A migraine is a very bad headache that tends to come back over and over again. You might feel nauseated and vomit when you have one. The pain is usually on one side of your head. When you have a migraine, you might be very sensitive to bright lights and noise. Moving around makes the headache feel worse. Migraine is a real disease, just like diabetes, heart disease and arthritis. If you have migraines, you need to be treated by your doctor.
Should I call my doctor right away about a migraine?
Migraines are not life-threatening. However, brain infections and brain tumors can also cause bad headaches. Here are signs of dangerous headaches:
- A sudden, severe headache, or the "worst-ever" headache
- A headache that gradually gets worse instead of getting better with time
- A headache with memory loss or thinking difficulty, disturbed vision or speech changes, loss of strength, tingling or numb feelings in one part of the body, such as arms or legs, or a change in balance
- A headache with fever, stiff neck, clumsiness, change in awareness, change in personality, vision problems that last more than an hour
- A headache that lasts for more than a week after you have had a head injury
Foods that might trigger a migraine
- Aged cheese
- Beer, wine and hard liquor
- Caffeine in coffee, tea and cola, and some over-the-counter medicines, as well as caffeine withdrawal (if you try to give up caffeinated sodas, for example); chocolate in sweets, foods and drinks
- Dairy products such as ice cream, milk, yogurt, cheese, whipped cream and sour cream
- Fermented and pickled foods such as pickled herring
- Most citrus fruits like oranges, grapefruit and lemons
- Bananas, figs and raisins
- Processed meats, deli sandwich meats, hotdogs and other nitrite-containing meats
- Monosodium glutamate (MSG), which is found in Chinese food, Accent seasoning, Lawry's seasoned salt, canned soups, TV dinners, processed meats, and some processed nuts and snack chips
- Saccharin or aspartame (Nutrasweet) in diet foods or diet sodas
- Sulfites in shrimp and processed potatoes, like boxed mashed potato mix
- Pea pods, or pods of lima or navy beans
- Yeast-containing products, such as fresh breads and donutsNuts and peanuts
What causes migraines?
Doctors think migraines may be caused by a chemical or electrical problem in certain parts of the brain. Some things can cause (trigger) a migraine or make a migraine get worse. Headache triggers can be something you eat, smell, hear or see. These are common migraine triggers:
- Stress and time pressure, major hassles, major losses, anger and conflict
- Hunger or fasting (not eating), and specific foods and beverages (see the box above)
- Smells and fumes, tobacco smoke, light glare or dazzle, weather changes
- Monthly period, birth control pills, estrogen therapy
- Too much, too little or interrupted sleep
- Excessive activity (especially if you're not in good shape)
What helps a headache besides medicine?
- Hold an ice pack to your forehead or temples to reduce your pain.
- Lie down in a quiet, dark room.
What else can I do about headaches?
You could try keeping a migraine diary (a headache journal). Writing down information about your headaches and what you were doing when they happened can help you find out what triggers your headaches. Then you can avoid those triggers. Write these things in your headache diary.
Can I do anything to avoid headaches?
- You can try to spread your work load evenly during the day to avoid highs and lows of stress at work or at home.
- Don't sleep later on weekends, because this often causes a "let-down" headache.
- Don't get overtired.
- Eat at regular times, and don't skip meals.
- Don't eat or drink anything you think brings on a headache.
- Limit the amount of tea, coffee and pain medicines you use. Too much of these may cause headaches.
- Watch your posture. Try to keep your neck straight. Think "tall."
- Keep your muscles relaxed when you're not physically active. Try not to frown or tighten your jaw.
- Restrict your physical activities in hot weather.
Avoid bright or flickering lights, loud noises or strong smells, if they trigger headaches for you.
- Remember the classic advice: "Moderation in all things."
What are "rebound headaches"?
Headaches that happen every day or almost every day are sometimes caused by using too much of the medicines that treat migraine pain. These headaches are called "medicine rebound headaches." Over-the-counter and prescription painkillers, sedative/tranquilizer medicines, and ergotamine-type medicines can cause rebound headaches if they are taken too often. If you stop overusing these medicines, your headaches will get better. If you have any of the problems in the box on the right, see your doctor.
What are the signs of medicine rebound headaches?
- Daily or almost-daily headaches, often early in the morning
- Too-frequent use of pain-relief medicines (on more than 15 to 20 days per month)
- A difference in type, severity and location of the headache
- A headache caused by a very small physical or mental effort
- One or more of the following with the headache: nausea, anxiety, irritability, memory problems, difficulty in concentrating, depression, sleep disturbances
- Occasional very severe migraine headaches
- A family history of frequent headaches
What can I do to stop having medicine rebound headaches?
You can stop taking some medicines right away. Other kinds of medicine have to be slowly reduced, not just stopped all at once. It's important to remember these things: after stopping the medicine that is giving you rebound headaches, your headache may get worse for a few days. You might even have a very bad headache for about three days. If you work, consider stopping the medicine just before a weekend. If you take off Friday or Monday, you'll have a longer time to rest. It might take 8 to 12 weeks before your body responds the right way to migraine pain medicines.
What medicines are available to treat migraines?
Three groups of medicines treat migraines. One group of medicines works to stop the pain. These medicines work best if taken when the migraine pain starts. Another group of medicines treats the nausea or vomiting that can happen along with a migraine. The third group of medicines prevents migraines from starting. These are called "preventive" medicines. Some people have migraines so often or the headaches are so bad, their doctors try to prevent the headaches by giving them preventive medicines. These should usually be taken every day. Your doctor will look at your headache history to find the best medicines for you.