Unlike regular headaches, migraines are chronic, with intense pain only on one part of the head. They also involve different stages and intensities of pain.
These are the typical stages of migraine:
Prodromal phase: This is the first stage – usually one or two days – before a migraine, when the warning signs appear. These vary from person to person and include irritability, stiff neck, food cravings, constipation, depression, hyperactivity and excessive yawning.
Aura phase: Not every migraine sufferer experiences these visual effects but they are fairly common and typically include flickering, or jagged or zigzag lines that appear at the corner of one’s vision. Other signs of this phase are tingling in the fingers of one hand, the lower face and lips, and numbness that can extend to feel like temporary paralysis on one side of the body.
Auras rarely last longer than an hour, and in most cases are followed by a headache. Some people do not experience this phase, instead experiencing a laundry list of possible symptoms such as nausea, vomiting, diarrhoea, fluid retention, urinating more than usual, mood changes, fatigue, mental fuzziness, nasal congestion, runny nose, tearing and/or sinus pain or pressure.
Attack phase: This is the actual migraine and can last between a few hours and several days. The signature relentless throbbing pain begins above the eyes and hits just one side of the head. The pain may move from one area to another, spread or worsen during activity.
Postponed phase: After the worst pain of a migraine subsides, the sufferer typically feels drained, washed out, confused or even mildly euphoric. Severe and frequent migraine headaches certainly affect one’s quality of life, so it is important to identify factors that can lead to an attack.
It is also important to recognize that there is no one single cause, and this means that your strategy should be based on the frequency and severity, how disabling the attacks are, and whether you have any other medical conditions.
Some sufferers are prescribed regular medication to prevent/decrease the severity, length or frequency of the attacks, and these can cause mild to severe side-effects which you will be advised about. Other sufferers are also prescribed specific medication to be taken only at the outset or when the first warning signs appear. Non-drug treatments for migraine also helps, such as avoiding known triggers.
Everyday triggers may include:
- Missing meals
- Alcohol, especially red wine
- Foods with MSG, caffeine (coffee, tea, colas), nitrates and nitrites (found in preserved meats) or tyramine (found in aged cheeses)
- Menstruation, oral contraceptives and menopause
- Too little or too much sleep
- Bright lights, strong smells, changes in weather or high altitudes
Get medical assistance as soon as possible if your headache:
- Is abrupt and severe
- Comes with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
- Happens after a head injury, especially if it gets worse
- Lasts for a few days or weeks and gets worse after coughing, exertion, straining or sudden movement