Migraine symptoms, types, causes and treatments

Are you one of many 10 million folks within the UK, aged 15-69 years, that suffer from migraine signs? We really feel your ache…

… As do the opposite one billion folks worldwide affected by this debilitating situation. Migraine is one the commonest issues there may be, and it prices us in additional methods than one. In line with the NHS, In Britain alone, the British financial system loses round £4.4billion per yr to migraine-related sick days. And girls are probably the most affected.

There’s much more to migraines than dangerous headaches. ‘Migraine is a fancy neurological entity which may current with bodily, cognitive and emotional signs,’ says Dr Giorgio Lambru, marketing consultant neurologist at London Bridge Hospital.

Victims are all too conscious that there isn’t any remedy for this neurological illness. However medicine, in addition to way of life and weight-reduction plan adjustments, could be very efficient. If what migraine signs there are, and the triggers and coverings out there, it would enable you take management.

Migraine signs

• Extreme, throbbing headache that often (however not at all times) impacts one aspect of the pinnacle
• Neck ache and stiffness
• Sensitivity to noise and lightweight
• Blurred imaginative and prescient
• Nausea and/or vomiting
• Tiredness and/or fatigue
• Sweating
• Diarrhoea
• Forgetfulness and problem in concentrating
• Several types of aura (see under)

Uncommon and extreme migraine signs

‘There are uncommon signs, together with irritability, extreme yawning, moodiness, irregular emotions of elation or sudden bursts of power, in addition to sturdy meals cravings and dizziness,’ says medical nutritionist Suzie Sawyer. These signs aren’t worrying, however there are different signs to pay attention to, resembling seizures or suits, confusion, or a sudden onset headache that will warn of a extra severe difficulty.

‘Some folks expertise very extreme and debilitating signs, resembling an abrupt, extreme headache (like a thunderclap), headache with fever, stiff neck, confusion, seizures, double imaginative and prescient, numbness or weak point in any a part of the physique, which may very well be an indication of a stroke,’ says Suzie. In the event you’re uncertain, call 111.

Migraine signs could appear unrelated. It’s possible you’ll solely attribute them to the situation for those who’re holding a trigger diary.

Headache could be simply considered one of many migraine signs. (Credit score: Getty)

What’s an aura migraine?

Aura migraines are migraines when victims expertise sensory or visible disturbances, together with the basic migraine symptom of a headache. ‘Migraines could be preceded in about 30 per cent of circumstances by visible disturbances known as aura, though most migraine episodes should not related to an aura,’ explains marketing consultant neurologist Dr Giorgio Lambru. He provides: ‘Though migraine with aura is classed individually from migraine with out aura, their administration is analogous.’ Some folks expertise aura with none ache – that is known as a silent migraine.

There are various kinds of aura. Visible aura is maybe probably the most recognised – signs embrace seeing spots, zig-zags and flashes of sunshine, in addition to hallucinations and non permanent sight loss. Sensory aura can embrace tingling and numbness on one aspect of the physique, slurred speech, vertigo and tinnitus and, not often, weak point on one aspect of the physique.

Several types of migraine

In line with The Migraine Trust, the various kinds of migraines embrace:

• Frequent migraine (with out aura)
• Migraine with aura (visible and/or sensory disturbances)
• Menstrual migraines (greater than half of girls with migraine report menstruation as a set off for his or her migraine assaults, says The Migraine Belief)
• Power migraine (headache for 15 or extra days a month, eight of that are migraine)
• Migraine with brainstem aura (often known as a basilar migraine, it is a uncommon kind with neurological signs)
• Vestibular migraine (impacts stability)
• Hemiplegic (one other uncommon kind of migraine that causes weak point down one aspect of the physique)
• Belly migraine (this impacts youngsters greater than adults and manifests as extreme abdomen ache)

Pressure within the neck can contribute to migraine signs. (Credit score: Getty)

What are the principle causes of a migraine?

