What is Migraine Headache?
A migraine is a painful throbbing headache, usually on one side of the head. The pain is so intense that it may disable a person to work or do a simple task at times. The pain is usually over the forehead, temple or even in the back of the head and neck areas. It can cause nausea, vomiting, light & noise sensitivity or even weakness and/or numbness in extremities. “Classic” migraines begin with an aura such as seeing dots, wavy lines or blurriness before the pain starts. About 20% of people have classic migraines.
Triggers for Migraine Headaches
Migraine headaches are often initiated or “triggered” by specific situations (environment, food, stress, hormonal changes). Examples include bright lights such as sunlight or flickering light, stress, sleep deprivation, dehydration or lack of timely food intake. Certain foods such as MSG, chocolate, soy sauce, processed meat, aged cheese, red wine and some nuts can also trigger migraine headaches. Caffeine may help relieve migraines during an acute episode. However, when the caffeine levels drop, the patient will often experience a rebound headache.
Migraines occur more often in women than men (3:1 ratio). Many women’s migraines are linked to their menstrual cycle.
Treatment Options for Migraine Headaches
There are many types of over the counter (OTC) medicines for headache pain but overuse can lead to toxicity and gastric ulcer. Also, long term and repeated use may cause rebound of migraine headaches.
Triptans such as Imitrex, Maxalt, Zomig, and Axert are the most commonly prescribed medications for the treatment of migraines. However, people with history of heart disease, stroke, and high blood pressure may not be eligible to take triptans. Newer medication such as Ubrelvy and Nurtec are used nowadays for treatment of migraine headaches. These meds have fewer side effects than triptans. Sometimes, combinations of few prescription
medications are used for severe episodes. At times, prophylactic medications such as Qulipta, Topiramate, blood pressure medications or SSRI’s have to be added to the regimen to reduce the frequency and severity of the headaches. Some patients do not respond to any treatments and develop chronic migraine headaches which is defined as a having headaches on 15 or more days per month with headaches lasting four hours a day or longer. Quality of life is greatly affected in this subcategory of migraine headache sufferers. Patients usually miss work or school and not able to attend to daily chores.
In 2010, the FDA approved Botox® as a treatment option for chronic migraine. Botox® to treat chronic migraines is given at intervals of about 12 weeks and is expected to lessen and fade away the pain up to three months depending on the individual patient. In some patients, it totally aborts the pain for the entire duration of 3 months. The treatments are quick and easy and last about 15 minutes.
Botox® is one of many treatment options available to individuals with chronic migraines, especially for patients who do not tolerate migraine medications. Most insurance providers now cover the expense of a Botox® injection if it is being used to treat chronic migraine.
If other preventative treatments have not helped ease your chronic migraine symptoms, it may be time for you to call us for an assessment.
