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Migraine: Not just a bad headache

Migraine headache can be simply defined as severe head pain that lasts for several hours, sometimes even for days.  Usually the pain is only on one side of the head. For about  twenty percent of the 24+ million migraine sufferers in the US, it is accompanied by an aura--a sensory disturbance such as a visual disturbance, hallucination, numbness, or tingling .

Migraine can be quite debilitating.  As a migraine sufferer myself, I cannot begin to tell you how many days of productivity I have personally lost due to migraine.  Multiply me by 24 million and...well, that's a lot!  The financial impact is also huge if you consider all the work days lost in addition to the money that is spent on doctor or ER visits and tests and prescription drugs related to this problem.

What causes migraine, you might ask?  Well, the jury is still out on that but it is proposed that there is a cascade of neurological events that lead to the swelling of blood vessels in the brain. Pain and inflammation accompany this series of events, and thus a migraine headache is born.  There is some evidence to suggest that there is a genetic component to the risk for migraine--so if you have a migraine sufferer in your family tree, there are likely others in the tree who suffer the same fate.

The symptoms of migraine can include the aura as described about, which can occur as early as 72 hours before the actual headache.  In addition, headache, nausea, vomiting, visual sensitivity (particularly to bright light), and sometimes numbness or tingling. Typically a migraine headache only occurs on one side of the head, but it may involve both sides, or even switch sides during an episode.

As far as prevention and treatment go, it is important to look in your history for triggers of headache and learn to prevent what they are.  One way to accomplish this is to keep a pain journal as I describe in my November 14th post. The following is a list of common migraine triggers:
Common food triggers include:
  • cheese
  • alcohol
  • caffeine products, and caffeine withdrawal
  • chocolate
  • intensely sweet foods
  • dairy products
  • fermented or pickled foods
  • citrus fruits
  • nuts
  • processed foods, especially those containing nitrites, sulfites, or monosodium glutamate (msg)
Environmental and event-related triggers include:
  • stress or time pressure
  • menstrual periods, menopause
  • sleep changes or disturbances, oversleeping
  • prolonged overexertion or uncomfortable posture
  • hunger or fasting
  • odors, smoke, or perfume
  • strong glare or flashing lights
Drugs which may trigger migraine include:
  • oral contraceptives
  • estrogen replacement therapy
  • nitrates
  • theophylline
  • reserpine
  • nifedipine
  • indomethicin
  • cimetidine
  • decongestant overuse
  • analgesic overuse
  • benzodiazepine withdrawal
Treatment of migraine usually involves knowing what these triggers are and learning to avoid them. There are medications available to prevent and actively treat migraine and its manage the symptoms once they occur.  The best non-drug intervention is to lay quietly in a dark room so as to avoid painful stimuli.

If you suffer from frequent migraine it is best to talk to your doctor about it.  He or she will be a good partner in helping you to lessen the frequency and/or severity of this troubling chronic pain problem.


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