Migraine Basics

You’re here, which means that migraines are affecting your daily life or the life of someone you care about and you are itching to know some migraine basics. We’ll call this, Migraine 101.

Let’s crush through a few of the basics and you can go on to find out what some of your triggers are (what can cause your severe headaches), and how you can get relief or get free of the migraine symptoms (how to treat the headaches). One of the biggest hurdles that I faced when I was diagnosed with headaches (cluster headaches, in my case) was the use of specific migraine terminology.

Getting the basics of migraine terminology is crucial if you want to communicate with doctors, forums, apps, and fellow humans who get migraines. We’ll dive into some of these details below.

What is a Migraine?

The Mayo clinic says that a migraine is a “headache of varying intensity, often accompanied by nausea and sensitivity to light and sound.” The exact cause of migraines is vague and varying, and migraine research is a bit sparse (we really wish it wasn’t), but most experts agree that genetics and environmental factors appear to play a role.

Serotonin levels in the brain will drop during the onset of a migraine – which appears to cause the trigeminal nerve to release neuropeptides into your system. Neuropeptides floating around the brain bring on the pain. Estrogen levels, which can fluctuate throughout a woman’s lifetime drastically affect the severity of migraine symptoms.

Additionally, changes in blood vessels and blood flow to the brain (such as intaking of caffeine) can affect the frequency and intensity of migraines. Serotonin is a chemical that your brain uses to communicate between nerve cells, and can also cause the narrowing of blood vessels.

What Does Migraine Mean?

When we say “Migraine”, we’re talking about one of two prominent theories about severe headaches.

Traditional Migraines

Significant and severe headaches that can bring on a variety of side-effects in addition to the pain. Side effects can include nausea, sensitivity to smells, sounds, and light, and vomiting, as well as what’s commonly referred to as “migraine aura”. We’ll call this “traditional migraines”, and there are many varieties of these migraines. In this case, any of your triggers may cause the migraine symptoms, and then the onset of an actual migraine. Different triggers likely have different severity of migraine onset, and the triggers can vary from person to person.

Migraine Threshold

A sensory trigger called migraine, which builds up throughout the days, weeks, or months and when you exceed the migraine trigger threshold level for your own body, it kicks in and whoops up on you. With this theory of migraine, your triggers that cause the migraine symptoms can vary from day to day and from person to person. We’ll call this “migraine threshold”. With this theory, different triggers can add up over time to create a migraine. A slow build can happen for some triggers, and a fast build can happen if the triggers push the migraine response over the top.

Both of these theories, migraine thresholds and traditional migraines, are valid – and they both make a lot of sense. Which one applies to you may depend a bit on your world view, and how immediate your triggers can summon up a migraine.

Severe headaches and their symptoms can last a few hours, or several days. If you’re one of the lucky (or unlucky) you may even feel the symptoms coming on before the migraine hits you. A sense of “achiness” or the beginnings of a headache are common, as are migraine auras, which can change up your sensitivity to light and sound, and even cause you to feel light headed and dizzy.

Migraines often first affect a person between the ages of 10 and 40, though they can onset before and after (ie, anyone can get a migraine). Females are three times as likely to get a migraine (sorry!), although most women report that migraines disappear or are significantly reduced after menopause.

Migraine Disease Terminology

One of the more confusing aspects of migraines is how to classify the people who get them, or what to call yourself if you get them. Webster’s dictionary says that a disease is:

A disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

Using this definition, migraine is a disease. So, if you are getting repetitive headaches, technically, you have a disease, and that disease is named migraine. I’m not sure about you, but that tends to cause me to cringe – because I don’t normally think of my headaches as a disease.

At least, not like other diseases that I’m more familiar with (my father is an environmental toxicologist, and prior to that, an entomologist … I’ve spent my whole life with strange diseases from all over the globe).

Which means that if I have a disease, and that disease is called “migraine”, then what term do I use to discuss my migraine? I can say “I have a migraine”, or “I get migraines”, but others would need to say “He gets migraines” or “They have migraines”. Worse might be “People with migraine disease.”

Doctors and insurance agencies tend to classify us as “victims” or “sufferers”. I personally dislike both terms, but I do understand the victimization of people who have severe headaches.

It’s extremely difficult to tell if someone has a bad headache or a migraine (unlike a broken arm, or a severed hand). Once you’ve had migraines for a few decades and the doctors are looking at you like a drug addict needing pain medications, and you are planning your outings around the barometric pressure, then both terms suddenly make a little more sense.

Migraine Causes & Triggers

What’s a migraine trigger? It’s lingo for “anything that can cause a migraine” or more specifically any internal or external event, change, stimulus or physical act that causes your body to react with a migraine. Significant and serious headaches (such as cluster headaches) react poorly to your individual triggers, and learning which ones affect you is important to your overall health.

