A migraine is a highly painful headache that is often accompanied by neurological symptoms, such as nausea and sensitivity to stimuli such as light and sound. These neurological symptoms are often what differentiates a migraine from a headache, as people with migraine experience a range of neurological symptoms alongside their pain. Many people experience migraines regularly.
An important thing to note is that a severe headache may sometimes be a sign of a more serious health concern. If you experience a very severe or sudden headache, a headache after an injury, or a headache with unusual symptoms such as fever, confusion, weakness or trouble speaking, call 000 or seek medical attention immediately. It is always best to have your headaches checked by your doctor to rule out any more serious causes such as a stroke.
Common symptoms of migraine:
- Severe headache
- Nausea and vomiting
- Feeling odd or fatigued for a day or two before the migraine
- Stiff neck
- Sensitivity to noise
- Sensitivity to light
- Sensory disturbances (aura)
Migraine auras
The term ‘migraine aura’ describes the temporary changes some people experience before or during a migraine. An aura usually builds up over a few minutes and lasts less than an hour. Visual changes are the most common, but aura can also affect feeling and speech, such as:
- Geometric designs that move around and obscure your vision, such as zig-zag lines or shapes that cause a blind spot
- Shimmers or stars that dance across the visual field
- Flashing lights
- Numbness or tingling, often spreading through a hand, arm or one side of the face
- Difficulty finding words or speaking
Some people experience a migraine aura without a headache. This can be alarming but is fairly common, especially as people get older. Because some of these symptoms can also be signs of a stroke, any new or unusual aura, weakness on one side of the body or loss of vision should be checked by a doctor straight away.
A rarer type, called retinal migraine, causes short-lived vision loss or blindness in one eye only. It needs to be assessed by a doctor, because loss of vision in one eye can have other, more serious causes.
What causes migraines?
Migraines are a complex process, and the exact cause is not clear. Current research suggests that changes in nerve pathways and brain chemicals play a role, and a slow wave of changed electrical activity spreading across the brain is thought to cause the aura that many people describe. There is also evidence to suggest that both environmental factors and genetics affect your chances of experiencing migraines.
While we don’t know the exact cause of migraines, we have become familiar with a range of triggers and the effect that they might have on the development of a migraine. One way to manage migraines is to identify personal triggers and avoid them where possible. These include:
Sleep and fatigue
If you are low on sleep or feeling burnt out and fatigued, you are more likely to experience a migraine. A sudden change in sleep patterns can also be a trigger.
Hormonal changes
For women who experience migraines, hormonal changes are likely to play a role. The hormone oestrogen fluctuates greatly throughout a woman’s cycle, as well as before, during and after pregnancy and menopause. This change can trigger migraines in women.
Stimuli
Experiencing strong sensory stimuli such as strong chemical smells, bright or flickering lights or loud noise may trigger a migraine.
Medication
Some common medications, such as oral contraceptives, may trigger migraines in some people. Taking pain medication too often can also lead to more frequent headaches, so talk to your doctor or pharmacist if you are using it on many days each month.
Exercise
Some people experience a migraine after a workout, and this is often called an ‘exercise-induced migraine’. It’s particularly likely to occur after an intense workout.
Stress
Becoming highly stressed or anxious is one of the most commonly reported migraine triggers.
Diet
Certain foods such as foods high in histamine are likely to trigger a migraine in certain people. Other common dietary triggers include dairy products, artificial sweeteners and unfortunately, caffeine and alcohol. Skipping meals can also be a trigger. It is worth being mindful of your consumption and keeping an eye out to see if what you are eating or drinking causes you any trouble.
Migraine treatments
Medications
Medications such as pain relievers can be taken when a migraine begins in order to reduce the severity of the pain experienced. For people who have frequent migraines, a doctor may suggest a preventive medication taken every day. Some of these medicines are also used for other conditions, such as high blood pressure or epilepsy.
Lifestyle changes
Changes to lifestyle such as diet, exercise, stress reduction and sleep can all help to reduce how often migraines happen. Mental and physical relaxation through methods such as yoga and acupuncture may help to reduce the frequency of migraines by easing stress and tension in the body.
How a physio can help
Some people who assume they have migraines may be experiencing cervicogenic headaches, where problems in the neck cause headaches. A physio can assess your neck and posture for problems that may be contributing to your headaches or migraines.
If you have exercise-induced migraines, then a physiotherapist can help you to identify an exercise plan that helps you to achieve your goals with less chance of triggering a migraine.
Additionally, a physiotherapist can provide you with services such as dry needling, and our team can offer remedial massage and exercise plans aimed at reducing stress and improving overall health and sleep.
*All information is general in nature. For specific advice please visit your health professional.
