A migraine, or migraine headache, can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. If you’ve ever experienced a migraine, you know the pain can be so severe that it interferes with your daily activities.
Read on to learn the symptoms, triggers, and what you can do for treatment and relief.
Migraines, which often begin in childhood, adolescence, or early adulthood, can progress through four stages: prodrome, aura, attack, and post-drome. People who have migraines may not experience all stages.
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine including:
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased thirst and urination
- Frequent yawning
For some people, aura might occur before or during the headache. Auras are reversible symptoms of the nervous system. They’re usually visual, but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes, and lasts for 20 to 60 minutes.
Examples of migraine aura include:
- Visual phenomena, such as seeing various shapes, bright spots, or flashes of light
- Vision loss
- Pins and needles sensations in an arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking
- Hearing noises or music
- Jerking or other movements
A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.
During a migraine you might have:
- Pain usually on one side of your head, but often on both sides
- Pain that throbs or pulses
- Sensitivity to light, sound, and sometimes smell and touch
- Nausea and vomiting
After a migraine attack, you might feel drained, confused, and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.
There are a number of migraine triggers, including:
- Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women. Hormonal medications, such as oral contraceptives and hormone replacement therapy, can also worsen migraines. Some women, however, find their migraines occur less often when taking these medications.
- Drinks including alcohol, especially wine, and too much caffeine, such as coffee
- Stress at work or home
- Sensory stimuli like bright lights and sun glare, loud sounds, and strong smells including perfume, paint thinner, secondhand smoke, and others
- Sleep changes like missing sleep, getting too much sleep, or jet lag
- Physical factors, like intense physical exertion, including sexual activity
- Weather changes, including barometric pressure
- Medications like oral contraceptives and vasodilators, such as a nitroglycerin
- Foods like aged cheeses and salty, processed foods and sometimes skipping meals or fasting
- Food additives like the sweetener aspartame and MSG
Treatment is aimed at stopping symptoms and preventing future attacks. Migraine medications fall into two broad categories:
- Pain-relieving medications are taken during migraine attacks to stop symptoms
- Preventive medications are taken regularly, often daily, to reduce the severity or frequency
The frequency and severity of your headaches and whether you have nausea and vomiting with your headaches will determine your treatment. How disabling your headaches are and other medical conditions will also be taken into consideration.
Head to a quiet, dark room when symptoms start so you can close your eyes and rest. Place a damp cloth on your forehead to ease tension. Other practices that might soothe headache pain include:
- Relaxation techniques
- Developing a sleeping and eating routine
- Drinking plenty of fluids, particularly water, will help you stay hydrated
- Keeping a headache diary will help you learn more about what triggers your migraines and which treatment is most effective
- Regular aerobic exercise reduces tension. If your doctor agrees, choose aerobic activity you enjoy, such as walking, swimming, and cycling. Warm up slowly, however, because sudden, intense exercise can cause headaches
Medications work best when taken at the first sign of an oncoming migraine — as soon as signs and symptoms begin. Medications that can be used to treat it include:
- Pain relievers, over-the-counter or prescription, include aspirin or ibuprofen (Advil, Motrin IB, others). If taken too long, these pain relievers might cause headaches from overuse and possibly ulcers and bleeding in the gastrointestinal tract
- Migraine relief medications that combine caffeine, aspirin and acetaminophen (Excedrin Migraine) may be helpful, but usually only against mild migraine pain
Your primary care provider may suggest prescription medication to help prevent and relieve migraines. Always consult your provider before taking any medication.
When to See a Doctor
Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches. Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.
Visiting the emergency room is recommended if you experience any of the following symptoms:
- An abrupt, severe headache like a thunderclap
- Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
- Headache after a head injury, especially if the headache worsens
- A chronic headache that is worse after coughing, exertion, straining or a sudden movement
- New headache pain after age 50
Schedule an in-clinic or telehealth visit at Advanced Urgent Care & Occupational Medicine. With locations across the Denver metro area, we’re open 7 days a week. Click here to learn more about the different types of headaches.