An estimated 10 percent of Australians and New Zealanders suffer from migraine headaches, but not all of them seek the medical treatment that could bring relief. There's no reason to suffer in silence. New medicines offer hope for breaking the pain cycle.
During a migraine, blood vessels in the brain deliver too little blood, causing irritation to the nerves around them. The word itself comes from the Greek, meaning half a skull, which describes a distinguishing characteristicof migraine headahces; they often involve a stabbing pain on one side of the head. Migraines are now recognised as a chronic disease, not just painful headaches. The excruciating, often debilitating pain is a symptom, not the underlying problem. This is a key distinction. For centuries, migraines were seen as a psychological problem or worse, a sign of weakness in those who had them. People with migraines were, in effect, often blamed for their own pain. Nothing could be further from the truth.
Although the exact cause of migraines is uncertain, there's a strong genetic link. If one of your parents has migraines, you have about a 50 percent chance of having them too. Many researchers say that people prone to migraines inherit an acutely sensitive nervous systems. Change in your body (diet, sleep, hormones or stress) or in your environment (weather, lighting) can 'trigger' a migraine attack. Low levels of the brain chemical serotonin are also believed to play a role.
Usually, there are four stages to a migraine. During the prodrome (the period before an attack), you may be sensitive to light, smell or sound. About 20 percent of people with a migraine experience an aura-bright, flashing lights or a partial loss of vision. During the attack, a throbbing or pulsating pain often starts on one side of the head and gradually worsens; sometimes it spreads to the other side as well. You may also have vomiting, blurred vision, neck and shoulder pain, tingling or difficulty concentrating. An attack can last from a few hours to several days if untreated. Afterwards, in the postdrome, you may feel drained, irritable and foggy, or refreshed and even euphoric.
Overall, about 1 in 10 people suffers from migraines. Women are three times more likely than men to have them, and an estimated 80 percent of people with migraines have a family history of the condition. The annual cost of migraine to the community has been estimated at between $302 and $721 million by the Centre for Applied Economic Research, University of New South Wales.
LIKELY FIRST STEPS
Prescription drugs are the first-line treatment for migraine attacks and the particular medication you end up taking will depend on your symptoms as well as your response to different medicines. Probably the most effective are the triptans, a group of drugs that enhance levels of the brain chemical serotonin and constrict blood vessels, Sumatriptan (Imigran), the key drug in this category, can be self-injected for fast relief, taken orally or inhaled as a nasal spray. In clinical trials, up to 80 percent of those who had sumatriptan injections reported milder headaches or compete relief within an hour. when taken orally, another triptan---zolmitriptan (Zomig)--works faster than sumatriptan, while naratriptan (Naramig) is a longer lasting medication. Some people get side effects from triptans, such as flushing, jaw tightness and neck pain. Because these drugs constrict blood vessels. People with heart disease shouldn't use them without a doctor's approval.
What is happening
During a migraine, blood vessels in the brain deliver too little blood, causing irritation to the nerves around them. The word itself comes from the Greek, meaning half a skull, which describes a distinguishing characteristicof migraine headahces; they often involve a stabbing pain on one side of the head. Migraines are now recognised as a chronic disease, not just painful headaches. The excruciating, often debilitating pain is a symptom, not the underlying problem. This is a key distinction. For centuries, migraines were seen as a psychological problem or worse, a sign of weakness in those who had them. People with migraines were, in effect, often blamed for their own pain. Nothing could be further from the truth.
Although the exact cause of migraines is uncertain, there's a strong genetic link. If one of your parents has migraines, you have about a 50 percent chance of having them too. Many researchers say that people prone to migraines inherit an acutely sensitive nervous systems. Change in your body (diet, sleep, hormones or stress) or in your environment (weather, lighting) can 'trigger' a migraine attack. Low levels of the brain chemical serotonin are also believed to play a role.
Usually, there are four stages to a migraine. During the prodrome (the period before an attack), you may be sensitive to light, smell or sound. About 20 percent of people with a migraine experience an aura-bright, flashing lights or a partial loss of vision. During the attack, a throbbing or pulsating pain often starts on one side of the head and gradually worsens; sometimes it spreads to the other side as well. You may also have vomiting, blurred vision, neck and shoulder pain, tingling or difficulty concentrating. An attack can last from a few hours to several days if untreated. Afterwards, in the postdrome, you may feel drained, irritable and foggy, or refreshed and even euphoric.
Overall, about 1 in 10 people suffers from migraines. Women are three times more likely than men to have them, and an estimated 80 percent of people with migraines have a family history of the condition. The annual cost of migraine to the community has been estimated at between $302 and $721 million by the Centre for Applied Economic Research, University of New South Wales.
- See your doctor to identify the best prescription medications for your symptoms.
- Lie down and rest in a dark, quiet room with an ice pack for immediate relief.
- Identify possible migraine triggers, such as food, drink, sleep patterns and stress.
QUESTIONS TO ASK
- How can I tell if certain foods or drinks are triggering my migraine attacks?
- Am I a candidate for medication to prevent migraines?
- Does the medication I'm on have a rebound effect if used too often?
