Migraines: Pain and Frustration

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The aura: Tunnel vision, dizziness, sensitivity to light, and other symptoms may warn you that it's coming. Lasting from four to seventy-two hours, a migraine headache may involve nausea, blurred vision, lightheadedness, and throbbing pain. Migraine headaches' cause, treatment, and prevention continue to be something of a medical mystery, and the lack of answers is a major source of frustration for many sufferers.

In terms of who is affected by migraines, there are some definite trends. Women are much more likely than men to suffer from migraines, and during times of decreased estrogen production, such as menstruation, pregnancy, and menopause, many women experience more frequent migraines, according to the Mayo Clinic.

Researchers have identified a vast number of triggers, including sleep deprivation, stress, weather changes, physical activity, certain foods and medication, blood sugar fluctuations, alcohol, and sensory stimulation. The wide range of triggers is part of many sufferers' frustration. For many people who experience migraines, avoiding all of these triggers is not a realistic approach to life, nor is keeping a daily log of all of these factors, trying to identify your specific triggers, especially if you experience migraines infrequently.

One of the biggest mysteries for those who suffer from migraines is a change in their frequency, with no identifiable cause or trigger. An article published by The Migraine Trust in 2008 stated, "Researchers are now saying that migraine is not just an episodic disorder, but a chronic disorder with episodic manifestations." The authors cited research indicating that an increase in the frequency of migraines can have multiple causes, including head injury, overuse of analgesics, depression, and menopause. An increase in frequency is more common in female migraine sufferers.

There is such a variety in treatment options that this, too, can be a source of frustration. In an article published by the British Journal of Medicine in May 2014, researchers said, "Despite the frequency of migraine as a presenting complaint and the cost of acute treatment, there is no clear consensus on the standard of care for acute migraine management in the ED (emergency department) or during hospitalization."

Drugs for prevention include beta-blockers, calcium-channel blockers, antidepressants, anticonvulsants, and Botox, and, there are a variety of medications in the triptan and ergot categories, which can be taken at the onset of a migraine to minimize its effects. Side effects, ranging from increased risk of stroke to opioid addiction, are a major concern for many migraine sufferers, in addition to the challenge of identifying an effective treatment, as patients' responses to different medicines vary. Homeopathic and alternative practices, such as acupuncture and massage therapy, have also been touted as possible treatments, although there is not much reliable data to support their efficacy. While acupuncture and massage therapy have been identified by several reputable studies as a means of managing the pain of a migraine for some sufferers, as well as a course for prevention, there have also been studies with indications to the contrary. Also, homeopathic remedies can react adversely with prescribed or over-the-counter medications. Lack of consensus within the medical field, coupled with anecdotal advice from friends and family, can leave migraine sufferers bewildered as to the best course of treatment.

The University of California at Berkeley offers these tips for developing an effective plan with your healthcare provider: Educate yourself about migraines, triggers, and treatment, and record your symptoms, suspected triggers, and response to treatment. Bring this information to appointments. Understand your treatment plan. Follow instructions, don't deviate from the plan, and attend follow-up appointments. Last, be realistic. Designing a plan that works for you may take some trial and error.

Tips for managing migraine pain:
• Apply an ice pack (or cold can of pop) wrapped in a towel to the back of your neck, or the area where the pain is most acute.
• Reduce sensory inputs.
• Drink plenty of liquids.
• Gently massage your neck and scalp.
• Take a nap.

Written by: Jennifer Reynolds is the staff writer for West Michigan Woman magazine.

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