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Overview

A migraine isn't just another word for a headache. Unlike common tension headaches that usually cause mild discomfort, migraines can be so debilitating they stop you from participating in daily activities. An estimated 3-million adults and 250-thousand children in Canada suffer from migraines. Symptoms, frequency and intensity vary from one person to another. However, migraines are generally characterized by throbbing pain, usually on just one side of the head, accompanied by nausea and sensitivity to light and sounds. Migraines can last from a few hours to a few days. Women are 2 to 3 times as likely to men to develop this condition.

It isn't known exactly what causes migraines, although there is a hereditary link. If a distant relative has migraines, your own risk will be increased by 20 per cent. The likelihood increases to 50 per cent if your mother or father suffers from migraines.

Some common triggers include:

Food and beverages

Many people will experience migraines after eating or drinking certain foods or beverages such as aged cheese, alcohol·especially red wine, excessive amounts of caffeine, chocolate, fermented, cured or pickled food, canned or processed foods, aspartame, monosodium glutamate (MSG), soy sauce and certain fruits such as passion fruit, papayas, raisins and red plums.

Hormonal changes

Women get migraines more often than men. Researchers say 60 per cent of those with a history of migraines report headaches immediately before or during their periods. They haven't been able to define the exact relationship between hormones and headaches but they feel fluctuations in estrogen and progesterone may trigger migraines in women. Some women will suffer more migraines during pregnancy or menopause and others may experience migraine pain taking hormonal medication such as contraceptives.

Stress

Job or personal related stress can trigger migraines.

Odors

Certain smells such as paint, paint thinner, secondhand smoke, perfume and flowers trigger migraines in some people.

Physical factors

Physical exertion and changes in your sleep pattern·either too much or not enough·can trigger migraines in some people.

Environment

Some people complain of migraines when there's a change of barometric pressure, season, or altitude level.

The two most common kinds of migraine headaches are called classic and common. Classic migraines usually start after you experience an aura (or warning sign). Some people's auras consist of seeing flashing lights and colours or temporary loss of some vision. Others feel a prickly, tingling or burning sensation or experience muscle weakness on one side of their body. Some people will experience head pain soon after the aura is gone or while the aura is still present. Common migraines will start without any warning. This type of migraine usually starts slower than the classic kind, will last longer and is often felt on just one side of the head.

Clearly, migraines aren't the same for everyone and the frequency with which they occur will also vary from person to person.

If you're experiencing some or all of these symptoms you should talk to your doctor:

• Moderate to severe pain on one or both sides of your head
• Pulsating or throbbing pain
• Pain stops you from daily activities
• Pain gets worse with physical activity
• Nausea
• Sensitivity to light and noise

Migraine headaches will typically last from 4-72 hours. Some people will experience them once or twice a year and others may have them as frequently as one to four times a month.

Migraines cannot be cured but they can be treated and managed with medications and lifestyle adjustments.

If migraines prevent you from performing daily activities, you may need to take medication prescribed by your doctor. Others find over-the-counter pain relievers to be effective. The frequency and severity of your migraines will help you and your doctor determine the type of medication you need.

Over-the-counter pain relievers

 Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin, etc.), aspirin may help relieve mild migraine pain. If your headaches are moderate, medications such acetaminophen and aspirin combined with caffeine (Excedrin Migraine) may also help ease the pain but aren't very effective if your migraines are severe. If you find over-the-counter medications aren't very helpful, you may need to talk to your doctor about prescribing you stronger pain relievers. Pain relievers most often prescribed for migraines fall into two categories: triptans and ergots.

Triptans

These drugs were specifically developed to treat migraines. Sumatriptan (Imitrex) was one of the first triptans developed. It imitates the action of serotonin (a chemical in your brain) and causes blood vessels to constrict, which helps to lessen your pain. More recent triptans such as rizatriptan (Maxalt), naratriptan (Amerge), zolmitriptan (Zomig) and eletriptan (Relpax) are very effective in treating migraine pain. These newer drugs come in different forms; some act quicker and some act longer. As well, as vomiting can be a problem for some with migraine, some come in different forms such as a wafer so it can be quickly ingested. The downside to taking triptans is the possible side affects that include, nausea, dizziness and muscle weakness. Always ask your doctor or pharmacist about possible side effects or interactions with other drugs you may be taking, especially if you have heart disease.

Ergots

Ergots such as ergotamine (Ergomar) and dihydroergotamine (D.H.E 45) and dihydroergotamine nasal spray (Migranal) also help relieve migraine pain. You should talk to your doctor about the possible side effects of taking ergots. It's possible you may experience even more side effects with this type of medication than with triptans.

If you suffer from migraines you might be able to ward off future headaches by making some lifestyle changes. One or more of these tips may be helpful:

Exercise

Exercising for at least 30 minutes, three times a week may help prevent migraines. Talk to your doctor about what type of aerobic activity would be best for you. It's important to choose an activity that you enjoy so you'll stick to it. Activities such as walking, swimming and cycling are great forms of exercise. Just remember to warm up slowly because sudden or intense exercise could cause a headache.

Keep a headache diary

A good way to avoid triggers is to keep a headache diary. Keep track of your eating, sleeping and exercise patterns. If you know certain scents are a problem, try to avoid them. If you write everything down, you'll be able to see what you were doing or what was happening right before your migraine started.

Reduce the effects of estrogen

If you're a woman and you feel your migraines may have something to do with your estrogen level, you may want to avoid or reduce the amount of medications you take that contain estrogen. Medications with high amounts of estrogen such as birth control pills may trigger or worsen your migraine pain. Be sure to talk to your doctor about the best alternatives or dosages for you.

Stop smoking

Smoking can trigger migraines or make them worse for some people. If you smoke, talk to your doctor about quitting.