- Can I get addicted to my migraine painkillers?
- Is there a danger that beta-blockers or calcium channel blockers will cause my blood pressure to drop too low?
Treatments
There is no permanent cure for a prediposition to migraines. But there are treatments that can both prevent attack and relieve symptoms and thereby restore some quality to your life. The key is understanding that a migraine isn't just a headache you have to ride out--it's a complex medical condition. You need to consult your
There is no permanent cure for a prediposition to migraines. But there are treatments that can both prevent attack and relieve symptoms and thereby restore some quality to your life. The key is understanding that a migraine isn't just a headache you have to ride out--it's a complex medical condition. You need to consult your
Treatment Options
MEDICATIONS
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Triptans First-line drugs constrict blood vessels.
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Ergot derivatives Second time; often used with antinausea drug.
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Opiates If no other drugs work for pain.
-------------------------------------------------------------------------------------------------------------------------------------------
Pain relievers From aspirin to special migraine products.
--------------------------------------------------------------------------------------------------------------------------------------------
Preventive medications Wide choice to stop a migraine before it starts.
LIFESTYLE CHANGES
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Diet Determine if foods are migraine triggers.
---------------------------------------------------------------------------------------------------------------------------------------------- Sleep Keep to a regular schedule.
---------------------------------------------------------------------------------------------------------------------------------------------
Relax Stress can trigger migraines.
NATURAL METHODS
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Herbs & vitamins Feverfew and vitamin B2.
-----------------------------------------------------------------------------------------------------------------------------------------------
Alternatives therapies Biofeedback, chiropractic, acupuncture.
doctor about the appropirate medication for you. There are many choices, depending on your specific symptoms. And they can bring fast relief. One survey showed that those who took prescription medications were twice as likely to experience complete headache relief within two hours compared to others who used over-the-counter products. In addition, lifestyle factors such as food, stress, exercise and sleep can make a big difference, and there are a number of natural methods that have helped many people find relief.
TAKING CONTROL
MedicationsMEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Triptans First-line drugs constrict blood vessels.
------------------------------------------------------------------------------------------------------------------------------------------
Ergot derivatives Second time; often used with antinausea drug.
-------------------------------------------------------------------------------------------------------------------------------------------
Opiates If no other drugs work for pain.
-------------------------------------------------------------------------------------------------------------------------------------------
Pain relievers From aspirin to special migraine products.
--------------------------------------------------------------------------------------------------------------------------------------------
Preventive medications Wide choice to stop a migraine before it starts.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Diet Determine if foods are migraine triggers.
---------------------------------------------------------------------------------------------------------------------------------------------- Sleep Keep to a regular schedule.
---------------------------------------------------------------------------------------------------------------------------------------------
Relax Stress can trigger migraines.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Herbs & vitamins Feverfew and vitamin B2.
-----------------------------------------------------------------------------------------------------------------------------------------------
Alternatives therapies Biofeedback, chiropractic, acupuncture.
doctor about the appropirate medication for you. There are many choices, depending on your specific symptoms. And they can bring fast relief. One survey showed that those who took prescription medications were twice as likely to experience complete headache relief within two hours compared to others who used over-the-counter products. In addition, lifestyle factors such as food, stress, exercise and sleep can make a big difference, and there are a number of natural methods that have helped many people find relief.
TAKING CONTROL
- Have a cup of coffee--strong and black-- at the first sign of an attack. Although too much caffeine can trigger a migraine attack, a little bit can relieve oncoming pain. This is especially helpful for people who have caffeine only rarely.
- Avoid the rebound. Over using headache medications, even the common non-prescription products, can lead to a vicious cycle of rebound headaches. Your body becomes so dependent on the medication that you get a new headache as soon as the drug wears off. Anyone who uses migraine medication more than two or three times a week is at risk of having this effect. Once you're locked into the cycle, the best way to break out is to go off all medications.
- Eat more fish. Varieties high in omega-3 fatty acid (salmon, tuna, sardines) may help prevent migraines from recurring. Omega-3s seem to alter blood chemicals, reducing the risk of blood vessel spasms that are associated with this type of headache.
- Watch out for additives. The artificial sweetener aspartame, found in many diet, soft drinks, may trigger migraines in some people, although saccharine does not. Some particular food colourings found in sweets, beverages, some cereals and ice cream have also been known to trigger migraines in certain individuals.
Prescription drugs are the first-line treatment for migraine attacks and the particular medication you end up taking will depend on your symptoms as well as your response to different medicines. Probably the most effective are the triptans, a group of drugs that enhance levels of the brain chemical serotonin and constrict blood vessels, Sumatriptan (Imigran), the key drug in this category, can be self-injected for fast relief, taken orally or inhaled as a nasal spray. In clinical trials, up to 80 percent of those who had sumatriptan injections reported milder headaches or compete relief within an hour. when taken orally, another triptan---zolmitriptan (Zomig)--works faster than sumatriptan, while naratriptan (Naramig) is a longer lasting medication. Some people get side effects from triptans, such as flushing, jaw tightness and neck pain. Because these drugs constrict blood vessels. People with heart disease shouldn't use them without a doctor's approval.
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