‘Migraine complications are historically considered principally triggered by environmental elements,’ says Dr Lambru. ‘Nonetheless, the present understanding of migraine means that many of the bodily, emotional, dietary and environmental triggers are the truth is premonitory migraine signs, which suggests they’re a part of the migraine which frequently begins hours or days earlier than the ache is felt.’

This means that, for many individuals, what they imagine is a set off is definitely a migraine in its early phases. So immediate or preventative motion is essential – earlier than the ache kicks in.

Bodily triggers

• Lack of sleep
• Tiredness and fatigue
• Poor posture, together with stress within the neck or shoulders
• Over-exercising or over-exerting your self

Emotional triggers

• Anger
• Anxiety
• Pleasure
• Shock
• Stress
• Fear

‘In instances of emotional stress, sure chemical substances are launched that provoke the vascular adjustments that trigger a migraine headache,’ says Suzie. ‘The assaults change into extra frequent in intervals of elevated stress.’

Dietary triggers

• Alcohol
• Baked items with yeast, resembling sourdough bread, bagels, doughnuts, and low cake
• Caffeine and caffeine withdrawal, though, conversely studies show caffeine may assist migraines
• Chocolate
• Citrus fruit
• Cultured dairy merchandise, resembling kefir and yoghurt
• Dehydration
• Hangovers
• Meals containing tyramine – present in sure cheeses and cured meats and fish
• Foods and drinks containing monosodium glutamate (MSG), sulphites, synthetic colors, sweeteners or preservatives
• Starvation or low blood sugar

Environmental triggers

• A change within the climate, temperature or barometric stress
• A change in routine
• Altitude
• Shiny mild
• Eye pressure from digital gadgets
• Excessive sound or noise
• Glare from lights or flickering lights
• Excessive winds
• Intense warmth
• Smells and vapours
• Travelling

Hormonal triggers

Generally it’s exhausting to be a girl, sang Tammy Wynette. And that’s very true on the subject of migraine signs. ‘Hormones are an element for a lot of girls, particularly round menopause,’ says Dr Allder. Puberty, menstruation and being pregnant are additionally triggering.

‘About 70 per cent of girls with migraine have a extreme migraine headache throughout menstruation. That is both on the onset, throughout, or on the finish of their interval,’ says neurologist Dr Giorgio Lambru. ‘Menstrual-related migraine complications are sometimes extreme, long-lasting and tough to deal with. They’re considered attributable to the sudden drop within the degree of oestrogen on the onset of the menstrual interval,’ he explains.

Taking hormones is an choice. Dr Lambru suggests progesterone-only contraceptives. ‘They’re usually protected and should enhance signs associated to menstrual migraine,’ he says.

Therapies for migraines

1. Train

It’s possible you’ll not really feel like exercising for those who’re within the depth of a nasty migraine. However common bodily exercise may also help hold migraine triggers at bay.

‘Once we train, our physique releases endorphins that are pure painkillers, says Dr Allder. ‘Some folks might discover that train relieves migraine. However most individuals shall be unable to handle train with a migraine as a result of depth of ache and different associated signs. Nonetheless, exercising usually has many advantages together with serving to cut back stress and enhancing high quality of sleep, which could be migraine triggers for some folks,’ he explains.

2. Abortive and preventative medication

The medicine that works on your migraine will not be what works for one more. Certainly, not everybody wants medicine to deal with migraine signs – different, non-pharmaceutical choices could also be sufficient. Nonetheless, if in case you have frequent migraines, abortive or preventative medicine could be very helpful.

“Preventive therapies depend upon the month-to-month variety of days with a migrainous headache,’ says neurologist Dr Giorgio Lambru. ‘The simplest abortive therapies (medicine that stops signs shortly) are the triptans – like sumatriptan or rizatriptan – particularly if taken on the very starting of an assault.” If these therapies be just right for you they must be taken for 6-12 months to permit them to rebalance the impaired mind neurochemistry chargeable for frequent migraines, provides Dr Lambru.

