Is it a migraine or just a bad headache? For those who have suffered from chronic migraines, the answer is quite obvious. Most tension headaches usually don’t cause the nausea, vomiting, abdominal pain, weakness, or numbness that can occur with severe migraines or other medical conditions. Although some people may be sensitive to light or sound with tension headaches, these symptoms are not as common as with migraines.
How common are migraines? The Migraine Research Foundation estimates that 12 percent of the population – including children – suffer from migraines. In the United States, an estimated 18 percent of women, 6 percent of men, and 10 percent of children have migraines.
The US Centers for Disease Control and Prevention (CDC) states that about 15 percent of US adults reported having had migraines or severe headaches in the past three months, “a number that has remained stable for nearly two decades “. (June is National Migraine Awareness Month).
In addition, migraines can be very debilitating and are one of the leading causes of disability worldwide. In a study of migraineurs in the United States, more than half of participants reported “severe impairment in activity, the need for bed rest, and / or decreased work or school productivity due to migraines,” according to the CDC.
But for those who do not have chronic migraines, when should they seek medical help?
Neurologist Pooja S. Patel, MD, director of the epilepsy program at the Marcus Neuroscience Institute, part of Baptist Health, said, “A person with a headache should see a doctor if the headache is thunderclap or theirs’ worst headache Life acts when they appear different from their usual headaches, which last longer than usual headaches, or constantly wake them from sleep. “
The most noticeable differences between migraines and headaches relate to duration, intensity, and other symptoms.
“Migraine is a primary headache, which means there is no obvious secondary cause,” explains Dr. Patel. “Migraines share some common traits such as sensitivity to light, sensitivity to noise, nausea / vomiting, and sometimes auras. Migraines are usually more intense and last longer than most other headaches, with the exception of a few. “
Migraines are considered chronic if they occur for 15 or more days per month for more than three months, explains Dr. Patel.
Migraine triggers vary from person to person, but common are stress, weather changes, hormonal changes in women, alcohol – especially red wine, certain foods like aged cheese, chocolate, processed foods, and foods that contain MSG, says Dr. Patel. Stress is a major trigger for most of the people who experience migraines on a regular basis. One study found that up to 70 percent of people had a significant association between their daily stress levels and daily migraine activity, according to the American Migraine Foundation.
Treatments for migraines
For most migraineurs, medication is the first line of defense to prevent or relieve pain and other symptoms.
“In the case of chronic migraines, we usually start with drugs of various classes to prevent headaches,” explains Dr. Patel. “When oral drugs aren’t effective, botox and newer injectable drugs that are CGRP receptor antagonists are offered that are highly effective. Other peripheral nerve blocks are also offered to treat severe migraines. “
Treatment of migraines in recent years has led to the development of drugs that target a protein called calcitonin gene-related peptide (CGRP). Its mechanism of action is to block the CGRP receptor on nerve cells that cause severe pain and activate a CGRP cascade. Blocking the CGRP receptors can prevent pain prior to induction.
Botox – mainly known as a drug made from a toxin that can temporarily smooth facial wrinkles – is believed to be an important tool in the treatment of chronic migraines. In 2010, Botox was approved by the US Food and Drug Administration (FDA) for use in chronic migraines. As part of a treatment regimen, botox is injected around the pain fibers and penetrates the nerve endings to block the release of chemicals that are involved in pain transmission.
“A botox injection prevents the pain activation before it starts,” says Dr. Patel. “Botox also works by relaxing the muscles.”