How to Manage Migraine Headaches

Headache is our most common form of pain and a major reason cited for days missed at work or school as well as visits to the doctor.  The International Classification of Headache Disorders, published by the International Headache Society, is used to classify more than 150 types of primary and secondary headache disorders. Primary headaches occur independently and are not caused by another medical condition.  Migraine, cluster, and tension-type headache are the more familiar types of primary headache.

Secondary headaches are symptoms of another health disorder that causes pain-sensitive nerve endings to be pressed on or pulled or pushed out of place. They may result from underlying conditions including fever, infection, medication overuse, stress or emotional conflict, high blood pressure, psychiatric disorders, head injury or trauma, stroke, tumors, and nerve disorders (particularly trigeminal neuralgia, a chronic pain condition that typically affects a major nerve on one side of the jaw or cheek).

Headaches can range in frequency and severity of pain. Some individuals may experience headaches once or twice a year, while others may experience headaches more than 15 days a month. Pain can range from mild to disabling and may be accompanied by symptoms such as nausea or increased sensitivity to noise or light, depending on the type of headache.

Fioricet is a well-known prescription medication used to stop a headache that has already started. It is intended to be used for tension-type (muscle tension) headaches. Although it can sometimes be effective against migraines, there are better options available for most people.

 

What is Migraine Headache ?

The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number of attacks (at least 5, lasting 4-72 hours if untreated), and additional symptoms including nausea and/or vomiting, or sensitivity to both light and sound.

Migraine is three times more common in women than in men and affects more than 10 percent of people worldwide. Roughly one-third of affected individuals can predict the onset of a migraine because it is preceded by an “aura,” visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a number of different factors, including stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and dietary substances.

Migraine in some women may relate to changes in hormones and hormonal levels during their menstrual cycle.  For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine has a genetic cause.

How to diagnosis Migraine ?

Responsive prevention and treatment of migraine is incredibly important.  Evidence shows an increased sensitivity after each successive attack, eventually leading to chronic daily migraine in some individuals  With proper combination of drugs for prevention and treatment of migraine attacks most individuals can overcome much of the discomfort from this debilitating disorder.  Women whose migraine attacks occur in association with their menstrual cycle are likely to have fewer attacks and milder symptoms after menopause.

Hot to Treat Migraine ?

There is no absolute cure for migraine since its pathophysiology has yet to be fully understood.  There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes.

The U.S. Food and Drug Administration (FDA) has approved erenumab (Aimovig) to prevent migraine in adults. The drug works by blocking the activity of calcitonin gene-related peptide, a molecule that is involved in migraine attacks. The FDA also has approved lasmiditan (Reyvow) for short-term treatment of migraine with our without aura.

The FDA also has approved ubrogepant tablets (Ubrelvy) for immediate treatment of migraine with or without aura.

Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine.

Botulinum toxin A has been shown to be effective in prevention of chronic migraine.  Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks.

Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine.

Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin.  The sooner these treatments are administered, the more effective they are.