Wondering what causes your migraine headaches? You're not alone. According to the American Migraine Foundation, over 39 million people in the United States experience the ill effects of migraines, but many are unaware of the root cause.
While a cause isn't always clear, one thing is certain: understanding what makes your migraines unique to you will help you determine the best way to manage them.
A migraine is a neurological condition that involves headaches and certain related symptoms such as light sensitivity, nausea, vomiting, and vision changes.
For most people, migraine pain can range from moderate to severe and make it difficult to perform their daily activities.
Although the exact cause of Migraine is still unknown, several factors may come into play:
Heredity is recognized as a key factor in the development of migraines. According to the American Migraine Foundation, if one of your parents has migraines, you have a 50%-70% chance of getting them, too.
Genes associated with migraine can impact everything from brain chemistry and blood flow to lifestyle factors like stress and poor diet, increasing a person’s susceptibility to migraines.
Researchers have found that many people prone to migraine may have overly sensitive nervous systems, causing nerve cells in their brains — part of the trigeminovascular system — to be more easily stimulated.
In an oversensitive brain, the areas responsible for regulating sensations like pain may become over-excited by both external or internal triggers. This excitation may be followed by a depressive movement throughout the brain, known as cortical spreading depression.
Cortical spreading depression starts in the occipital region near the base of the skull, an area responsible for controlling vision, then spreads forward through the rest of the brain. It may last for several hours or even days, creating intense pain and other debilitating symptoms. It also may play a role in triggering aura and other common visual complaints during migraines.
A protein in the brain called CGRP (calcitonin gene-related peptide) can spur intense inflammation around the meninges, the layers of membrane protecting the brain. Studies have indicated areas within specific genes that are involved with the production and release of CGRP. For most people with migraine, CGRP is the cause of pain.
Serotonin is a chemical that helps cells communicate with each other. This chemical is a critical component in regulating many aspects of our bodies, from emotion and moods to appetite and sleep cycles.
One well-understood aspect of serotonin is its link to migraine. Changes in serotonin levels in the brain can trigger the dilation of blood vessels in the head, resulting in migraine symptoms such as pain, nausea, light and sound sensitivity.
Many women experience migraines; women are, in fact, more prone than men to get them. Shifting hormone levels, including normal changes in estrogen levels throughout a woman's life, can trigger cyclic migraines.
Such hormone-level changes occur during:
How a migraine feels can vary from one person to another. In general, migraines typically present with pulsating, throbbing pain on one side of the head, although they can also occur on both sides.
Other common symptoms include:
A migraine episode can feature four distinct stages: prodrome, aura, attack, and postdrome. In the prodrome stage, you may experience changes in mood or food cravings, as well as other physical symptoms like chills or stomach upset. Aura can manifest in a variety of ways, from flashing lights to a sensation of pins and needles. About 20% of people with migraines have auras.
The attack phase includes the actual migraine, usually begins on one side of the head and can be severe. It can last from several hours to several days. Lastly, during postdrome, many people report feeling exhausted and foggy-headed. About 80% of people with migraines experience this migraine "hangover” effect.
Most people have experienced a headache at some point. But what exactly is a headache, and how is it different from a migraine?
In simple terms, a headache is pain or discomfort that occurs in the head or face, caused by tension, lack of sleep, dehydration, or eye strain, among other things. Headache is very common and can affect people of all ages.
Common types of headache include:
Most headache pain is typically located in or around the head, usually on both sides at once. Headaches tend to come and go relatively quickly, typically lasting no more than a few hours. Symptoms usually respond well to a pain reliever or anti-inflammatory medication.
In contrast, migraine pain is usually focused on one side of the head and is more intense than headache, with significant pain and discomfort. As noted, migraine can last several days, with symptoms ranging from intense pulsating pain, to light and sound sensitivity, to changes in vision such as flashes of light, sparkles, lines, or blind spots. A migraine attack may also cause nausea and vomiting, or even numbness and tingling in the face or hands.
Interestingly, the line between migraine and headache is not always clear. Some migraines cause little pain, while some headaches can be quite intense.
A trigger is something that leads to or increases your chances of having a migraine. Triggers can include factors such as:
Stress: According to the American Migraine Foundation, 70% of people with migraines report stress as a trigger. Physical and emotional reactions, even to day-to-day stressors, can be enough to trigger a migraine.
Sleep: For people prone to migraine, sleep can be a mixed blessing. Adequate high-quality sleep is essential for maintaining health and well-being. But, for some people, getting too little — or even too much — sleep may trigger a migraine. Changes in sleep patterns, such as sleeping in or staying up late for a few nights in a row, may spur episodes of migraine.