Triptans additionally work for menstrual migraines, particularly if taken alongside anti-inflammatories resembling ibuprofen, though one factor you shouldn’t do is handle frequent migraines with painkillers. ‘Opioids like codeine are greatest prevented in migraine,’ says Dr Lambru. In the event you expertise extra than simply menstrual migraine complications, preventive remedy must be mentioned with their medical doctors to keep away from an extreme consumption of painkillers.’

He continues: ‘The simplest preventive therapies for migraine (medicine that stops migraines occurring) are the tricyclics antidepressants and beta-blockers, which may enhance severity and frequency and enhance deep sleep, low temper and anxiousness on the identical time.’ Each abortive and preventative medication will must be prescribed.

‘Lastly, the brand new CGRP monoclonal antibodies have revolutionised the migraine remedy – it being the primary very efficient migraine-specific class of remedy of this situation,’ says Dr Lambru. ‘In line with NICE, “Erenumab is a human monoclonal antibody that binds to the calcitonin gene-related peptide (CGRP) receptor, inhibiting the perform of CGRP, and thereby stopping migraine assaults.” It’s administered by month-to-month injection as a preventative measure and is obtainable on the NHS and privately.’

3. B nutritional vitamins and magnesium

Studies present that sure nutritional vitamins and minerals may also help with the depth or frequency of migraines; specifically B2, B6 and magnesium. ‘Low ranges of magnesium have been proven to be an unbiased danger think about migraine assaults and oral supplementation has been discovered to cut back stress complications and migraines,’ says vitamin knowledgeable Hayley Pedrick.

‘Riboflavin (vitamin B2) has been proven to have good impact in lowering frequency and depth of migraines,’ she continues. ‘One examine of 41 paediatric and adolescent sufferers receiving 200mg-400mg of riboflavin every day for 3, 4 or 6 months discovered 68% of circumstances had a 50% discount in frequency and 21% discount in depth at follow-up. Riboflavins advantages are probably as a consequence of its means to reinforce mitochondrial power.’

Then there may be B6, which additionally might assist with migraine signs. Hayley explains: ‘A double-blind, randomised medical trial on utilizing 80mg vitamin B6 (pyridoxine) has additionally been proven to supply assist for migraine suffers. The trial adopted 66 sufferers with migraine with aura, and pyridoxine supplementation led to a major lower in headache severity and the period of the assaults,’ she says. ‘It didn’t, sadly, seem to affect frequency, although.’

Go for B-complex with magnesium – we like Viridian’s B-Advanced with Magnesium (120 capsules, Amazon | £15). Alternatively, contemplate a vitamin drip. ‘Many individuals with migraines use dietary supplements to assist their signs. Our Vitality Drip comprises each B nutritional vitamins and magnesium,’ says Dr Sheena Kent, a pharmacist at Get a Drip, which has places in and round London and in Dublin. ‘

Sure nutritional vitamins and minerals could be very useful. (Credit score: Viridian)

4. Probiotics

With increasingly more analysis pointing to a hyperlink between our intestine and our mind, it stands to cause {that a} wholesome intestine can have a optimistic impact on us neurologically. ‘Consideration has turned to the position of the intestine and its micro-organisms within the administration of migraine,’ says Dr Richard Day, medical advisor at Bio-Kult. ‘In a latest examine utilizing 14 strains of probiotic micro-organisms present in Bio-Kult Migrea, researchers confirmed dramatic reductions in migraine frequency. People who acquired the probiotic intervention noticed a 40-45 per cent discount within the frequency of migraine over the trial interval.’

He provides: ‘This examine is a superb instance of how probiotics can have profound and useful results on distant elements of the physique. As such, people affected by migraine might want to contemplate probiotics as an adjunct to their common administration routine.’ Strive Bio-Kult’s Migréa (60 capsules, Boots | £20).

Merely staying hydrated can cease a migraine. (Credit score: Getty)

5. Water

Dehydration could also be extra widespread than folks realise at inflicting migraine signs. Even gentle dehydration generally is a set off.

