Migraines are "primary headaches," meaning they are not caused by an underlying medical condition such as a tumor. Two other forms of primary headaches are tension-type and cluster headaches. Tension headaches are the most common type and are usually characterized by a steady ache rather than the throbbing pain that is typical of migraines.
Cluster headaches affect only about 1 percent of the population, mostly males. The headaches come in groups over weeks or months. The pain is very severe, usually centering around one eye, but rarely lasts more than an hour or two.
Many scientists think migraine is a vascular disorder caused by a tightening (constriction) and sudden opening (dilation) of the blood vessels in the head, neck or scalp.
Others believe that the throbbing pain of migraine is caused by an abnormal release of neurochemicals in the brain, such as serotonin or noradrenaline.
Migraine sufferers may be born with a hypersensitive nervous system that makes them prone to the headaches. Then, a lifestyle or environmental "trigger," such as a hormonal change or a certain food or chemical, can provoke an attack.
A simple change in lifestyle to avoid personal triggers may minimize the frequency of migraines in some patients.
alcoholic drinks (especially red wine)
foods containing a chemical called "tyramine" (for example, aged cheeses, sour cream, and yogurt)
foods with additives such as nitrites, MSG, or aspartame.
A change in caffeine intake, either up or down, can also trigger migraine.
Other lifestyle factors, such as change in sleep habits and even overuse of headache medicines, may sometimes provoke migraines, as can environmental factors, such as:
change in weather (often the approach of a low-pressure weather front) or temperature
bright or fluorescent lights or sunlight
The role of hormones in provoking migraine helps explain why three times as many women as men suffer from this type of headache. Because of the impact of hormones, women who are pregnant, using birth control pills, or going through menopause often experience an increase or decrease in the frequency of headaches.
Migraines can also be triggered by emotional factors, including not only negative feelings like frustration, anxiety or depression, but also by relaxation and positive feelings such as excitement. "Someone can go through a very stressful time--no headache--and then the weekend or holiday comes and they can finally relax, and the headache comes on," Levin says.
For this reason, experts say that keeping a personal "headache diary" may help in determining the best treatment approach. The diary should include characteristics of each attack, including triggers as well as the date and length of the attack, preheadache symptoms, level of pain (on a scale of 1 to 4, for example), sensitivities during the headache, medicine taken within 48 hours before the attack started, and other observations.
Stress as Aggravator
The fact that stress can play a role in migraine, experts say, doesn't mean that migraine is a psychological disorder. The role of psychological stress on migraines is like the role of psychological factors on epilepsy, asthma, hypertension, and heart disease. Stress is not the cause of migraines, but psychological issues can worsen migraines as they can these other medical conditions.
Like someone with high blood pressure or heart disease, people with migraines should maintain a healthy lifestyle, including regular sleep patterns, a healthy diet, and exercise. Beyond those traditional healthy habits, some people report benefiting from behavioral treatments even though these have not been scientifically proven effective. These treatments include relaxation therapy, yoga, or biofeedback, which teaches people to reduce their muscle tension.
Many doctors, too, lack knowledge about migraines which may account at least in part for the high rate of undiagnosed migraine cases--an estimated 60 percent of women sufferers and 70 percent of men.
It is recommended to form a partnership with your health-care professional to ensure the most effective treatment. Seek a knowledgeable and interested doctor who will work with you, he says, and get information yourself from headache organizations.
There's a great deal more that can be done for migraine today than 20 years ago
Don't accept that you have to live with migraines. |