By Catherine Winters
Nearly 30 million Americans suffer from the debilitating, life-altering pain of migraine. Learn what causes the throb and how to stop it.
Who Gets Migraine
It's not clear why some people develop migraines and others don't. If both your parents are migraine sufferers, there's a 75 percent chance you'll be one, too. If only one parent is, your risk drops to 50 percent. And if a distant relative complains of the headaches, there's still a 20 percent chance you could end up a migraineur. (That's the term used to describe a migraine sufferer.) Your gender may predispose you to migraines as well: Women are three times more likely than men to get this type of headache.
What Happens
"The brain of a migraine sufferer is inherently more sensitive than the brains of others," says Fred Freitag, D.O., associate director of the Diamond Headache Clinic in Chicago—and himself a migraineur. "When this sensitive brain gets bombarded by outside and inside stimuli, cells in the cortex of the brain become hyperexcited and start a process of electrical discharge." As electrical impulses spread across the surface of the brain, chemicals that dilate blood vessels and inflame surrounding tissue are released and kick into action. These chemicals trigger a series of events that eventually produce the throbbing pain (usually on one side of the head), nausea, and sensitivity to light and sound that are hallmark migraine symptoms. Before the headache comes on, about one third of sufferers also experience an aura—flashes of light, blind spots or zigzag lines, or tingling in the face and arm.
What Can be Done
Avoiding triggers is the first step to heading migraines off. Headache experts usually have migraineurs keep a diary for two to three months to identify foods, external factors and behaviors that might be making their heads throb. Then they're ready for action. "If you that know certain foods give you a headache, avoid them," says Dr. Freitag. Also, get on a schedule. Eat at regular times and go to bed and get up at the same time every day. If you go to bed at 11 and get up at 6 all week but sleep in on Saturday, your blood sugar will drop because you're eating breakfast later. In addition, your internal clock gets thrown off. "Both can stimulate a sensitive brain," says Dr. Freitag.
Eat a healthy diet. Magnesium-rich foods, such as whole grain breads and pasta, may help stave off migraines. And exercise regularly. Even 20 minutes of aerobic exercise a few times per week stimulates the production of endorphins, the brain's natural painkillers. Relaxation training, acupuncture and massage can help, too. If these measures aren't enough, ask your doctor whether you are a candidate for medication. The good news: With a little trial and error, experts say, you can usually find relief.
Trigger Effect
Experts have identified a slew of stimuli that can cause migraine attacks. These range from preservatives to perfumes to changes in barometric pressure. In women, hormone levels are often to blame. "Their hormones peak, drop during ovulation and then climb again, and then fall just before menstruation," says Robert Kunkel, M.D., a consultant in the department of neurology at the Cleveland Clinic Headache Center. "It seems to be the fall of estrogen levels in the blood that excites brain cells, not hormone levels per se."
Writer: Catherine Winters
©MediZine's Healthy Living, Second Quarter 2007
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