Migraines are thought to affect one in 10 people worldwide. These intense headaches involve throbbing pain and many people experience nausea, vomiting, and sensitivity to light and sound.

Neuraxpharm provides medication alternatives for migraine and once your doctor has determined your specific needs, they can prescribe the product that best adapts to your needs and condition.

Read more about the symptoms and stages of migraines, and how they are treated.

What is migraine?

A migraine is an intense headache with throbbing pain that usually affects one side of the head. It often comes with nausea, vomiting, and extreme sensitivity to light and sound. Migraines commonly last for at least four hours and can go on for several days – in many cases they affect the ability to carry on with daily activities.

What are the main types of migraine?

Migraines are generally split into two categories: migraine with aura and migraine without aura.


‘Aura’ is a word used to describe symptoms that can come on before a migraine attack, lasting up to an hour. These symptoms act as warning signs to indicate a migraine is coming. Auras often involve visual symptoms, such as seeing flashing lights or wavy lines, or getting tunnel vision. Some people also experience tingling in the arms and legs and changes to smell, taste, touch, or speech.

How many people have migraines?

According to the World Health Organization (WHO), it’s estimated that half to three-quarters of adults aged 18 to 65 have experienced a headache in the last year. Of those, 30% or more have had a migraine.


A 2017 review in the Journal of the Neurological Sciences found that migraine affects one in 10 people worldwide and reported that migraines are on the rise around the globe. In Europe, studies show that migraine occurs in 15% of adults.

Symptoms

The main symptom of migraine is an intense headache. This usually involves throbbing pain on one side of the head, but some people get pain on both sides of the head or even in the face and neck.

What are the symptoms of migraine?

The most common migraine symptoms are:

  • A headache that tends to start as a dull ache and develops into throbbing pain, often on one side of the head
  • Pain that gets worse with movement and often prevents daily activities
  • Nausea
  • Vomiting
  • Sensitivity to light and sound

Other symptoms may include:

  • Feeling faint
  • Feeling very hot or cold
  • Sweating or feeling clammy

What are the stages of migraine?

Everyone’s experience of migraine is different. For many people, migraines follow four stages – prodrome, aura, attack, and postdrome – but not everyone experiences every stage.

1. Prodrome

The prodrome stage can come on one or two days before the migraine appears. During this stage, it’s common to notice subtle signs that indicate a migraine may be coming. These include:

  • Increased sensitivity to light, sound, or smell
  • Tiredness and yawning
  • Food cravings, change in appetite or increased thirst
  • Mood changes
  • Bloating, constipation, or diarrhoea
  • Stiffness in the neck

2. Aura

Migraines may also be accompanied by an aura. ‘Aura’ is a term used to describe symptoms that appear before a migraine, acting like a warning. Not everyone who gets migraines experiences auras. For those who do, they can last for up to an hour and include one or more of:

  • Seeing flashing lights, black dots or wavy lines
  • Hallucinations (seeing things that aren’t there)
  • Developing tunnel vision or losing vision for a short time
  • A tingling or numb sensation on one side of the body
  • Ringing in the ears
  • Changes to speech, smell, taste, or touch

3. Migraine attack

A migraine itself usually lasts for at least four hours and can go on for several days if untreated. The regularity and severity vary from person to person.

4. Postdrome

After having a migraine it’s common to feel tired, drained, and lacking in energy for up to a day, and the pain may even return briefly with sudden movement. This period is known as the ‘postdrome’ phase.

Causes, risk factors and life expectancy

While migraines in themselves are not life-threatening, they can have a big impact on general health and greatly affect daily life.


Research from Harvard Medical School shows that people who experience frequent migraines are more likely to have other health issues, such as anxiety, depression, insomnia, and irritable bowel syndrome. Other research suggests that migraines are associated with an increased risk of heart attack and stroke.

What causes migraines?

Doctors are still unsure about the exact causes of migraine, but they think it could be related to temporary changes in the chemicals, nerves, and blood vessels in the brain. Some people find their migraines are related to certain factors such as their menstrual cycle, diet, tiredness, or stress.

Are migraines hereditary?

Around half of people who experience migraines have a close relative who also gets them, suggesting there may be a genetic link.

Scientists know that migraines often run in families, but they aren't sure exactly how. There is ongoing research into why some families are susceptible to migraines and how genetics may influence people’s experiences of migraine.

Who gets migraines?

Migraines tend to affect more women than men. A global review of migraines published in 20172 found that they affect 13.8% of females, compared with 6.9% of males. The same review found that students are a high-risk group, with 12.4% affected. It also revealed that where people live can be significant, with over 11% of urban residents experiencing migraines compared with 8.4% of people living in rural areas.


Migraines can come on at any age. However, they seem to be more problematic in middle age and ease off in the later stages of life. Children are also susceptible – 10% of 5-15 year-olds experience migraine, and common symptoms in this age group include episodic attacks of moderate to very severe headache accompanied by nausea and sensitivity to light and sound.

