Understanding Migraines and Headaches

Almost everyone has experienced a headache. It is the most common type of pain. It is usually described as a pain or discomfort anywhere in the head, scalp, or neck. Headaches vary greatly in terms of location, intensity, frequency, and duration.

What are the symptoms of a headache?

Headache symptoms depend on the type of headache. The frequency of headaches and the intensity of the symptoms may vary. Typical headache symptoms include:

• Slow onset of the headache
• Head hurts on both sides
• Pain is dull or feels like a band around the head
• Pain may involve the back part of the head or neck
• Pain is mild to moderate but not severe

Tension headaches are the most common type of headache. Stress and tight muscles are often triggers in tension-type headaches. Cluster headaches are usually limited to one side of the head, typically around the eye accompanied by other symptoms such as nasal congestion and eye-watering. They come in repeated episodes and can last for weeks to months.

Tension and cluster headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia) or sensitivity to sound (phonophobia).

What is a migraine?

The most severe type of headache is a migraine. This throbbing type of headache is different from other types of headaches because in addition to the pain you may have symptoms such as nausea, vomiting, lightheadedness, sensitivity to light and sound, and other visual disturbances. A migraine headache may last anywhere from 4 to 72 hours. These headaches may occur as often as several times a week to only once a year.

The cause of a migraine headache is uncertain. Many experts think an imbalance in brain chemicals, such as serotonin, and changes in nerve pathways are involved. Migraines may also run in families suggesting a genetic link.

What are the symptoms of a migraine?

To get an accurate diagnosis, it is important to describe your migraine symptoms to your doctor. Also, it is helpful to track when migraines occur (such as dates and times) and the details associated with migraine headaches. The most common symptoms of migraine headaches include:

• Throbbing, severe pain with a specific location on either side of the head
• Nausea and vomiting, lightheadedness, sensitivity to light and sound
• Visual disturbances such as flashing or shimmering lights, zigzagging lines, stars, colored lights or psychedelic images and sometimes even lack of sight for a short period of time preceding a migraine headache, this is called an aura.
• A change in mood or behavior for hours or days before the headache
• Depression or anxiety symptoms
• Fatigue, irritability and trouble concentrating once the headache resolves

The symptoms of migraine headaches may look like other conditions or medical problems. It is important to speak to your healthcare provider for an accurate diagnosis.

What triggers a migraine?

People who get migraines may be able to identify triggers that seem to kick off the symptoms. Possible triggers include:

• Stress at home or work
• Changes in the sleep-wake cycle, getting too much or too little sleep and also jet lag
• Sensory stimuli such as loud sounds, bright lights, sun glare, strong smells like perfume, paint thinner, or second-hand smoke.
• Weather changes or change in barometric pressure
• Physical exertion, including sexual activity
• Hormonal changes during menstruation, pregnancy or menopause
• Certain foods such as aged cheeses, salty foods, processed foods and chocolate
• Food additives like the sweetener aspartame and the preservative monosodium glutamate (MSG)
• Certain drinks like alcohol, especially wine
• Skipping meals
• Medications such as birth control pills and vasodilators like nitroglycerin

The American Headache Society suggests documenting triggers in a headache diary. Sometimes, your efforts to control your migraines may cause more problems such as abdominal problems from side effects of pain relievers as well as medication overuse headaches.

It is important to talk to your physician about your symptoms, take your diary to your visit, and avoid overuse of over-the-counter medications. This will help your physician identify the cause of your headache and formulate a treatment plan that will help you prevent and treat your headaches.

Click here to visit our health library to learn more about headaches and migraines.

Dr. Aarti Pais is a Family Medicine Physician at Crescent City Physicians, Inc., a subsidiary of Touro Infirmary. She completed her internship at Tulane University and her residency at East Jefferson General Hospital. Dr. Pais is Board Certified by the American Board of Family Medicine and treats patients at her uptown clinic located on the campus of Touro Infirmary.