Healthy Manhattan: More Than a Headache

Written by Dr. Cynthia Paulis on . Posted in Healthy Manhattan, Posts.


If you feel like your head is being held in a vice grip and the slightest sound and light puts you into intense pain, you may be experiencing a migraine headache. Migraine is the most common form of disabling headache, affecting 29.5 million Americans, and the headache most seen in emergency rooms.

Migraines affect people between the ages of 15 and 55, and are most commonly found in women. Often there is a family history of migraine. The migraine headache is a vascular headache brought on by the enlargement of blood vessels that causes the release of chemicals from nerve fibers that coil around the large arteries of the brain. When these blood vessels stretch, they cause the nerves to release chemicals. This in turn causes inflammation and pain.

People who have migraines tend to have certain factors or events that trigger these headaches. Such triggers include lack of or too much sleep, hormone changes during the menstrual cycle, missing meals, loud noises and bright lights, weather changes and stress. Food also factors into causing headaches, especially food products containing MSG, nitrates found in hot dogs and lunch meats, and tyramine, found in aged cheese, sausages, smoked fish and soy products.

Alcohol, specifically red wine, also tends to be a trigger, along with caffeine if you are withdrawing from it or having too much.

There are many forms of migraines, but the two most common ones are those with and without an aura. The migraines with an aura are considered the "classic migraine" and are experienced by only one out of five people. When a person experiences an aura they tend to have sensory symptoms 30 minutes before the attack of the headache. With an aura they will see flashing lights, blind spots, have numbness or tingling in the face or hands and have a disturbed sense of taste and smell. Men seem to be more prone to auras with migraines than women.

Not all migraines are the same, but studies have shown that hours before a headache strikes some people have symptoms of thirst, irritability, drowsiness or depression. They can also have feelings of elation or intense energy coupled with the cravings for sweets.

With a migraine, the person is often incapacitated due to the severity of the pain, many times accompanied by nausea and vomiting. These migraines can last hours to days.

Treatments for migraines run the gamut from over-the-counter meds, such as aspirin and nonsteroidals (Motrin, Advil), to prescription medications. A class of drugs known as Triptans seems to be effective for severe migraines, relieving the pain, nausea and sensitivity to light and sound which occurs during the attack. Some of the older medicines such as Ergotamine’s and Butalbital have fallen out of favor. There are some preventive drugs such as antidepressants which seem to help some patients. One of the newest lines of treatment for chronic headaches is Botox, which has mixed results. Injections are made into the forehead and neck muscles and are given every three months.

Prevention is key for migraines, and a helpful tool is a headache diary. Take notes on when your headache starts, how long it lasts and if anything provides relief. Also keep track of the foods you ate in the last 24 hours. Try to avoid the triggers that cause migraines. Exercise regularly, get plenty of sleep and try to manage your stress. Limit your caffeine to no more than two cups daily and don’t skip meals. Try to keep your sleeping patterns regular.

When a migraine hits, lie down and rest in a dark, quiet room. Place a cool cloth over your head and eyes. If you are not nauseated, drink water and try to take your pain meds immediately. Massage your temples and rub or apply pressure to the spot where you feel pain.

There is no cure for migraines, but lifestyle changes and leading a healthy lifestyle can minimize them. If the headaches are constant and nothing is relieving the pain, then it is time to consult your doctor.

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