Alcohol: Alcohol consumption can trigger the release of certain chemicals, causing blood vessels in the brain to expand and leading to a migraine. Red wine is a frequent trigger, but white wine, beer, and liquor can cause migraines as well.
Caffeine: The relationship between migraine and caffeine is complicated. Some people must avoid caffeine intake to avoid triggering migraines, while others can use caffeine to treat or prevent them. For each individual, the key is learning how your body reacts to caffeine.
Weather: Barometric pressure changes can trigger migraines, possibly because these changes affect how blood flows through your brain. This effect is most common in areas with frequently shifting weather, such as mountains or coasts.
Diet: Your diet can trigger a migraine, so it’s critical to understand the foods that may create that potential for you.
Food triggers can include:
Dehydration: Dehydration is a common trigger for migraines, especially in women. If your body is not adequately hydrated, blood vessels may constrict, leading to migraine.
Light: People prone to migraines can be hypersensitive to light due to how their brains process it. In these people, light sensitivity can not only trigger migraines, it may also worsen an attack. Any type of light is a potential migraine trigger, including:
The amount of light is also a factor — bright, intense light can cause greater discomfort in people who suffer from migraines.
Smell: For many people with migraines, certain smells can trigger an attack. Although the exact mechanism is not yet fully understood, it is thought that certain odors can activate the nerve responsible for facial sensation, the trigeminal nerve. This activation creates a chain reaction that results in a migraine. For some, simple exposure to a strong smell may be enough to trigger a migraine.
Medications: Many medications — for example, oral contraceptives, vasodilators used to lower blood pressure, and some sleeping pills — can trigger a migraine in some people. Taken regularly, certain pain medications (such as codeine) and non-steroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen and naproxen), can also bring on a migraine.
A common problem for people who take these types of medications is rebound headache. Rebound headache may occur, for instance, if you stop taking migraine medication itself; ceasing the medication suddenly or missing doses could result in the sudden onset of painful headaches. NSAIDs are known to be associated with rebound headaches if taken daily over long periods of time.
If you experience migraines, you understand their potential to disrupt your life. Fortunately, there are ways to potentially sidestep them. The key is to try different things to see what works best for you.
Although not every approach will work for every person, the Mayo Clinic reports that some people find success by making healthy lifestyle choices and taking preventative medication.
One of the most important measures you can take is to avoid triggers. If you know what sets off your migraines, do your best to avoid them. If you get migraines when you drink red wine, don’t drink it. Sticking to a regular and restful sleep schedule, eating healthy meals, and staying hydrated can help keep migraines away.
Medications such as topiramate, propranolol, and amitriptyline may also help prevent migraines from happening. Discuss with your healthcare provider which one might be right for you. Some common ways to stop a migraine in progress include both over-the-counter and prescription medications (such as acetaminophen and triptans), applying warm or cold compresses, or trying relaxation or stress management techniques, such as meditation or rhythmic breathing. Biofeedback and cognitive-behavioral therapy help some people to manage their migraine symptoms as well.
Learning to live with migraines is not easy. Functioning normally with migraine pain is extremely difficult, and discovering an optimal treatment can require time and patience. A few tips that may help:
Seek help early: The sooner you seek treatment, the better. Many options exist, and a professional can help you find the one that works best for you.
Keep a positive attitude: This may be difficult but remember, migraines are not permanent. There will be good days, and there will be bad days. Focus on the good days, don’t let the bad days get you down.
Keep a journal: Recording your experiences can help you track progress and identify patterns. It can also give you positive reinforcement on tough days.
Focus on diet and exercise: Eating healthy and staying active will not cure migraines, but it can help to reduce their frequency and severity.
Stay informed: Learn as much as you can about migraines. Stay current with new developments.
Listen to your body: Everyone is different. What works for one person may not work for another. Know when it’s time to try a different approach.
Most people experience migraines at some point in their lives; for most, they are a passing nuisance. But here's when a migraine may signal something more serious:
When it comes to treating migraines, one size does not fit all. To find the best treatment for your specific needs, it's important to identify what makes your migraines unique. For many people, genetics plays a major role. Other factors may include lifestyle choices, stress levels, and environmental conditions.
That's why working with a headache specialist can be particularly beneficial. By applying cutting-edge tools, Mable’s migraine specialists can help you understand the cause of your migraines and develop a treatment plan specifically for you.
So if you're struggling with migraines, don't wait – see if personalized DNA-guided migraine care is right for you!