Headache You Can’t Shake? There’s Help!

By Tsui Rangum, MD female headache

Got six friends? If you’re a woman, odds are at least one of them suffers from migraine headaches.

Who’s At Risk?

Three-quarters of migraine sufferers are women. In fact, one in six women has suffered a migraine.  The incidence is lower among African- and Asian-Americans. About 70 percent of patients have a first-degree relative with a history of migraine. Loss of productivity from migraines in U.S. work force is more than $13 billion per year.

What Are the Symptoms of a Migraine?

Migraines are a complex, recurrent headache disorder that requires lifestyle changes at some level to overcome. Classic migraine is characterized by head pain only on one side. Before head pain is experienced, however, 60 percent of patients experience:

  •  Sluggishness
  •  Food cravings
  •  Mood changes
  •  Sensitivity to light, sound and/or odors

Some migraines are accompanied by aura, a sensation like a cold breeze or bright light.

Factors that can bring on a migraine headache include:

  •  Stress
  •  Excessive or insufficient sleep
  •  Smoking
  •  Exposure to bright light
  •  Hormonal changes
  •  Weather changes
  •  Strong odors
  •  Food additives
  •  Alcohol
  •  Caffeine
  •  Chocolate
  •  Sweeteners
  •  MSG
  •  Nitrites
  •  Foods containing the amino acid tyramine, like aged cheese, chicken livers, yogurt, raisins and peanuts
  •  Medications like vasodilators and oral contraceptives

How Are Migraines Diagnosed?

Migraines are diagnosed clinically based on the criteria established by the International Headache Society. Migraines are typically inherited in 50 to 80 percent of cases due to abnormal brain processing of normal sensory signals.

To diagnose a migraine, your doctor will want to know:

  • How many headaches you’ve had in the past three months
  • How long your headaches typically last
  • If your headaches are accompanied by any other symptoms, such as nausea or light sensitivity
  • If headaches have limited your ability to work, study or do what you need to do
  • Where and what type of pain you’re experiencing: throbbing, only on one side, etc.

How Are Migraines Treated?

Treatment aims at ending the current attack and preventing recurrent attacks.  Therapy includes prescription and non-prescription treatments. Prescriptions that have benefited patients include that classes of drugs called NSAIDS, triptans, DHE, acetaminophens and butorphenols.

Non-prescription therapies involve behavioral changes such as:

  • Sleeping at least six to eight hours consistently
  • Exercising
  • Managing your stress management
  • Biofeedback techniques, such as relaxation or visualization
  • Limiting caffeine to 6 ounces a day
  • Eliminating artificial sweeteners
  • Quitting smoking
  • Eating fresh, non-processed foods in rainbow of colors throughout the day

Acute treatment aims at stopping, preventing progression and reversing the headache as soon as it starts. Preventive treatment begins once the headache has subsided and aims to reduce the frequency and severity of future migraine attacks.

Patient education is the key to successful, long-term management, since migraines are a chronic neurological disorder that requires lifestyle changes to manage.

If you are experiencing severe headaches, visit eMedical Urgent Care or your primary care provider.

Tsui Rangam, M.D., has been with eMedical Urgent Care since 2010. She is board-certified in emergency medicine. Prior to joining eMedical Urgent Care, Dr. Rangam was an emergency physician with Emergency Medical Associates. She earned her medical degree from Andhra College, India, completed her internal medicine residency at Jersey City Medical Center, Jersey City, N.J. and fellowship in hematology/oncology at Long Island College Hospital, Brooklyn, N.Y.

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