When those that endure from migraines change into run down as a consequence of not receiving sufficient water or fluids all through the day you’re risking a migraine. When this occurs, your mind quickly shrinks or contracts as a result of loss in fluids. You may additionally really feel drained, weak and really thirsty. It’s possible you’ll then really feel a headache come on as a result of mind pulling away from the cranium, leading to ache which we really feel as migraines.

‘Reducing alcohol intake – which may trigger dehydration – consuming no less than 2 litres of water per day and reviewing your weight-reduction plan may also help enhance and finally remove the onset of a migraine,’ says Dr Allder.

6. Feverfew

Medical nutritionist Suzie Sawyer is a fan of a feverfew. ‘It’s a natural medicinal product used for the prevention of migraine complications completely primarily based upon longstanding use,’ she says. It’s so properly established that it’s common for medical doctors to advocate it.

‘The herb feverfew (Tanacetum parthenium) comprises a wealth of plant compounds with anti-inflammatory and different properties, together with the flexibility to cut back manufacturing of histamine,’ says Suzie. ‘Research means that the parthenolide compounds may assist cut back blood vessel constriction in addition to performing on the mind’s serotonin system in the same technique to medicines used to deal with migraine. By inhibiting the manufacturing of inflammatory prostaglandins, the severity of assaults are diminished,’ she explains. Strive MigraHerb Feverfew (30 capsules, Holland & Barrett | £7.99).

Botox could be very efficient for some. (Credit score: Getty)

7. Botox

Sure, you learn it proper. Botox cannot solely clean out wrinkles, it may well work as a remedy for migraines.

‘For continual migraine, Botulinum toxin A (Botox) is a really efficient and well-tolerated injectable remedy, which permits sufferers to not take every day tablets,’ says Dr Lambru. Nonetheless, this remedy is barely out there on the NHS if in case you have continual migraines (described as a headache for 15 or extra days a month, eight of that are migraine). In the event you can afford it, go non-public. The London Migraine Clinic presents a migraine remedy with Botox and session for £465 (or £795 for those who go the prolonged remedy which incorporates Botox within the neck).

9. Therapeutic massage or osteopathy

If postural points are inflicting your migraines, an alternative choice is bodily manipulation. ‘Working from house throughout the pandemic has meant sitting at makeshift desks on chairs not meant for all-day working, ensuing within the vulture posture inflicting an enormous quantity of poor posture-related issues,’ says Ali Cullen, dietary practitioner for A. Vogel Herbal Remedies. ‘Something that occurs within the decrease again can even influence on the neck, which then travels into the pinnacle and may trigger stress.’ This stress can result in migraine signs.

Whereas a one-off therapeutic massage may also help relieve stress across the neck, shoulders and face, a course of therapies could also be higher. ‘Osteopathy may also help with the symptomatic presentation of your migraines in addition to understanding your migraine sample,’ says Kemmy. ‘The primary purpose is to remove or cut back the quantity of migraines that you’ve got,’ she explains. ‘Firstly, I might ask the person to do a diary of their migraines to search for triggers. Then I’ll monitor the way it adjustments after every remedy. Every particular person responds to therapies otherwise, so it’s necessary to tailor this to the individual.’

Kemmy continues: ‘A remedy might embrace mobilising your cervical backbone (neck), releasing the sub occipital (smaller muscle groups in the back of your neck), and releasing stress build-up in your jaw. And gentle tissue methods to work on the muscle groups surrounding your neck. If acceptable I might finish by adjusting the highest of the neck.’

When to hunt medical recommendation for a migraine

In the event you suspect you’re getting migraine signs at all times search medical recommendation. A health care provider will rule out different situations and supply data on – and entry to – therapies.

For instance, ‘if the migraines are arterial [basilar] they need to search additional investigation as this may very well be a extra severe matter,’ says Kemmy. ‘If a girl has hormonal migraines, looking for recommendation on enhancing hormone ranges to cut back their migraine sample may very well be extremely useful,’ she provides.

Converse to your GP or, for extra recommendation, go to The Migraine Trust.

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