The short answer: Migraine is a neurological condition, not just a bad headache. Experts believe it starts with changes in how the brain and its nerves and blood vessels work, and genes play a big role. Things like poor sleep, stress, skipped meals, hormone changes, and weather can trigger an attack in people who already have migraine.
Migraine vs. a regular headache
Most headaches cause head pain and little else. Migraine attacks usually come with other symptoms too.
A typical tension headache:
- Mild to moderate pain
- Feels like pressure or a tight band around the head
- Usually doesn't get worse with activity
- Lasts 30 minutes to a few hours, sometimes longer
A typical migraine attack:
- Moderate to severe pain, often throbbing
- Often on one side of the head, but can be on both
- Gets worse with movement
- Comes with nausea or vomiting, or sensitivity to light and sound
- Lasts from 4 hours to 3 days if not treated
Some people also get an "aura" before the pain starts, such as flashing lights, blind spots, or tingling.
What causes migraine?
Researchers are still learning. Here's what we know so far:
- Genes. Migraine runs in families. If a parent has migraine, your chance of having it is higher.
- Brain and nerve changes. During an attack, nerves around the brain release chemicals, like one called CGRP, that cause inflammation and pain. Several newer migraine medicines block CGRP.
- Hormones. Women are about three times more likely than men to have migraine. Changes in estrogen, like around a period, can trigger attacks.
Common migraine triggers
A trigger doesn't cause migraine. It sets off an attack in someone who already has it. Triggers are different for everyone. Common ones include:
- Too little sleep, or a change in your sleep schedule
- Stress, or the "let-down" after stress ends
- Skipping meals or not drinking enough water
- Alcohol, especially red wine
- Too much caffeine, or suddenly cutting back
- Bright or flickering lights, loud sounds, or strong smells
- Weather changes
- Hormone changes
Can pain medicine make headaches worse?
Yes. Taking pain relievers too often can lead to "medication overuse headache." This can happen if you take over-the-counter pain relievers on 15 or more days a month, or prescription migraine medicines like triptans on 10 or more days a month. If you need pain medicine that often, talk to a clinician. Don't stop a prescribed medicine on your own.
How to find your triggers
Keep a headache diary for a few weeks. Write down:
- When the headache started and how long it lasted
- How bad it was, from 1 to 10
- What you ate and drank, and how much caffeine you had
- How you slept the night before
- Your stress level and activities
- Where you were in your menstrual cycle, if that applies
- What medicine you took and if it helped
Bring your diary to your visit. It's one of the most useful tools we have.
Treatment options
Migraine treatment usually has two parts:
- Acute treatment stops an attack once it starts.
- Preventive treatment lowers how often attacks happen and how bad they are.
For adults with chronic migraine (15 or more headache days a month),
Botox injections are an FDA-approved preventive treatment. Treatment is a series of small injections around the head and neck, usually every 12 weeks.
When to get help right away
Call 911 or go to the emergency room if you have:
- A sudden, severe headache that feels like the worst of your life
- A headache with fever, stiff neck, confusion, or a seizure
- A headache with weakness, numbness, trouble speaking, or vision loss
- A headache after a head injury
Migraine care at Neurokin
We treat adults with migraine and chronic headaches at our Westfield, NJ office, including Botox for chronic migraine.
Learn about migraine care or see
migraine treatment in New Jersey.
Schedule a visit or call
(908) 215-2331.
Sources
This article is for education only. It is not a diagnosis or medical advice.
