DO I HAVE A HEADACHE OR MIGRAINE?

By LEAH RASMUSSEN

We all get headaches, but a migraine is different than even a bad headache. When a migraine strikes, it can be debilitating and keep people from participating in everyday life.

As a neurology practitioner, I help patients reduce the number of days they experience migraines each month. Migraines are among 10 of the most disabling illnesses. We cannot participate fully in our lives when we are suffering from migraines.

The American Migraine Foundation estimates that at least 39 million Americans live with migraines, but since this neurological condition is not always diagnosed or treated, the number may be higher.

Symptoms Migraine symptoms vary greatly from person to person. If you have two or more of these symptoms, you may have migraines. If so, it's best to see your primary care provider.

• Your head pain is moderate or severe and often intense. The pain may be hard to endure and may be unbearable.

• The pain may be on one side of the head or both. It could be in the front or in the back. Some patients experience migraines in or around their eyes and behind their cheeks.

• Your head pain causes a throbbing, pounding, or pulsating sensation.

• Your head pain gets worse with physical activity or any movement.

• You experience nausea and/or vomiting.

• You are sensitive to light, noise and/or smells.

• Your head pain is severe enough to make you miss school, work or other activities (or it keeps you from being at your best when you do those activities).

• A migraine attack lasts anywhere from four hours to several days.Source: American Migraine Foundation

In order to diagnose migraines, we will discuss your symptoms, frequency, types of pain, location of pain and remedies that make it better. For instance, some find relief by laying down in a dark, quiet room with a cold compress.

Triggers and Signs The brain is a puzzle that affects every part of the body. Sometimes, we can identify triggers that cause the migraine attack. Triggers include stress, lack of sleep, alcohol, certain food, certain smells, weather, bright lights, poor posture while working at your computer, and hormonal fluctuations.

We often associate migraines with auras. However, only about one-third of people with migraines have an aura according to the American Migraine Foundation. An aura is usually visual such as blurry vision, vision loss, flashing or shimmering lights, appearance of geometric patterns. Sensory auras include tingling, numbness, and trouble speaking. Auras usually begin just prior to the headache but can occur with the headache.

Some people experience warning signs of a migraine in what is called the prodrome phase. Typical symptoms include difficulty concentrating, problems speaking and reading, nausea, sensitivity to light or sound, yawning, muscle stiffness, fatigue, or food cravings. The prodrome phase can occur anywhere from a few hours to a few days prior.

Keeping a journal and tracking migraines helps identify triggers and warning signs. These signs and symptoms could serve as a cue to take abortive medication and avoid triggers to prevent the migraine or make it less severe. A migraine journal also helps you and your healthcare provider understand your migraine frequency and timing, helping them find the best treatment plan for you.

Diagnosis and Treatment A variety of abortive and rescue medications can be prescribed. Abortive medications are taken at the first signs of a migraine. These medications can be very effective and make it possible to carry on with everyday activities.

For people who are having migraines several times a month, preventive treatments can be beneficial and reduce the number of migraines per month. There are many different options for preventative medications including pills and injections. We have also seen some success in prevention with dry needling depending on the migraine location.

For migraine patients who have forward head posture, reduced range of motion in their neck and increased sensitivity in the neck muscles, the presence of trigger points have been confirmed. Trigger points are knots in the muscle that refer pain elsewhere. Trained physical therapists insert a tiny threadlike needle into trigger points to help release the tension.

There also may be lifestyle changes that can help prevent migraines such as an exercise routine, proper water intake and adequate sleep. For example, exercise causes the body to release endorphins, our body's natural painkillers. Exercise can also help reduce stress and improve sleep. Both stress and poor sleep can trigger migraines.

Another thing to consider is caffeine intake. If your day is fueled by caffeine, your provider may recommend gradually reducing your caffeinated beverages to safer levels.

If you are experiencing migraines, talk to your primary care provider about the best prevention and treatment options for you. ■

To learn more, visit mankatoclinic.com/neurology