Migraines

Difference Between Migraines and Headaches

Headaches are the result of muscle contraction between the neck and head. Common types include cluster headaches and sinus headaches. Migraines generally are described as “throbbing.” The pain tends to be in the front or side of the head and is typically more intense than headaches.

Unlike migraines, headaches often occur without any warning signs unlike migraines. Migraines can also cause impaired vision, nausea, and sensitivity to sound and light. 

Risk Factors

Those with family members that struggle with migraines are at an increased risk of experiencing them as well. Initially, migraines tend to appear in the teenage years and become most intense as the individual enters their 30s. In the decades that follow, the severity and frequency tend to decline.

Women are much more likely to suffer from migraines than men. One contributing factor for women relates to hormonal changes. Many women experience migraines during menstruation, pregnancy, and before menopause. 

Symptoms

There are specific symptoms that occur before or during an attack. Some people also experience symptoms just before an attack occurs. A pins and needles sensation, vision phenomena and uncontrollable movements are a few symptoms that may occur before a migraine. The most common signs prior to an attack are constipation, neck stiffness, mood changes and increased thirst.

The most common symptoms are those felt during an attack. These include:

• Throbbing pain on one or both sides of the head
• Sensitivity to lights and sounds
• Pulsing pain
• Feeling lightheaded
• Blurred vision
• Nausea and vomiting

Chronic vs. Episodic Migraines

Migraines are broadly categorized as being episodic or chronic. Episodic migraines are those that occur less than 14 times per month. Migraines that occur on 15 days or more each month are considered chronic. Those who experience chronic migraines are more likely to feel that the condition lowers the overall quality of their life. These individuals tend to feel that the condition impairs them financially, relationally, and in other aspects of life. 

Vestibular Migraines

Roughly 40% of those who suffer from migraines experience vestibular symptoms. These are feelings related to vertigo including dizziness and loss of balance. Many of these patients will be treated by a neurologist. Vestibular migraines are often triggered by certain foods. Therapists that specialize in vestibular rehabilitation can assist with exercises that can help patients with their balance. 

Optical Migraines

Optical migraines are also commonly referred to as eye, ocular or ophthalmic migraines. These are classified as migraines with aura and typically affect one of the eyes. The International Headache Society explains that the symptoms are temporary and reversible. Vision may be partially impaired or a blind spot may develop. Sometimes the visual impairment occurs without the presence of migraine-related pain. 

Migraine Headaches With Aura

Roughly 25% of migraines are migraines with aura. Those who experience them may sometimes have migraines without aura. The feeling of aura may be caused by electrical waves that are processing through the brain and tends to begin before the headache. 

Migraines with aura create problems that relate to the senses. Some of the common symptoms include the following: 

• Scotomas, which are visual blind spots
• Impaired vision in one or both of the eyes
• Fortification spectra, where the individual sees types of visual patterns
• Scintilla, which is where the individual sees flashes of light
• Hallucinations may occur such as smelling or hearing things that do not exist 

Menstrual Migraines

Many women experience migraines two to three days before starting their period. Usage of birth control pills may trigger migraines in some women or prevent migraines from occurring in others. Some women benefit from using birth control products that contain small amounts of estrogen. 

Many women find that hormone replacement therapy, which is often used during menopause, prevents migraines. Estrogen patches can be an effective method to deliver estrogen because the patches produce a low and steady dosage of estrogen. 

Hemiplegic Migraine

Conditions that are hemiplegic involve weakness on one side of the body. These are classified as a type of migraine with aura that is uncommon. They often occur together with symptoms including impaired speech or vision. 

Abdominal Migraines

Migraine sufferers may experience significant feelings of pain in the abdominal region. The pain tends to be intense and continues for up to two hours. Children that experience the symptoms often become “nonfunctional.” Many parents will bring their child to an emergency room based on the intensity of the pain. 

Abdominal migraines are very similar to a condition called cyclic vomiting syndrome. Only about 4% of migraine sufferers experience abdominal pain. It most commonly affects children between the ages of seven and eleven years old. Many of these children will continue to have migraines later in life that does not involve abdominal pain. 

Silent Migraines

Migraines that occur without pain are considered “silent.” Although there is no pain, the individual experiences problems including sensitivity to light or sound, dizziness, and stomach problems. Those who suffer from silent migraines will notice signs and symptoms that indicate the beginning of the migraine. This is known as the “prodrome phase” where the following symptoms are common: 

• Feelings of depression and irritability
• An inability to concentrate, speak or read
• Feelings of extreme fatigue
• Stiffness in the muscles
• Upset stomach and nausea 

The Postdrome Phase

After a migraine headache subsides, many sufferers experience a postdrome phase, also known as a migraine hangover. Nearly 80% of those with migraines experience this phase. The majority of people will experience body aches and fatigue. Many continue to be sensitive to light and may be dizzy for a period of time. Some people find it relieving to stretch, meditate or participate in yoga. 

Migraines in Children

Pediatric migraines affect children and teens. Many pediatricians will refer these patients to a pediatric neurologist for diagnosis and treatment. Approximately 7% of children and teens experience migraines and this rate rises slightly through puberty. Children who experience migraines will miss an average of eight school days per year. 

Many parents and teachers underestimate the severity of migraines in children and often are not formally diagnosed. Many children experience relief through treatment with triptans but there are a variety of options. 

Diagnosing the Condition

Migraines are not diagnosed with one particular test. Your medical professional will begin by considering your family history and then begin ruling out other potential causes. The symptoms that accompany your migraines are a key consideration. A neurological evaluation may be necessary. Imaging tests such as a CT or MRI do not diagnose migraines, but they rule out other conditions.

Treatment

There is not a permanent cure for migraines. Symptoms may be alleviated through migraine remedies and treatments. Painkillers such as paracetamol and ibuprofen can lessen migraine pain or make it go away altogether. Triptans and antiemetics are also used to treat migraines. However, consult your doctor before beginning any new medications.

During an attack, sleep and rest can help alleviate migraine symptoms. Since some people become sensitive to light and sound during an attack, it helps to rest in a dark, quiet room until symptoms subside.

Prevention

Many doctors have found that certain medications that are used primarily for other conditions are effective in preventing migraines. These include prescription medications approved for depression, seizure, and hypertension. Patients generally take medication for several weeks before noticing a change. 

Those who experience migraines for 15 or more days per month may benefit from Botox. This involves receiving several injections in the head and neck region every few months. Botox has shown to reduce the number of monthly episodes by 10%. Side effects may include double vision or pain and stiffness in the neck area. 

Calcitonin gene-related peptide (CGRP) monoclonal antibodies are an emerging form of treatment for migraines. They are believed to be effective because they have the ability to prevent proteins that often create inflammation in the brain. Three of the most common brands include Aimovig, Ajovy, and Emgality. The products are typically given as an injection each month. 

Alternative Therapies

A study conducted reported in Headache Journal discussed the potential effectiveness that acupuncture treatment may offer for migraines. There were 22 studies conducted over an eight-week period that involved 5000 patients. Overall, roughly 50% of patients reported some reduction in the frequency of headaches. 

The researchers found that individuals who do not respond to prophylactic (preventative) medications derive the most benefit. They also explained that acupuncture therapy has a very low risk of side effects.  

Why Choose the Arizona Pain and Spine Institute

At the Arizona Pain and Spine Institute, we provide an array of migraine treatment options for our patients. We will work with you to provide migraine relief tailored towards your needs. We use a wide range of pain management solutions and treatment combinations and want you to find relief.

If you’re suffering from migraines, don’t prolong your agony. Make an appointment with us today and work with us to make your days pain-free again.