Migraine Symptoms and Treatments

A common type of headache, migraine is thought to affect around one in every five women and one in every 15 men in the UK, with those aged between 35 and 45 the most affected (i).

Indeed, according to the Migraine Trust, migraine is the third most common health condition in the world, behind dental cavities and tension-type headache (ii). The World Health Organization also claims migraine is a common neurological condition that affects more than 10 per cent of the world’s population (iii), and that in the UK around 25 million working or school days are lost every year because of it (iv).

Many people have their first migraine in childhood, with about half having their first attack before their 12th birthday (v). Migraines can also run in families. The frequency of migraine attacks can vary enormously – according to the Migraine Trust, more than three quarters of people who have migraines experience at least one attack a month (i), though some have them only occasionally, sometimes with years passing between attacks (vi).

A migraine attack can last from four to 72 hours, with symptoms including a pounding or throbbing pain. Up to 30 per cent of people with migraine (vii) also experience visual disturbances such as flashing lights, zigzag patterns, blind spots, numbness, tingling and pins and needles in the limbs, as well as dizziness and feeling off-balance, all of which are collectively known as aura.

Migraine triggers

A type of primary headache, migraine has no clear cause, though some experts believe it’s the result of certain chemicals being released in the brain.

Several things may trigger a migraine, including hormone changes (called menstrual migraine – see below), depression, excitement, worry, shock, anxiety, over-exertion, late nights, bad posture, drinking alcohol, low blood sugar and certain foods.  

Other migraine triggers include bright lights, loud noises, strong smells, a smoky or stuffy atmosphere, eye strain, sinus problems, computer or television screens and very cold temperatures, as well as certain types of medicines including hormone replacement therapy (HRT), the oral contraceptive pill and some sleeping tablets.

Despite there being no cure for migraine, the good news is they can be treated and usually aren’t serious. In many cases, they can become less severe as you get older, often disappearing altogether after a number of years.

Types of migraine

The three most common types of migraine are migraine with aura, migraine without aura and migraine aura without headache (the latter is sometimes called a silent migraine as it causes aura symptoms but not the pounding head).

Migraine without aura

This is the most common form of migraine. You may experience intense, throbbing pain, often on just one side of the head. Movement can make the pain worse, which is why sufferers often want to lie down still, ideally in a quiet, darkened room because migraine can also make you more sensitive to light and sound. Other symptoms can include sensitivity to smells, nausea, vomiting and other gastro-intestinal problems.

Some people have a migraine without warning, whereas others find they have signs that a migraine is on the way, including feelings of confusion, lack of concentration or energy, or excessive yawning.

After a migraine you may still feel tired and run down for a few days, but largely you should be symptom free between attacks.

Migraine with aura

This used to be known as a classic migraine. You may have the same symptoms as a migraine without aura, but with the addition of neurological disturbances (blind spots, flashing lights etc) for 15 minutes to an hour before your head starts to pound. Some people are only affected by the aura part of a migraine attack (silent migraine) and don’t go on to develop a headache, or may have just a mild headache.

Abdominal migraine

Rare in adults, abdominal migraine is thought to be a variant of migraine that’s more common in children. The main symptom is pain in the abdomen that may last for an hour up to several days, accompanied by nausea and vomiting in some cases. Children with abdominal migraine often have a family history of migraine, with many developing migraine as adults after outgrowing the abdominal symptoms.

Menstrual migraine

Also called hormone headache, menstrual migraine is linked to a woman’s menstrual cycle, with symptoms happening within two days either side of a monthly period. Experts believe it’s probably caused by low oestrogen levels. According to the American Academy of Family Physicians, 14 percent of women with migraine only ever have attacks during their period, almost always during the first two days, though 60 percent of women with migraine say they’re more likely to have an attack during their period (viii).

Migraine with brainstem aura

This is a rare type of migraine formerly known as basilar artery migraine because it involves the basilar artery – a blood vessel at the base of the brain – going into spasm and reducing the blood supply to parts of the brain. This can cause fainting, double vision and other visual disturbances, hearing problems, tingling in the hands and feet, vertigo and ringing in the ears.

Other forms of migraine are rare, including hemiplegic migraine, a condition linked to a problem with electrical and chemical signalling in the brain. Symptoms include temporary paralysis down one side of the body that can last for several days, as well as vertigo, double vision, hearing problems, speaking problems and confusion.

Discover more on the different types and treatments of headaches in our guide.

 

Pain relief for migraine

Many people who have migraines find they can be treated with simple pain relief medicines such as paracetamol, ibuprofen or aspirin:

Paracetamol

This is thought to act on the production of prostaglandins, substances produced by the body in response to injury that sensitise nerve endings involved in the process of inflammation. Paracetamol is available in tablets including effervescent/dissolvable tablets or as a liquid. Dissolvable paracetamol may treat migraine symptoms more effectively as the active ingredient is absorbed by the body faster compared with a tablet. Combination remedies are also available for migraine that contain both paracetamol and an opioid painkiller called codeine. Paracetamol on its own is suitable for adults, children over the age of two months and pregnant women.

