Migraines can be extremely painful and disruptive to a person’s life. The pain may be unbearable, affecting your ability to work and conduct routine activities. We know that migraine has been around since the start of time with descriptions found in the Old Testament Bible. The Greek physicians studied and treated it. Through the ages it has afflicted people from former presidents to scientists to world-class athletes. The World Health Organization ranks migraines as one of the most disabling conditions.
Migraines are an inherited disorder characterized by pain, neurological symptoms and gastrointestinal symptoms. They can come in different forms. Understanding what kind you have will help in determining the best treatment.
Most migraines are called episodic and occur either with a neurological warning called an aura, which is usually a visual disturbance, or without an aura. Episodic migraines affect about 15 to 18 percent of the population. These occur on average from two to eight times per month. The headache is typically severe enough to curtail activities and often makes a person becomes hypersensitive to light, noise and smells. Even simple acts like bending over can make the pain worse. Most people lose their appetite and become sick to their stomach. Untreated an episodic migraine lasts from one to three days.
Chronic migraine symptoms resemble an episodic migraine except that chronic migraines occur more than half the days of the month over a period of months to years. This has a long-term impact on a person’s ability to function as well as treatment options. Chronic migraine syndrome can develop because a person gets a lot of migraines and does not have a way to stop them quickly, so each migraine drives the chances of the next one occurring until the condition becomes chronic and severely debilitating. There are other factors involved in causing this transformation from episodic to chronic migraine. Addressing these issues can help prevent the development and reverse the course of chronic migraine syndrome.
Working with your doctor, finding the right combination of medications to treat migraine headaches is possible. Most of these medicines can alleviate 50 percent or more of headaches within the first three to six months. Further improvement may be possible by combining medicine with nonmedical treatments such as biofeedback.
Other medical issues may compound the migraine cycle and need to be addressed — such as anxiety, depression, high blood pressure, snoring, hormone imbalance and weight. Lifestyle choices need to be considered, too. Healthy well-balanced meals, regular exercise, a consistent sleep schedule and stress management are all parts of controlling migraine headaches. Newer therapies are being developed for patients with episodic and chronic migraines. Clinical trials are underway right now at Froedtert & MCW health network and around the country to determine if medications that block a chemical transmitter called CGRP can stop the acute migraine.
Migraine headache is a very debilitating disorder. However, a comprehensive approach to care, with patient and physician working together to address lifestyle, nonmedication approaches, specific treatments for headaches as they occur and treatments to reduce the frequency and severity of headaches allow the vast majority of patients to achieve a better quality of life.