Headache or Migraine?

Nearly everyone gets a headache once in a while. For many of us, they are little more than an inconvenience. They last a short time or a dose of over-the-counter pain reliever gets us through until the headache goes away. But for the nearly 40 million Americans who suffer from migraines, a headache can be a long debilitating ordeal. The good news is that migraines are highly treatable and new treatments are becoming available every day. So, how do you tell the difference between an ordinary headache and a migraine?

Most migraines can last anywhere from 4 - 72 hours.
Over-the-counter pain relievers frequently don’t work to relieve the pain.
You often cannot work or function normally during a migraine.
Your head throbs and pulses.
A migraine often occurs on one side of the head.
The pain worsens with activity, like walking up stairs.
Migraines sometimes occur with nausea, vomiting, and sensitivity to light and sound.
One third of migraine sufferers also experience “an aura.” The headache comes with strange symptoms, like flashing lights or zig-zag lines, difficulty speaking, weakness, tingling on one side of the face or in one arm, or some loss of sensation in parts of the body.
The National Migraine Center offers a quick three-question test to help determine if you are suffering from a migraine.

While migraines can often run in the family or be associated with other conditions, they can sometimes be prevented with some basic lifestyle modifications. Getting enough high quality sleep, avoiding alcohol, staying hydrated, getting enough aerobic exercise, and eating regular nutritious meals can help. Managing stress in healthy ways can sometimes help too. Through journaling and other methods, some patients can identify environmental triggers. Avoiding these triggers can help prevent migraines.

For those with migraines that cannot be prevented with the steps above, there are many effective treatments. Some are just becoming available now. They can be used in conjunction with one another to create a customized approach to minimizing suffering from migraines.

Prescription-strength medications called triptans taken within 15 – 30 minutes of the onset of symptoms can shorten the duration of the migraine and not allow it to reoccur. Acute treatments like this should not be used more than 2 – 3 times a week.
Many medications, which have been available for some time, some of which were originally used to treat other conditions, can be prescribed by a doctor to take daily. In the right patients, these can help prevent migraines from occurring as frequently. These include common anti-seizure medications, anti-depressants, blood pressure medications, and some dietary supplements.
Specialized Botox injections are a very low-risk treatment that helps many migraine sufferers.
New treatments block the neurotransmitter CGRP (calcitonin gene-related peptide), which relaxes blood vessels and causes migraines. This therapy can be delivered via IV or as a once-monthly shot, but an oral form of the drug has been recently approved by the FDA.
Finally, new non-medical devices are available for patients to wear across their forehead or on their arm. They stimulate nerves that are involved in migraine mechanisms and have been shown to help sufferers of chronic migraines.

There is no need to suffer through migraine pain, which can cause those affected to miss work or important family activities. Relief is available. Talk to your primary care provider or ask for a referral to a neurologist to see what treatment might be best for you.

Dr. Emma Weiskopf is a neurologist at SVMC Neurology in Bennington, VT.