Ibuprofen

This anti-inflammatory painkiller works by blocking a chemical called COX, an enzyme used in the body to produce prostaglandins. It may be a good option for migraine sufferers who find paracetamol isn’t effective. However, it isn’t recommended for long-term use, as it can cause stomach-related side effects.

It’s available in tablets, caplets and capsules and is suitable for adults and children over the age of three months (though older people should use ibuprofen with care).

Aspirin

Because aspirin can cause side effects in the stomach, it isn’t usually recommended as a migraine treatment. However, some experts believe it is an effective treatment for migraine. Aspirin is also found in pain relief medicines combined with other ingredients such as caffeine or paracetamol.
Do not give aspirin to children under the age of 16. It’s also not suitable for pregnant women or people who have asthma.

Over-the-counter migraine medicines

Some combination medicines designed specifically for migraine are available over the counter. These contain painkillers and anti-sickness medicines (anti-emetics – see below). However, according to Patient.co.uk, they may not suit everyone or be strong enough to relieve the symptoms of a migraine (ix).

Triptans

Prescription medicines called triptans may help if over-the-counter painkillers aren’t effective at relieving your migraine symptoms. Triptans aren’t painkillers in the conventional sense, but are thought to work by interfering with a brain chemical called 5-HT. Several types of triptan medicines are available – including frovatriptan, sumatriptan, naratriptan and zolmitriptan – and some people affected by migraine may have to try several before finding one that works for them. Triptans are available as tablets, nasal sprays and injections, and while most are only available on prescription, you can buy sumatriptan from pharmacies.

Anti-emetics

These are medicines that relieve the nausea associated with migraine and are usually given in tablet form, but they’re also available as a suppository. There is no medication designed to be taken for the aura part of an attack. Like painkillers, these medicines work best if you take them as soon as possible after your symptoms start.

Self help for migraine

One of the best ways to try and keep your migraines under control is to try to find out what triggers them. And the way to do just that is to keep a migraine diary.

Keeping a record of when you have migraines may help you to notice a pattern in how and when your attacks happen. This may help, since some migraine medicines are more effective if taken as soon as your symptoms start. It may also help you to avoid certain triggers, where possible.

In your migraine diary, make notes of what you eat and how regularly you eat, since missing a meal or having a meal later than usual can be a migraine trigger. Also record whether or not you’re under stress and anything else that may contribute towards your migraines (it may be that your symptoms are triggered when two or more factors are combined, rather than a single factor). See our guide to the signs and symptoms of stress for more information.

 Your migraine diary should also include notes of how severe your migraines are, how long they last and what effect they have on your day-to-day living. If you do need to see your GP for your migraines, this may help them to devise a treatment plan for you.

You can download a free migraine diary in pdf format from the Migraine Trust website.

Here are some other things you can do that may help:

• Eat regular meals and try to avoid foods that are high in sugar to keep your blood sugar levels stable. Follow as healthy a diet as possible, and have at least five portions of fruit and vegetables every day. Drink plenty of water too, and try to avoid caffeine and alcohol.

• Sleep well by sticking to a regular bedtime and getting up time (avoid late nights and long lie-ins whenever you can). Also avoid working night shifts, if possible.

• Stay away from strong smells, such as perfumes, paints, air fresheners and cleaning products.

• Get plenty of exercise, preferably while getting some fresh air at the same time. Try walking or cycling to work instead of driving or going on the bus/tube. Or if you can’t avoid using public transport or driving to work, go for a brisk walk at lunchtime (wear sunglasses whenever you’re in bright sunlight).

• When you’re at work or busy at home, try to take regular breaks. It’s also a good idea to practise some form of relaxation on a regular basis, especially when you feel you’re under stress.

• Try to avoid bright, flickering or flashing lights. If you use a computer at work or at home, take regular breaks and make sure your computer monitor has been set up correctly to prevent glare and reflections from windows and bright surfaces. Your chair and desk should also be set up to prevent neck, shoulder and back strain.

Natural migraine relief

Nutritional or herbal supplements and natural treatments that may help to alleviate migraine include the following:

Magnesium

The mineral magnesium has been shown to be an effective treatment for migraine. For instance, in one study, volunteers who took a daily magnesium supplement had 40 percent fewer migraine attacks than those who took a placebo (x), while a review of 21 studies suggests magnesium supplements alleviate the frequency and intensity of migraines (xi). Other studies have produced similar findings, while some suggest magnesium may be useful as a treatment for menstrual migraine in women (xii). Good food sources of magnesium include brewer’s yeast, blackstrap molasses, wheat bran and dry roasted nuts.
 

Ginger

There is also some evidence to suggest ginger may help to reduce the pain of a migraine. In a study published in 2014, migraine sufferers were given either ginger powder or a prescription migraine drug called sumatriptan (a type of triptan). Both groups claimed their migraine improved by 90 percent within two hours, with the researchers concluding that ginger may be as effective as sumatriptan (xiii). Another study suggests that adding ginger extract supplements to a standard anti-inflammatory medication may contribute to the treatment of a migraine attack when compared with a placebo (dummy pill) (xiv).
 

