.
• Smoking or being around someone who smokes.
• Excessive caffeine or caffeine withdrawal.
• Birth control pills and hormone therapy.
• Medicines that expand (dilate) the blood vessels (vasodilators), such as nifedipine, and nitrates.
• Allergies.
• Excessive noise.

The most common symptom of a migraine headache is a throbbing pain on one side of your head or behind an eye. Some people have an aura shortly before or during the headache. An aura is a set of neurological symptoms that usually precede a migraine attack. It can include visual disturbances, such as seeing spots or flashing lights, or other sensory changes. During an aura, you may see spots or flashing lights. Other symptoms of migraine include nausea, vomiting and sensitivity to light.

To diagnose migraines, your provider will ask about your personal and family history and examine you. They will ask how many headaches you have, how long they last and what symptoms you have. If your provider thinks another disease may cause your symptoms, you may need tests.

When seeking help from your provider for migraine headaches, you must bring with you the duration and frequency of when your headaches occur. This helps your provider understand the type of migraine or headaches you’re experiencing and how to best help you with treatment. If you experience three to four headaches per month, your provider may help you determine what is causing the migraines and help you eliminate them altogether. 15 – 20 migraines per month may need medication treatment with a daily preventative. Your provider will know best once they assess your specific situation.

When we sometimes have headaches, especially ones that don’t seem to go away or hurt more than usual, we may think something worse is wrong with us, such as a brain tumor or aneurysm. While these are important critical conditions to monitor for, it’s also important to recognize that brain tumors are very rare and occur in only .05% of the population. Not every headache or migraine is linked to aneurysms. So, the chances of these severe conditions are very low.

Trigger Elimination Process. To better understand which foods or triggers cause your migraine headaches, aim to eliminate one factor for a week, like artificial sweeteners or alcohol. It’s not ideal to eliminate all factors. Add the potential triggers back into your routine the following week and see if the headache returns. How are migraine headaches treated? Avoid self-medicating with painkillers and over-the-counter medications, etc. They can potentially cause rebound headaches and, over time, can cause organ damage. Although you can't cure migraines, medicines and other treatments may help you feel better. Avoiding triggers can help, too. If that doesn't work, your provider can prescribe stronger medicine. You may also try medicine to help prevent migraines. BOTOX injections have become an excellent preventative treatment for migraine headaches. If you have 15 or more migraine headaches per month and have tried at least three other preventative medicines without success, talk with your provider to see if BOTOX is the right option for you. CGRP antagonists have become another game-changing treatment for our patients. These medications intercept CGRPs, which are large molecules that can cause inflammation and migraine headaches. They can be taken as a monthly injection or in the form of a pill.

Our expert team of neurologists has the experience to diagnose and treat many forms of headaches and migraine conditions. Once we’ve gathered all the information about your headaches, we can focus on finding the proper treatment options to help you get back to living your everyday life. Contact us today to schedule an appointment.