Why Do Migraine Headaches Cause So Much Pain?
A migraine headache is a throbbing, moderate to severe pain, usually on one side of the head, that is worsened by physical activity, like, sounds, or smells and that is associated with nausea and vomiting.
Although migraines can start any age, they usually begin between the ages of 10 and 40. In most people, migraines recur periodically, but they usually become significantly less severe or resolve entirely after age 50-60.
Migraines are three times more common among women than among men. Migraines tend to run in families; more than half of the people who have migraines have a close relative who also has them.
The cause of migraines is not well understood. According to one theory, migraines occur when arteries to the brain become narrow and then widen and dilation is thought to activate nearby pain receptors.
Estrogen, the main female hormone, appears to trigger migraines, possibly explaining while migraines are more common among women. During puberty, migraines become much more common among girls than among boys. Some women have migraines just before, during or just after menstrual periods.
As menopause approaches, migraines become particularly difficult to control.
Oral contraceptives and estrogen replacement therapy often make migraines worse. Insomnia, changes in barometric pressure, and hunger may also trigger migraines.
Symptoms and diagnosis
In a migraine, throbbing pain is typically felt on one side of the head. The pain may be moderate but is often severe and incapacitating. Physical activity, like, sounds, or smells may make the headache worse.
The headache is often accompanied by nausea, sometimes with vomiting.
A migraine attack often involves more than a headache. It may include a prodrome, and aura, and a postdrome.
The prodrome is a change in mood or behavior, which can precede the rest of the migraine by 24 hours. People may become depressed, elated, irritated, or restless. Nausea or loss of appetite may also occur.
About 25% of people experience an aura. The aura involves temporary, reversible disturbances in your vision, sensation, balance, movement, or speech. Commonly, people see jagged, shimmering or flashing lights or develop a blind spot with flickering edges.
The aura occurs within the hour before the migraine and ends as the migraine begins. About 25% of people experience a postdrome, which involve changes in mood and behavior after the migraine.
Migraine attacks may occur frequently for a long period of time but then may disappear for many weeks, months or even years.
Migraines are diagnosed on the basis of symptoms. No procedure can confirm the diagnosis. If headaches have developed recently or if the pattern of symptoms has changed, computed tomography or magnetic resonance imaging of the head is performed to exclude other disorders.
Prevention and treatment
If you drink a lot of coffee or soda pop every day and then go for a day without any caffeine, you could get a very severe migraine from caffeine withdrawal. I know from personal experience and the headache is extremely painful.
Treatment of migraine headaches involves three types of drugs: drugs to prevent migraines, drugs to stop or abort a migraine as it is beginning, and drugs to relieve pain.
People who have more than one migraine a week often benefit from taking drugs every day to prevent migraine attacks. Beta blockers are often given first. Calcium channel blockers, antidepressants, and some anticonvulsants, are also effective.
To abort a migraine as it is beginning, most doctors prefer a relatively new group of drugs called triptans. Triptans specifically target the receptors that stimulate the nerves supplying the cerebral blood vessels.
Triptans may reverse the dilation of these blood vessels, which contributes to a migraine. As soon as people sense a migraine attack is beginning, they take one of these drugs to stop the attack from progressing.
Because triptans cause blood vessels to narrow, they are not recommended for people who have angina or other heart disease or for people who have prodromal symptoms that resemble those of stroke.
For less severe migraines, analgesics alone or analgesics that contain caffeine can be useful. They can be taken as needed during a migraine, with or instead of a triptan.
Overuse of analgesics or caffeine can make the migraine worse. For more severe migraines opiates may be needed.