You may have had some warning, but maybe you didn’t. Whatever the case, your world has narrowed down to intense, unrelenting pain, with all the side effects that come with it. You’re having a migraine attack, and you’re in for a bumpy ride that can last for days.
Migraine is different from other types of headaches, like the common tension-type headache that resolves with an over-the-counter pain reliever, in that it’s a neurological disorder.
Along with crippling pain, attacks cause sensory disturbances, difficulty focusing on any task, and severe nausea and vomiting. Everybody experiences an attack somewhat differently, but it’s never an easy journey.
The Migraine Research Foundation reports that migraine is the sixth-most disabling disease in the world, and one in four American households contains someone living with chronic migraine pain.
Dr. Patrick Brennan and our team at Coastal Pain Medicine in Pompano Beach, Florida, understand just how debilitating migraine attacks can be, which is why we offer a number of treatments to help those dealing with the disorder.
Here’s what you need to know about migraine attacks and their treatment.
The exact cause of migraine is unknown, though researchers believe there may be a genetic predisposition toward getting these attacks. Migraine often runs in families.
Many of our patients who suffer from migraine find that certain foods, caffeine, tobacco, lack of sleep, and hormonal changes, among other things, serve as triggers for an attack. But some other people seem to have no triggers.
Compared with tension-type headaches, migraine pain is considered more severe, and unlike with tension headaches, the pain usually presents on just one side of the head, usually as a throbbing sensation that worsens with any kind of movement.
In addition, migraine comes with a wide range of neurological symptoms that includes an increased sensitivity to light, sound, and odors; brain fog; and gastrointestinal effects such as constipation, nausea, and vomiting.
A migraine attack presents with four discrete phases, though you can get just one, a combination of two or more, or all of them. The phases, in order of presentation, are:
This phase can start one to two days before the pain starts, giving you a warning of what’s to come. The symptoms vary, but some of the most common include uncontrollable yawning, food cravings, mood changes, and a sense that something is wrong.
Migraine comes in two types — with aura and without aura. Generally an individual experiences one type or the other, not both.
If you get an aura, you may have visual disturbances like flashing lights or zigzag lines, muscle weakness, and garbled speech. If present, the aura lasts somewhere in the vicinity of 20-30 minutes before the pain hits.
This phase is what most people think of when describing a migraine attack. The pain can start gradually or hit all at once, and it may come up the back of your neck, then settle into a throbbing or pulsating on one side of your head that can last four to 72 hours.
This phase also comes with side effects including GI distress and sensitivities to light, sound, and smell.
The attack isn’t over once the pain recedes. Most people experience a postdrome phase, which is like a post-adrenaline crash. You can feel weak, tired, and mentally disoriented for a day or two afterward.
Because migraine is different from other types of headaches, it requires different kinds of treatment, both to prevent attacks and to abort them when they occur.
Preventive measures include a variety of medications, as well as neuromodulation devices. Some pharmaceutical options for aborting an attack include the triptans, the ergotamines, and the highly touted new anti-CGRP monoclonal antibodies and gepants.
Talk with Dr. Brennan about which may be appropriate for you.
Dr. Brennan also provides longer-lasting options, like acupuncture therapy and Botox® injections. The active ingredient in Botox comes from the Clostridium botulinum bacterium, the same neurotoxin that causes botulism (food poisoning).
But when diluted and administered by a properly trained physician like Dr. Brennan, this FDA-approved migraine treatment temporarily paralyzes the nerve fibers that send out pain signals, preventing them from reaching your brain.
The treatment lasts 3-4 months, after which you can repeat it. Many people see lasting relief from the injections.
If you suffer from migraine and need help managing the condition, we can help. Call us at Coastal Pain Medicine to set up a consultation or request and appointment today through our online tool.