By controlling your migraine triggers you can reduce how often headaches occur, when they occur, and their intensity. This is where a migraine logbook comes into play. Make sure you keep one, because there is a long list of migraine triggers. The list is very, very long. Some lucky folks only have one or two triggers, but other people can be stuck with dozens of triggers. I myself have more than ten.

Stress
Sleep (too much, or too little)
Caffeine (too little, or too much)
Changes in routine
Hormonal changes in women
Barometric pressure
Bright sunlight
Chocolate

Humidity
Loud noises
Glare and flickering lights
Computer screens
Sex (or lack of sex)
Cheese or wine
Bananas
Perfume
Marinated, pickled, and fermented food

Nuts, peanut butter (my favorite!)
Alcohol, including beer and wine
Lack of food, or a change in when you eat
Severe or mild dehydration
Food additives
Exercise
Teeth grinding and bruxism
Oral contraceptives

Understanding which of your triggers are associated with your pain is important, as-is understanding the symptoms that start or cause your migraine to get going or to steamroll.

Need to know more about migraine causes? We’ve got you covered.

Migraine Symptoms

A wide variety of symptoms await migraine sufferers, and most of them are unpleasant. Headache symptoms are often a problem before onset of the migraine, as the migraine is occurring, and some linger well after the core migraine pain is gone. Migraines often follow a standard pattern:

A few days before the pain starts, symptoms begin
If you have auras, the aura can start about the same time pain begins
The core attack, where the pain kicks in
After the pain subsides, you may be completely wiped out and exhausted

Migraine symptoms can include pain around the face and neck, or across your entire body where you may be dizzy, lightheaded or may feel malaise (lazy beyond belief). Some migraine sufferers become irritable (I certainly do!), get nasal congestion, and can have a tender scalp. Gastrointestinal symptoms can come along as well, including vomiting and nausea. And all of this can be compounded with the actual pain of the migraine – acute, frequent, severe, and throbbing. After you’ve had a few of these headaches, you may have your own not-nice terms to describe these symptoms.

Need to know more about migraine symptoms? We’ve got you covered.

A list of common symptoms include:

Throbbing and pulsing pain
Light sensitivity
Fatigue / Malaise
Sound sensitivity
Difficulty concentrating
Nausea
Diarrhea and/or constipation
Pain on one side or the other, or even on the top of the head
Food cravings or loss of appetite
Vertigo
Vision changes
Difficulty falling or staying asleep
Migraine aura
Vomiting
Hot or cold flashes
Sulfites
Tannins

Understanding which of your symptoms are associated with your migraines is important, as-is understanding the triggers that start or cause your migraine to get going or to steamroll.

Migraine Treatments

Migraines have the ability to lay you out – they can be debilitating, and if you are suffering from a migraine you often will do anything to get rid of it and seek some relief. One of the most frustrating parts of treating a migraine is that standard headache treatments that might be used for say, a hangover headache, or a light cold / sinus headache, may not work at all for a full-blown migraine.

To find out what treatments are going to work for you, we highly recommend using a migraine diary. Migraine diaries will allow you to see when a migraine starts, what triggers started it, how your body responds to preventative treatments, how long the migraine lasts, and what abortive treatment is working. You need a headache diary!

Migraine treatments are often split into two categories:

Preventative – Anything that keeps migraines at bay. You’ll want to do all of this that you can, so migraines never affect you, or their effects are minimized.
Abortive – Treatments that stop a migraine in its tracks. When a migraine starts coming on, these are treatments you reach for to kill it before it starts affecting your day.

Where possible, you’ll want to learn a few treatments in both categories that can help you with your migraines. Some treatments are “natural”, some are environmental, and others are pharmaceutical.

For example, preventative treatments could include:

Yoga and stress relief
Keeping a constant daily sleep routine
Taking a multi-vitamin and B12 supplement
Daily ginger and coenzyme Q10

These may help keep your migraines at bay, and when you have a migraine coming on, you may switch to abortive treatments, such as:

Motrin and Tylenol (two different nonsteroidal anti-inflammatory drugs – NSAIDs)
Midrin
All of the triptans (sumatriptan, frovatriptan, and many others)
Nausea medications
Narcotics in some cases

The goal of any short-term migraine treatment should be to stop the migraine. Long-term migraine treatments should attempt to reduce frequency and severity of your migraines, and to reduce migraine drug escalations (the first drug doesn’t work, so try a more potent one, then a stronger one, until something works).

We have an entire section devoted to migraine treatments. New treatments are emerging all the time.