Migraines are more than just bad headaches. Learn to identify your triggers, find effective treatments, and discover strategies to prevent future attacks.
Migraine: Far More Than "Just a Headache"
If you've ever had someone dismiss your migraine as "just a headache," you know how frustrating—and wrong—that statement is. Migraines are a complex neurological condition affecting over 1 billion people worldwide, including millions of Filipinos. They cause intense, debilitating pain that can last for hours or even days, often accompanied by nausea, sensitivity to light and sound, and an inability to function normally.
Migraines rank among the top 10 most disabling medical conditions globally. Yet many sufferers never seek treatment, thinking they just have to endure. The truth is that migraines are treatable—both during attacks and preventively. Understanding your migraines is the first step toward getting control over them.
"Migraine is not a character flaw or a sign of weakness. It's a real neurological disease with real treatments. No one should suffer in silence when effective help is available." — Philippine Neurological Association
Understanding the Migraine Brain
Migraines involve changes in brain chemistry and activity. During a migraine, brain cells become hyperexcitable, triggering a wave of electrical activity followed by changes in blood flow and inflammation around nerves and blood vessels in the brain. This process activates the trigeminal nerve system, which is responsible for sensation in the face and head—resulting in the characteristic throbbing pain.
Genetics play a significant role—if one parent has migraines, you have about a 50% chance of developing them; if both parents do, that rises to 75%.
The Four Phases of a Migraine
A migraine isn't just the headache phase—it's a process that can span days:
📊 Migraine Phases
- Prodrome (hours to days before): Mood changes, food cravings, neck stiffness, increased thirst, frequent yawning, fatigue
- Aura (5-60 minutes before or during): Visual disturbances, tingling, speech difficulty—occurs in about 25% of migraineurs
- Headache (4-72 hours): Throbbing pain, nausea, light/sound/smell sensitivity, worsened by movement
- Postdrome (hours to days after): Fatigue, difficulty concentrating, mood changes—the "migraine hangover"
During the Headache Phase
- Pain characteristics: Usually on one side of the head (but can be both), throbbing or pulsating quality, moderate to severe intensity
- Photophobia: Sensitivity to light—even normal room light can be unbearable
- Phonophobia: Sensitivity to sound—conversations and everyday noises become painful
- Osmophobia: Sensitivity to smells—perfumes, cooking odors, cigarette smoke
- Nausea and vomiting: Occurs in up to 80% of migraine sufferers
- Activity intolerance: Physical activity worsens the pain
Aura Symptoms
About 25% of migraine sufferers experience aura—usually visual disturbances that precede or accompany the headache:
- Flashing lights or spots (scintillating scotoma)
- Zigzag lines
- Temporary blind spots
- Tunnel vision
- Tingling or numbness in face, hands, or body (usually one side)
- Difficulty speaking or finding words
- Weakness on one side (hemiplegic migraine—rare but important to recognize)
Common Migraine Triggers
Identifying your personal triggers is crucial for prevention. Common triggers include:
Dietary Triggers
- Alcohol: Especially red wine and beer
- Caffeine: Both excess consumption and withdrawal
- Aged cheeses: Contain tyramine
- Processed meats: Contain nitrates (hotdogs, bacon, ham)
- MSG: Common in instant noodles, fast food, some restaurant cooking
- Artificial sweeteners: Aspartame in diet drinks
- Chocolate: Trigger for some, relief for others
- Skipping meals: Low blood sugar triggers migraines
- Dehydration: Common and preventable trigger
Lifestyle and Environmental Triggers
- Sleep disturbances: Too much, too little, or irregular sleep patterns
- Stress: Or the "let-down" after stress (weekend migraines)
- Hormonal changes: Menstruation, ovulation, pregnancy, menopause, birth control pills
- Weather changes: Barometric pressure changes, extreme heat, high humidity
- Bright or flickering lights: Sunlight, fluorescent lights, computer screens
- Strong smells: Perfume, cigarette smoke, gasoline, cleaning products
- Physical exertion: Intense exercise, especially if dehydrated
✅ Keep a Migraine Diary
Track your migraines to identify patterns and triggers. Record: date and time, duration, pain severity (1-10), symptoms, potential triggers (food, sleep, stress, weather, hormones), medications taken and their effectiveness. After a few months, patterns often emerge that help with prevention.
