Most of us experience headaches. They're common when we have a cold or flu. After a stressful day, a tension headache might accompany us through the evening. But annoying as these may be, they're tame, compared to migraines.

Unlike other headaches, a migraine is a regular occurrence. Its pain is far more intense, and sometimes even temporarily disabling. The pain typically throbs on one or both sides of the head and is accompanied by sensitivity to light, as well as dizziness and vomiting.

The Painful Truth

About 10 percent of adults experience migraines. The headaches typically last from four to 72 hours. Migraines are connected to abnormalities in the nerves and blood vessels in the head. Most experts now believe these abnormalities are inherited, and exist in genes that control certain cell populations in the brain.

Women suffer from migraines three times more than men. A relationship between migraines and the hormone estrogen may explain this. Both men and women produce estrogen, but women have it in higher amounts.

Migraines are most prominent in women between 15 and 35 years old where hormonal disturbances related to the menstrual cycle are believed to be triggers for migraines. A family history of migraine also puts someone at greater risk. There is evidence of a possible connection to birth control pills as these cause fluctuations in hormones. Migraine symptoms may subside when a woman enters menopause.

While research is not yet conclusive, many experts believe that migraines may begin with a change in serotonin levels in the brain. Serotonin is a chemical that regulates pain messages through the trigeminal nerve, a pathway in the nervous system. When serotonin levels drop, other chemicals, called neuropeptides, are released. These neuropeptides travel to the outer covering of the brain, and cause blood vessels there to become dilated and inflamed resulting in an intense, throbbing pain.

Research has also shown that magnesium levels drop before or during a migraine. Since magnesium is involved in nerve cell function, it is theorized that low levels of it may also play a role in migraines, by causing nerves in the brain to misfire.

Research is still being done to determine the exact origin of the migraine condition.

But there are several triggers, or events that set off an episode. They include lack of food, too much or too little sleep, smoking, weather changes, travel, exposure to light, hormonal irregularities (in women), anxiety, stress, and at times, even relaxation after stress. 

Certain types of food items may trigger migraine. Some are dairy-based, such as cheese and ice cream. Others involve additives such as caffeine, alcohol, aspartame, and mono-sodium glutamate (MSG). Other possible triggers include fatty and fried foods and processed foods like lunch meats, hot dogs, pizza, and chocolate.

Some people who experience migraines experience premonitions called prodromes (ex. fatigue or mood changes) hours or days before a migraine attack. People with migraines can also experience auras, which are sensory warning signs that often occur 10 to 30 minutes before a migraine episode. Auras can include blurred vision, or visions of spots, colored balls, jagged lines, or bright and flashing lights. These can be accompanied by a bad odor.

There are also auras that begin several hours to a few days before the migraine. These may cause cravings for certain foods, thirst, irritability, or feelings of intense energy. 

Other rare symptoms in migraine are muscle weakness, loss of sense of coordination, stumbling, or trouble talking either just before or while you have a headache.

Types of Migraine

There are several types of migraines. Some are more common than others. They include:

• Migraine without aura (previously called common migraine). This is the most prevalent type. It starts slowly, lasts longer than the other types, and interferes more intensely with daily activities.

• Migraine with aura (previously called classical migraine). Prior to onset, the patient experiences intense flashing lights and colors, often in a zigzag pattern.

• Another type of migraine with aura may be accompanied by temporary loss of vision, muscle weakness, depression, irritation, or restlessness.

• The most severe type is called Status Migrainosus. It is the most painful and it lasts more than 72 hours. Status Migrainosus does not go away by itself. People who experience this should immediately go to the doctor or emergency room for professional treatment.

First and foremost a doctor will get a detailed history of a patient's headaches: when they occurred, how long, how often, what part of the head was affected, and all accompanying symptoms. It is advised to keep a diary of all episodes and present all information when going for your visit.

The doctor may also order some blood tests, imaging tests like Computerized Axial Tomography (CAT), Magnetic Resonance Imaging (MRI), and lumbar puncture, which is performed by inserting a needle into the low end of the spine and withdrawing fluid for analysis; it is also known as a spinal tap. All of these procedures are useful in ruling out other medical problems that could be the cause of the headaches.

Treatment

Sadly, there is no cure for migraine. However, there is evidence that certain herbal supplements, properly administered, may help prevent the headaches during episodes by correcting tiny abnormalities in the brain cells. These include amino acid proteins, magnesium, and vitamin B2.

Other medicines, called triptans, are prescribed for relief of pain during acute episodes. These medicines tend to constrict the blood vessels in the brain, thereby reducing symptoms such as pain, nausea, and sensitivity to light and noise. Narcotics or barbiturates are classes of drugs that can help in severe cases but since they are habit forming they need to be used cautiously. Those who suffer from migraine due to hormonal disturbances linked to your menstrual cycle may need hormonal therapy.

Alternative therapies, such as acupuncture and certain herbs like feverfew and butterbur, are known to provide relief from migraine. However, always consult a doctor before using herbal supplements, because they are known to trigger side effects and interfere with more traditional methods of management. You may also benefit from stress management strategies such as exercise, relaxation, and biofeedback, a technique that teaches you to relax and helps you to use your brain to help control body functions related to tension and pain.

When you get a migraine headache, take action as soon as possible to minimize the effects. Lie down in a quiet dark room. Massage your scalp with lots of pressure. Put cold compresses over your forehead, and applying pressure to your temples. Drink plenty of fluids, especially if you have vomited.

If your headache is especially intense with a different pattern compared to previous episodes, you should contact your doctor immediately to determine whether there is a more serious problem, such as stroke or bleeding in the brain. Some of these accompanying red flags include:

• Speech problems

• Change in vision

• Increased pain when you lie down

• Loss of balance

• Difficulty moving

• Try to figure out what triggers your migraine episodes so you can avoid them as much as possible

• Get enough sleep at night, but not too much

• Avoid food triggers, and eat regularly

• Cut down on caffeine

• Avoid cigarettes

• Drink plenty of fluids and water

• Exercise regularly

• Keep your weight in check

• Reduce the stress in your life

Outlook

Migraine is the most common cause of disabling headache in people between 15 and 35 years of age. Medicines may be prescribed by your doctor to provide relief from the acute pain or prevent future episodes. Migraine headaches can often be prevented by avoiding the triggers and following simple lifestyle changes like eating a healthy diet and including regular physical activity in your daily life.