How long can you live with migraines?

Migraines can have a severe impact on daily life, especially for people who suffer from regular, long-lasting attacks.
A 2019 report in the Journal of Head and Face Pain looked at the effects of migraine on relationships, careers, and finances and found that the condition can negatively affect many important aspects of life. These included marital, parenting, romantic and family relationships, career/financial achievement and stability, and overall health. In the report, over 32% of survey respondents said they worried about long‐term financial security due to migraine.

Diagnosis

It can take time to diagnose migraines, because they are often unpredictable and the process can include several tests. It can be helpful to keep a migraine diary to help doctors get a better picture of what’s happening.

How are migraines diagnosed?

First, the doctor will examine vision, reflexes, and coordination and ask questions about the symptoms. Keeping a migraine diary can help them to spot any patterns and is often a useful tool for making a firm diagnosis.

How to keep a migraine diary

It’s easy to keep a migraine diary – simply draw up a table or print one off from an online source and note down any of the following information whenever a migraine occurs:

  • When the migraine happened
  • How long it lasted
  • The type of pain experienced
  • Whether there were any other symptoms, such as being sick
  • Whether any medication or treatments were taken that day
  • Whether any vitamins or supplements were taken
  • What was eaten and drunk that day (see also ‘Diet’)
  • Other factors that may be relevant, such as the weather, menstrual cycle phase, stress factors, and social or work activities

Tests to diagnose migraine

There are no specific tests to identify migraines, but sometimes doctors will want to do tests to rule out other conditions with similar symptoms. These may include: blood tests; magnetic resonance imaging (MRI) scans, which provide detailed images from magnetic fields and radio waves; and an electroencephalogram (EEG), which detects electrical activity in the brain using small electrodes attached to the scalp.

Treatment and medication

While there is no cure for migraines, there are different treatment options available that can help to reduce their impact or prevent them from happening.

How is migraine treated?

The main way to treat migraine is with medication. However, there are a range of other therapies and interventions that can be helpful; lifestyle changes are often effective, too.

Medication

Medication for migraine falls into two categories:

  • Prophylactic medication: This is also known as preventive treatment and includes beta-blockers, anticonvulsants, tricyclic antidepressants and – more recently – calcitonin gene-related peptide (CGRP) target drugs. It is mostly used for people who experience at least three migraines every month or at least eight headache days per month, but it can take several months before it works properly.
  • Acute medication: This is medication that is taken at the time of the attack to stop or greatly reduce the pain. It includes NSAIDs and triptans as well as over-the-counter painkillers and prescription medicines.
Another possible medication for migraine is anti-sickness medicine (anti-emetics). Some people find that these help their migraines, even when they don’t experience feeling or being sick (nausea or vomiting) as a side effect.

Remember that all medication may have side effects. Always talk to a doctor before starting any new medication.

Therapy and intervention

Studies have found that acupuncture can help to lessen the effects of migraine in some people. In one study, patients who were given 12 acupuncture treatments over the course of three months experienced 34% fewer headache days than they recorded at the start of the study.

Green light therapy has also been found to be beneficial for migraines. This involves spending time in a specific, narrow band of green light from a special lamp while filtering out all other light. It’s important to use this therapy properly, as lights of other colours – including white, blue, amber, and red – can exacerbate migraines.

Using relaxation techniques to reduce stress levels has also been shown to be effective. The methods to use will depend on what works best for each person, but meditation, yoga, and mindfulness can all be beneficial.

Alternative treatments that work on the body – such as massage, acupressure, acupuncture, and craniosacral therapy – might also help to ease stress. Always talk to a doctor before trying any complementary or alternative treatments.

Diet

Altering diet may be useful as part of a wider approach to lifestyle changes to help alleviate migraines. As a general rule, try to stick to a healthy, balanced diet and eat at regular times.

Again, keeping a headache diary will help you to identify any foods that may affect migraines. This should include details about:

  • Everything eaten and drunk
  • The time of day
  • Activity and location at the time of eating or drinking (for example, watching TV, sitting at the dining table, working at a desk)
Keeping a diary may help identify that dietary factors are triggering migraines. For example, delayed or irregular meals, fasting, extreme dieting, and missing meals can cause blood glucose levels to fall, which could be a migraine trigger. Caffeine, alcohol, high-sugar foods, and cheese can also play a part.

Adding certain supplements to the diet, including vitamins, minerals, and herbal preparations, can be considered. For example, magnesium may contribute to normal functioning of the nervous system and to energy-yielding metabolism, while some botanicals may help to reduce tension states localised to one area, or promote relaxation.

Exercices

Some people find that exercise can trigger migraines, while others say it is beneficial. The main benefit of regular exercise is that it helps to reduce stress, which is a common trigger for migraines. As obesity is thought to be linked with migraines, it’s also worthwhile exercising regularly to maintain a healthy body weight.