Treatment: Stopping a Migraine in Its Tracks
Acute (Abortive) Treatments
The goal is to stop the migraine as quickly as possible. Treat early—medications work best when taken at the first sign of a migraine:
- Over-the-counter pain relievers: Aspirin, ibuprofen, naproxen, acetaminophen—most effective early in mild-moderate migraines
- Combination analgesics: Excedrin-type products containing caffeine enhance effectiveness
- Triptans: Prescription medications specifically designed for migraines (sumatriptan, rizatriptan, etc.)—highly effective for moderate-severe migraines
- Anti-nausea medications: Metoclopramide or ondansetron help with nausea and improve absorption of other medications
- Gepants: Newer class of medications targeting CGRP (ubrogepant, rimegepant)
- Ditans: Lasmiditan for those who can't use triptans
Non-Medication Approaches During an Attack
- Rest in a dark, quiet room: Minimize sensory input
- Cold compress: On forehead, temples, or back of neck
- Hydration: Drink water, especially if vomiting
- Caffeine: Can help mild migraines and boost pain reliever effectiveness (but don't overuse)
- Sleep: If possible, sleeping often helps end a migraine
⚠️ Medication Overuse Headache
Using acute migraine medications (especially combination painkillers and triptans) more than 10-15 days per month can lead to medication overuse headache—a cycle where the medications themselves cause more frequent headaches. If you're using acute medications this often, talk to your doctor about preventive treatment.
Prevention: Reducing Migraine Frequency
If you have frequent migraines (4 or more per month), significantly disabling migraines, or migraines that don't respond well to acute treatment, preventive therapy may be appropriate:
Lifestyle Prevention
- Regular sleep schedule: Same bedtime and wake time daily, even on weekends
- Consistent meals: Don't skip meals; eat at regular times
- Stay hydrated: Drink plenty of water throughout the day
- Regular exercise: 30 minutes of moderate aerobic exercise most days
- Stress management: Relaxation techniques, meditation, yoga
- Avoid known triggers: Based on your migraine diary
Preventive Medications
- Beta-blockers: Propranolol, metoprolol
- Antidepressants: Amitriptyline, venlafaxine
- Anti-seizure medications: Topiramate, valproate
- CGRP monoclonal antibodies: Newer, highly effective options (erenumab, fremanezumab, galcanezumab)
- Botox: For chronic migraine (15+ headache days per month)
Supplements That May Help
- Magnesium: 400-600 mg daily
- Riboflavin (Vitamin B2): 400 mg daily
- Coenzyme Q10: 100-300 mg daily
- Feverfew: Herbal supplement with some evidence
When to See a Neurologist
Consult a headache specialist or neurologist if:
- Your migraines are frequent, severe, or not responding to treatment
- You're using acute medications more than 2-3 days per week
- Your headache pattern changes significantly
- You experience new neurological symptoms
- Headaches are affecting your work, relationships, or quality of life
🚨 Seek Emergency Care For:
- The worst headache of your life ("thunderclap headache")
- Headache with fever, stiff neck, rash, confusion, or seizures
- Headache after head injury
- New headache with weakness, numbness, vision loss, or difficulty speaking
- Headache that progressively worsens over days or weeks
"I've had patients who suffered with severe migraines for years before seeking help, thinking nothing could be done. With proper treatment, many achieve significant reduction in migraine frequency and severity. You don't have to just endure—effective treatments exist." — Dr. Elena Torres, Neurologist
Living Well with Migraines
Migraines may be a chronic condition, but they don't have to control your life. With proper management—identifying triggers, treating attacks early, and using preventive strategies—most people can significantly reduce their migraine burden and improve their quality of life.
You don't have to suffer in silence. Take the first step—talk to a healthcare provider about your migraines today.