Coenzyme Q10

Also known as ubiquinone, coenzyme Q10 (CoQ10) is found in every cell of the body and plays an important role in the mitochondria, components within cells that produce energy. Some experts believe a problem with the mitochondria may play a role in migraine, and studies have been carried out to investigate the use of CoQ10 as a possible treatment. One study suggests taking 100mg of CoQ10 three times a day may significantly reduce the frequency of migraine (iv). Another trial treated 32 migraine patients with a daily dose of 150mg of CoQ10, with most finding they had fewer migraines after 12 weeks (only two patients from the trial showed no improvement) (v).
 

PEA

Also known as palmitoylethanolamide, PEA is a type of fatty acid made naturally by the body and found in all cells, tissues and fluids including the brain (it’s also found in foods such as soya beans, peanuts, eggs, flaxseed and milk). Described as an endocannbinoid-like chemical that belongs to a family of fatty acid compounds called amides (xviii), PEA is an alternative to CBD, since both substances are thought to have similar properties including the ability to reduce pain and inflammation. However researchers suggest PEA is safer than CBD, since it has been studied more extensively and has a more robust safety profile (xix) with no known side effects (xviii).

Your body naturally increases its production of PEA when your cells are damaged or threatened. But in certain situations – such as when your body is experiencing chronic inflammation – the level of PEA in your cells drops (xviii). When this happens, PEA supplements may be helpful. In fact a small-scale study suggests PEA supplements could even be useful in migraine prevention (xx).
 

Sticks and strips

Designed to be applied directly to the forehead, these sticks and strips contain an ingredient called levomenthol (a type of peppermint). The idea behind them is that they may block pain signals and relax the muscles in the head.

Meanwhile, guidelines from the National Institute of Health and Care Excellence (NICE) state that riboflavin (vitamin B2) – when taken as a 400mg daily dose – may be effective in reducing migraine frequency and intensity for some people (xvii).

Managing migraines, whether they are one-off occurrences, or happen all of the time, can be difficult at times, but this guide should help to ease the symptoms. To discover more information on a range of other health conditions, why not visit our health library?

 

References:

1. Available online: https://www.migrainetrust.org/about-migraine/migraine-what-is-it/facts-figures/

2. Available online: https://www.migrainetrust.org/about-migraine/migraine-what-is-it/facts-figures/

3. Available online: https://www.who.int/features/qa/55/en/

4. Available online: https://www.who.int/news-room/fact-sheets/detail/headache-disorders

5. Available online: https://www.migrainetrust.org/living-with-migraine/coping-managing/young-sufferers/guide-for-parents-and-carers/

6. Available online: https://www.nhs.uk/conditions/migraine/

7. Available online: https://www.migrainetrust.org/about-migraine/types-of-migraine/migraine-with-aura/

8. Available online: https://www.aafp.org/afp/2002/0901/p856.html

9. Available online: https://patient.info/brain-nerves/migraine-leaflet/migraine-treatment-medication-and-prevention#nav-2

10. Peikert. A, Wilimzig. C, Kohne-Volland. R. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia. 1996;16:257-263.

11. Chiu HY et al., Effects of Intravenous and Oral magnesium on Reducing Migraine: A Meta-analysis of Randomized Controlled Trials. Pain Physician. 2016;19:E97-E112.Available online: https://www.painphysicianjournal.com/current/pdf?article=MjQ4Nw%3D%3D&journal=93

12. Facchinetti. F, Sances. G, Borella. P, et al. Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium. Headache. 1991;31:298-301.

13. Facchinetti. F, Sances. G, Borella. P, et al. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991;78:177-181.

14. Maghbooli M et al., Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res. 2014 Mar;28(3):412-5.Available online: https://www.ncbi.nlm.nih.gov/pubmed/23657930

15. Martins LB et al., Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officiale Rosc.) addition in migraine acute treatment. Cephalalgia. 2019 Jan;39(1):68-76.Available online: https://www.ncbi.nlm.nih.gov/pubmed/29768938

16. Sandor. PS, Di Clemente. L, Coppola. G, et al. Efficacy of coenzyme Q 10 in migraine prophylaxis: a randomized controlled trial. Neurology. 2005;64:713-715.

17. Rozen. TD, et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalagia. 2002 Mar;22(2):137-41.

18. Clayton P. et al., Palmitoylethanolamide: A Natural Compound for Health Management. Int J Mol Sci. 2021 May;22(10): 5305. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157570/

19. Clayton P. et al., Palmitoylethanolamide: A Potential Alternative to Cannabidiol. J Diet Suppl. 2021 Nov;28;1-26. Available online: https://www.tandfonline.com/doi/full/10.1080/19390211.2021.2005733

20. Hernandez AG. et al., Palmitoylethanolamide-based nutraceutical Calmux® in preventive treatment of migraine. Neurol Neurosurg. 2022 Jul;218:107282. Available online: https://www.sciencedirect.com/science/article/abs/pii/S0303846722001639

21. Available online: https://www.nice.org.uk/guidance/cg150/chapter/Recommendations#management-2

 

Related Posts

 

Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
 

---