Prevention

Research2 shows that improved awareness, early treatment and a healthy lifestyle can be significant in the prevention of migraine, so it’s advisable to talk to a doctor as soon as symptoms appear.


Many people who suffer from migraines find that by gaining a better understanding of the factors that can trigger a migraine, they can take steps to prevent them from happening so frequently. One of the best ways to do this is through a migraine diary that can help to show whether a certain food, or something like stress or a lack of sleep, is triggering an attack.


Certain drugs have been shown to help prevent migraines in some people, but they may not be suitable if there are any other health problems and should only be prescribed by a doctor.

Scientific studies

Research into migraine medication has made notable strides in the past five years, including clinical trials of new medication classes to treat acute migraine, and non-drug therapies such as magnetic stimulation and non-invasive vagus nerve stimulation (nVNS).

Researchers are also interested in prophylaxis drugs that target calcitonin gene-related peptide (CGRP), a neuropeptide which neurons use to communicate.

Research has also shown the importance of understanding the prodromal phase of migraine,15 when symptoms such as yawning, tiredness, cognitive dysfunction, and food cravings can occur. It’s thought that this may help to explain migraine triggers in some people and allow them to self-manage their condition more effectively.

Referenced sources

  1. Headache disorders. World Health Organization. Published April 2016. Accessed January 2021. https://www.who.int/news-room/fact-sheets/detail/headache-disorders
  2. Woldeamanuel YW, Cowan RP. Migraine affects 1 in 10 people worldwide featuring recent rise: a systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci. 2017;372:307-315. doi:10.1016/j.jns.2016.11.071
  3.  Stovner LJ, Andree C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain. 2010;11(4):289-299. doi:10.1007/s10194-010-0217-0
  4.  Feel your pain: the health risk of migraines in men. Harvard Health Publishing. Published September 2016. Accessed December 2020. https://www.health.harvard.edu/mens-health/feel-your-pain-the-health-risk-of-migraines-in-men.
  5. Kurth T, Winter AC, Eliassen AH, et al. Migraine and risk of cardiovascular disease in women: prospective cohort study [published correction appears in BMJ. 2016 Jun 17;353:i3411]. BMJ. 2016;353:i2610. Published 2016 May 31. doi:10.1136/bmj.i2610
  6.  Øie LR, Kurth T, Gulati S, Dodick DW. Migraine and risk of stroke. J Neurol Neurosurg Psychiatry. 2020;91(6):593-604. doi:10.1136/jnnp-2018-318254
  7. Gormley P, Kurki M, Kiekkala ME et al. Common variant burden contributes to the familial aggregation of migraine in 1,589 families. Neuron. 2018;98(4):743-753. doi:10.1016/j.neuron.2018.04.014
  8.  Teleanu RI, Vladacenco O, Teleanu DM, Epure DA. Treatment of Pediatric Migraine: a Review. Maedica (Bucur). 2016;11(2):136-143
  9.  Buse DC, Fanning KM, Reed ML et al. Life with migraine: effects on relationships, career, and finances from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study. Headache. 2019;59(8):1286-1299. doi:10.1111/head.13613.
  10.  Edvinsson L, Haanes KA, Warfvinge K, Krause DN. CGRP as the target of new migraine therapies – successful translation from bench to clinic. Nat Rev Neurol. 2018 Jun;14(6):338-350. doi: 10.1038/s41582-018-0003-1. PMID: 29691490.
  11.  Kumar A, Kadian R. Migraine prophylaxis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing LLC. Updated October 27, 2020. Accessed January 18, 2021. https://www.ncbi.nlm.nih.gov/books/NBK507873/
  12.  Öztürk V. Acute Treatment of Migraine. Noro Psikiyatr Ars. 2013;50(Suppl 1):S26-S29. doi:10.4274/Npa.y7299
  13. Vickers AJ, Rees RW, Zollman CE et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. 2004;328(7442):744. doi:10.1136/bmj.38029.421863.EB
  14.  Noseda R, Bernstein CA, Nir R-R et al. Migraine photophobia originating in cone-driven retinal pathways. Brain. 2016;139(Pt 7):1971-1986. doi:10.1093/brain/aww119
  15.  Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25(5):446-452. doi:10.1097/AJP.0b013e31819a6f65
  16. Amin FM, Aristeidou S, Baraldi C et al. The association between migraine and physical exercise. J Headache Pain. 2018;19(1):83. doi:10.1186/s10194-018-0902-y
  17. Goadsby J. Primary headache disorders: five new things. Neurol Clin Pract. 2019;9(3):233-240. doi:10.1212/CPJ.0000000000000654
  18.  Woo M. A new generation of headache drugs. Nature. 2020;586:S4-S6 doi:10.1038/d41586-020-02862-9
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