What is migraine headache?

Migraine Headache

Migraine headache: Overview

Migraines are painful, throbbing headaches that often start on one side of the head. They may cause nausea and vomiting and make you sensitive to light, sound, or smell.

Without treatment, migraines can last from 4 hours to a few days. Medicines can help prevent migraines or stop them after they have started. Your doctor can help you find which ones work best for you.

Migraine headaches

Migraines are throbbing headaches that last from 4 to 72 hours, usually on one side of your head. They may be triggered by certain foods or smells.

They may cause nausea and vomiting. And light may make the pain worse. Some people have an aura, like seeing wavy lines or flashing lights. This may happen shortly before or during the headache.

Although migraines are painful, they can often be treated with pain medicines and sometimes with medicines to prevent the headaches.

What happens when you have a migraine headache?

Migraines sometimes start with an aura of spots, wavy lines, or flashing lights about 30 minutes before the headache begins. Without treatment, a migraine headache can last from 4 to 72 hours. Muscle aches or feeling very tired may last for up to a day after the migraine ends.

Migraine Headaches

Areas of pain associated with migraine headaches

Symptoms of a migraine can include:

  • Throbbing pain on one side of the head. But you can have pain on both sides.
  • Pain behind one of your eyes.
  • Moderate to very bad pain. The pain may be so bad that you can't do any of your usual activities.
  • Pain that gets worse with routine physical activity.
  • Pain that gets worse when you're around light, noise, and sometimes smells.

Other symptoms include nausea, vomiting, or both.

How are migraine headaches treated?

You can't cure migraines. But you can use medicines and other treatments to feel better. Finding and avoiding the things that trigger your headaches may also help.

The goal of treatment is to reduce how often you get migraines and to stop the headaches with the fewest drug side effects.

For mild to moderate migraines, you may first want to try over-the-counter pain relievers. They have fewer side effects. And they cost less than other medicines. But if they don't help, you may need prescription medicines.

Your doctor may prescribe medicines to stop or to prevent a migraine.

If treatment doesn't help your migraines, you and your doctor may make changes. You may try different medicines, a new mix of medicines, or different doses. Sometimes, treatments that don't use medicines are tried. It may take some time to find the right treatment to help you.

How can you prevent migraine headaches?

To help prevent migraine headaches:

  • Avoid things that trigger your migraines, such as certain foods.
  • Find healthy ways to cope with stress.
  • Get regular exercise.
  • Keep a regular schedule for sleeping and eating.
  • Take medicine that prevents migraines, if your doctor prescribed it.

How are migraine headaches diagnosed?

To diagnose migraines, your doctor will ask about your personal and family history and examine you. Your doctor will ask how many headaches you have, how long they last, and what symptoms you have. You may get tests if your doctor thinks your symptoms may be caused by another disease.

How are medicines used to treat migraine headaches?

Two kinds of medicines are used to treat migraines. There are medicines to stop a migraine and medicines to prevent migraines.

Finding the right mix of medicines for you may take some time. So work closely with your doctor to try different medicines and doses. In most cases, your doctor will first prescribe a medicine that causes the fewest side effects. Medicines may be prescribed based on your type of migraine.

Medicines can help you feel better. But they can also be dangerous, especially if you don't take them the right way. Be safe with medicines. Take them as prescribed by your doctor. Read and follow all instructions on the label.

Medicines to stop a migraine

These are sometimes called abortive medicines. They may be over-the-counter or prescription medicines. If you take the medicine at the first sign you're getting a migraine, you may stop the headache before it starts.

If your migraines are mild to moderate, you may need only an over-the-counter medicine to stop the pain. Most doctors recommend that you try these medicines first. That's because they may have fewer side effects than prescription medicines. But if they don't stop your headaches, your doctor may prescribe other medicine.

Your doctor may suggest that you take a mix of medicines to stop a headache. For example, you may take acetaminophen or naproxen along with a prescription medicine, such as a triptan.

Medicines used to stop a migraine include:

  • Over-the-counter medicines. Examples include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve). Some over-the-counter medicines combine acetaminophen, aspirin, and caffeine.
  • Triptans (serotonin receptor agonists). Examples are sumatriptan and zolmitriptan.
  • Ergotamine derivatives. An example is dihydroergotamine.

Medicines such as ubrogepant may be tried if you can't take other medicines or the medicines did not work.

Talk to your doctor if you are taking medicine more than 2 days a week to stop a headache. Taking too much pain medicine can lead to more headaches. These are called medicine-overuse headaches.

If you have nausea or vomiting during migraine attacks, your doctor also may prescribe medicine to help with these symptoms.

Medicines to prevent a migraine

These medicines are often called preventive medicines. You get most of them with a prescription, but some over-the-counter herbs and supplements may be tried too. You take these every day or whenever your doctor tells you to.

Medicines used to prevent migraines include:

  • Anticonvulsants, such as topiramate.
  • Antidepressants, such as amitriptyline.
  • Beta-blockers, such as propranolol.
  • CGRP antagonists, such as erenumab.
  • Botulinum toxin, such as Botox. This is used for prevention if you have chronic migraines.

You may want to try medicine to prevent a headache if:

  • You use medicines to stop headaches more than twice a week.
  • Medicines to stop migraines aren't working well for you.
  • You have four or more headaches a month that keep you from doing your daily activities.
  • You have menstrual migraines.
  • You have uncommon migraine symptoms. These may include a long period with aura or numbness during your headache.

Medicines to prevent migraines may cause side effects. Some of these side effects may last for as long as you take the medicine. Or they may go away within a few weeks. You may need to decide which bothers you more—the side effects of the medicine or your migraines.

Medicines may not prevent every migraine. So you may still need to take another kind of medicine that can stop a migraine after it has started. But prevention medicines can reduce how many migraines you get, reduce how long they last, and make your symptoms less severe.

Caring for yourself when you have a migraine headache

There are some things you can do when you feel a migraine starting.

  • Stop what you are doing, and take your medicine.

    Don't wait for the migraine to get worse. Take your medicine exactly as your doctor told you to. Keep your medicine with you at all times so you are ready when a headache starts.

  • Rest in a quiet, dark room until your headache is gone.

    Close your eyes, and try to relax or go to sleep. Don't watch TV or read.

  • Put a cold, moist cloth or cold pack on the painful area.

    Leave it there for 10 to 20 minutes at a time. Put a thin cloth between the cold pack and your skin.

  • Relax your muscles.

    Have someone gently massage your neck and shoulders.

  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you aren't taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Don't take medicine for headache pain too often.

    Talk to your doctor if you are taking medicine more than 2 days a week to stop a headache. Taking too much pain medicine can lead to more headaches. These are called medicine-overuse headaches.

What puts you at risk for migraine headaches?

You may be more likely to get migraines if you have a family history of migraines. Females are more likely to get migraines than males. You may also be at higher risk if you are a teenager or young adult. Migraines often start during these years but may peak in your 30s.

What causes migraine headaches?

Experts aren't sure what causes migraines. They believe that changes in the activity of brain cells may lead to inflammation in certain nerves, which causes pain. Migraines often run in families, so genetics may play a role for some people. Some things, called triggers, can cause a migraine to start.

What are migraine headaches?

Migraines are painful, throbbing headaches that last from 4 to 72 hours. When you have a migraine, it may be so painful that you aren't able to do your usual activities. But migraines can be treated. And even though they make you feel bad, they don't cause long-term damage.

Migraine headache: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.

Call your doctor now or seek immediate medical care if:

  • You have new or worse nausea and vomiting.
  • You have a new or higher fever.
  • Your headache gets much worse.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You are not getting better after 2 days (48 hours).

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.

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