04 May Managing Migraine Headaches

Migraine headaches are distinct from other types of headaches in that they typically occur regularly, sometimes on a yearly basis, others occur monthly or several times per month. They are described as throbbing, pounding and intense pain on one side of the head that may spread to the other side. Migraines are accompanied by nausea and/or vomiting and the person may experience sensitivity to light (photophobia), sound (phonophobia) and intolerance to certain smells. Some people experience an aura before the start of a migraine, and symptoms can include seeing flashing lights and zigzag patterns and blurry or distorted vision. The aura can last up to 60 minutes.

Effective management of migraine headaches occurs with first understanding and recognizing the symptoms. Seeing a headache specialist is important to developing a treatment plan that includes avoiding triggers whether physical, environmental, or chemical and using medications appropriately.

First, keeping a headache diary allows the person and headache specialist to understand the patterns of the migraine headaches. This is a written journal describing the frequency, the intensity, the duration, and possible trigger of the headache. The journal also includes the medications used, over the counter and/or prescriptions and their effectiveness in decreasing the headache. This data is very important to the patient and health care provider because it allows for the development of the most effective approach and treatment to the problem.

Second, developing a trusting and collaborative relationship with a health care provider is important to effective treatment. Communication and mutual dialogue can help develop strategies that best fit the patient’s lifestyle, ensuring optimal solutions and healthy behaviors.

Third, reducing and controlling stress can affect how the mind and body react to changes in the environment and other triggers that can exacerbate migraine headaches. Stress can cause symptoms of clammy hands, dry mouth, and tight muscles. It can also show with anger, confusion, or sleep problems. Some people turn to alcohol or drugs to relieve stressful situations. lf stress is improperly managed and not controlled, migraine headaches may only get worse. Stress is caused by family and social interactions that affect finances, relationships, and work. Stress can come from minor problems like running late  and can also come from life events such as getting married or losing a job. Controlling stress is important to everyone, especially migraineurs. Stress reduction strategies include regular cardiovascular physical exercise from activities such as dancing, running, and swimming. Taking time for relaxation from busy schedules to enjoy hobbies or friends is also a wonderful stress reducer. Finally, getting a good night’s rest to include 6 to 8 hours of sleep is very important in controlling and managing stress. Developing a personal stress reduction strategy can be very useful to managing migraine headaches.

Michael M Tuchman, MD, FAAN

Vivian Carta Sanchez, NP