Migraine is an extremely debilitating, neurological condition which can have a substantial impact on the quality of life of the sufferer. It affects people of both sexes, all ages, and all cultures. Migraine is a complex condition, affecting people in many different ways, and often evolving throughout the lifetime of a sufferer.
Symptoms can include:
Intense, throbbing headache – usually on one side of the head
Increased sensitivity to light, sound and / or smells
Nausea, vomiting and diarrhoea
Some sufferers also experience an ‘aura’ which may be:
Visual disturbances, such as blind spots or zig-zag patterns
Other neurological symptoms, such as an inability to concentrate confusion, or pins and needles / numbness on the affected side
Migraine attacks usually last between 4 and 72 hours, and can leave the sufferer feeling ‘washed out’ for 2 or 3 days afterwards. Attacks often start without warning, and this unpredictability can cause severe disruption to working, family and social life. At the moment there is no cure for this condition, but there are a wide range of treatments available which can reduce its severity and the frequency of attacks. Combining treatments with some basic lifestyle changes, as well as avoiding identified trigger factors, can enable you to manage your migraine effectively.
Migraine is believed to be caused by changes in the chemicals and blood vessels in the brain, but the reasons for these changes are still being researched. Evidence suggests that there is a genetic predisposition to migraine. Certain ‘trigger’ factors may spark an attack. These vary from person to person, but may include:
Stress, or relaxation after stress
Overtiredness (physical or mental)
Dehydration
Lack of food / infrequent meals
Certain foods / drinks
Changing sleep patterns
Environmental factors (eg. weather conditions, bright lights, loud noise)
Hormonal factors (eg. periods, menopause)
For most people there is not just one trigger, but a combination of factors causing the migraines. Individually these factors may not cause a problem, but when several occur together, a threshold is passed and an attack is triggered.
Keeping a diary can help you to identify your own trigger factors: you might find that a pattern emerges and that by making a few minor changes to your diet or lifestyle you can reduce the frequency and / or severity of your attacks.
To keep your migraine threshold as high as possible and avoid attacks:
Eat regularly – no longer than 4 hours without food during the day and 12 hours overnight, to maintain regular blood sugar levels.
Drink at least 2 litres of water every day
Avoid sugary snacks
Reduce your intake of caffeine, alcohol and soft drinks containing artificial sweeteners
Maintain a regular sleep pattern, with 8 or 9 hours sleep each night – avoid long lie-ins, late nights, or sleeping in the day
Practice relaxation techniques to rid the body of tension and stress and try to get some ‘me’ time every day: recognise your limitations and try not to push yourself too hard
Wear sunglasses and a hat in bright sunlight
Avoid prolonged periods of concentration (eg. watching TV, using a computer, reading)
At work try to make sure you have adequate, adjustable and well-maintained lighting sources (avoid flickering lights eg. fluorescent lights)
Position computer screens to avoid reflection from windows and fit anti-glare screens
Change your working position regularly (eg. standing instead of sitting)
Take care with your posture and ensure your working environment is as ergonomically designed as possible (eg. chair at correct height, back rest properly positioned, so as to avoid stretching or twisting)
Avoid working through breaks
Ensure that ventilation indoors is good and try to keep rooms at a constant temperature
Preventative treatments and complementary therapies can be used to reduce the frequency and severity of migraine attacks. There is mounting research evidence and anecdotal reports by sufferers that the following therapies can be very beneficial:
Acupuncture: this treatment aims to not only relax the patient and help control levels of stress, but also to treat the body holistically, working at a much deeper level, helping the body to work more harmoniously, with more long term benefits. Treatments will be tailored to the individual after a consultation with a practitioner to discuss the patient’s medical history. Acupuncture has been found to be very effective for some migraine sufferers.
Physiotherapy: This can help people whose migraines are triggered by tension in the neck and shoulders, or by neck problems.
Osteopathy: Again this can help people with migraines being caused by neck and shoulder problems, especially those who think their migraine might have been caused as a result of an accident or trauma.
Massage: Similarly this can be extremely helpful in treating people with migraines caused by tension in the neck and shoulders, but massage can also be very valuable in reducing stress levels.
Herbal and homeopathic remedies: feverfew, butterbur, ginger, peppermint and ginkgo biloba have found to be beneficial in treating migraine. A consultation with a practitioner will enable a suitable remedy to be tailored to an individual.
Relaxation therapies / meditation: Most migraine sufferers will recognise that stress can be a factor in causing their attacks, and it is therefore extremely helpful to find relaxation techniques or therapies that work for you. You will feel the benefits throughout your life.
Analgesic-based medication (painkillers) can sometimes be effective if taken at the very first sign of an attack. Products available over the counter will contain one or more of the following:
Aspirin: has analgesic and anti-inflammatory properties
Ibuprofen: a non-steroidal anti-inflammatory drug
Paracetamol: this drug is preferred by some as it is less likely to cause gastro-intestinal side-effects
In addition some products may also contain codeine, caffeine or anti-histamine. During a migraine attack, the digestive system shuts down (‘gastric stasis’) so that painkillers cannot be absorbed: anti-sickness medication may be prescribed to overcome this.
If over the counter products do not relieve your migraine symptoms, there are effective treatments available on prescription from your GP. Triptans (5HT agonists) are migraine specific treatments which are usually prescribed for moderate to severe migraine. An imbalance of serotonin, a chemical in the brain, is believed to be implicated with migraine and these drugs work to correct this imbalance and address all of the symptoms involved in migraine, not just the inflammatory process.
Caution: There is a danger of rebound headaches when medication is being taken at high doses over a prolonged period of time: rather than solving your headaches, the drugs are actually beginning to cause your headaches. This could be the case if you are taking painkillers or triptans for 10 days or more per month, for more than 3 months.
As migraine is a complex condition, with a great deal of individual variation, sufferers have to be their own detective and follow up their own clues. Finding the right treatment for you can therefore take time and you might need a combination of complementary treatments, medication and lifestyle changes to enable you to bring your migraine under control. But it is worth persevering: remember that whilst there is no miracle cure for migraine yet, it is possible to manage this condition rather than allowing it to control your life.
If you would like any further information on migraine and the issues discussed here, you can contact the Migraine Action Association at www.migraine.org.uk or on telephone number 0870 050 5898.
Information from the Migraine Action Association.