Migraines can strike at the worst times and can be debilitating. Once they start, extreme sufferers can expect to be out of commission for hours, even days. For those prone to migraine headaches, it is important to know what not to do in the throes of a migraine and between migraines. These are the dos and don’ts for chronic migraines.
How Do You Know If You Have a Migraine?
Most migraine sufferers report an intense, throbbing pain that worsens with movements, lights, sounds, smells, and other triggers. For some people, there are symptoms that arise before the actual headache. There are four stages of a migraine.
Phase 1: The Prodome
The prodome isn’t experienced by everyone. It’s kind of a “premonitory” or “pre-headache” stage. During the prodome, one can find it hard to concentrate, speak, read, or sleep. They can feel irritable, anxious, or even depressed without explanation. Nausea and muscle stiffness can also occur. People may feel sensitive to lights, sounds, and smells.
Phase 2: The Aura
Not everyone is aware of or feels an aura, period. It happens quickly — between five minutes and an hour. The aura stage may overlap with the actual headache for some migraine sufferers. During the aura phase of a migraine, people may experience visual disturbances or even temporarily lose sight. There is numbness, tingling, or weakness in one side of the head or body. Speech may even be affected.
Phase 3: The Headache
A migraine headache typically brings a strong, throbbing pain in the head (that may move from one side of the head to the other), neck pain, stiffness, nausea, vomiting, and/or nasal congestion. Symptoms of anxiety and depression are also common. Migraine sufferers can expect this phase to last from four hours to three days.
Phase 4: The Postdrome
This last stage is akin to a hangover that may linger for one to two days. It can be difficult to concentrate or comprehend things, and many people feel fatigued and somewhat depressed — although some even experience a sort of euphoria when the pain is over.
What Can Worsen a Migraine?
Not everyone experiences a migraine the same way, and what triggers or exacerbates one person’s pain may have no effect on someone else. However, there are a few things that tend to worsen migraines.
It’s essential to eat and sleep properly in any event, but for people who get migraines, these habits may have tangible effects on migraine frequency, duration, and level of pain. Consuming lots of alcohol, caffeine, and even foods like sweets, artificial sweeteners, and heavily salted foods (such as cured meats) can also have a negative effect on someone’s migraines. Oversleeping or not sleeping enough, dehydration, and low glucose levels can also exacerbate migraine symptoms — as can stress.
Over-Medication for Pain
Just because a medicine is available over the counter doesn’t mean it should be taken regularly. In fact, taking things like ibuprofen, acetaminophen, or aspirin for more than a couple of days in a row may result in medication overuse headaches (MOH) — sometimes referred to as “rebound headaches.” People who take opioid medications for long periods of time can also experience a heightened pain response called opioid-induced hyperalgesia.
More clinical studies are needed to confirm the correlation between migraines and these medications, but for some people, migraines are triggered or made worsened by:
- SSRI (Selective Serotonin Reuptake Inhibitor) Antidepressants
- Nasal Decongestants and Steroids — for chronic allergies
- Oral Contraceptives or Hormone Replacement Therapy
- PPIs (Proton Pump Inhibitors) — for acid reflux, such as Nexium
Someone who is on one or more of these medications and finds that their migraines have gotten more intense should speak to their doctor.
What Should You Not Do with Migraines?
It’s important for migraine sufferers to identify their particular triggers, and this list may be a good start.
- Do not mess with your sleep schedule. Aim to get 7-9 hours of sleep every night.
- Do not skip meals, and do not eat lots of junk food. A sudden drop in blood sugar can trigger a migraine. Regular indulgence in high sodium, MSG, artificial ingredients, heavily processed foods, and high quantities of sugar may make you more prone to migraines.
- Do not let yourself get dehydrated. Dehydration is a common trigger for headaches and can exacerbate a migraine.
- Do not take pain medication for more than 3 or 4 days in a row. Developing the body’s resistance and expectation of medication can bring on a headache and affect the efficacy and effectiveness of the medicine.
- Do not try to “motor through” a migraine. Ignoring the pain will not make it go away — in fact, it may make the pain worse and the duration of the migraine longer.
What Should I Do While Having a Migraine?
At the first sign of the onset of a migraine, you should:
- Take a time-out. Stress only makes things worse, and migraines usually come with sensitivity to stimuli. Find somewhere quiet, dark, and peaceful to rest.
- Drink some water. Staying hydrated — and getting hydrated if you have become dehydrated — goes a long way to fending off migraines. If you think you need to replenish your electrolytes, get a sports drink, preferably a low-sugar option.
- Apply something cold or hot to your head. Some people feel some relief with an ice pack, while others find that heat works better for them. Use whatever works in your experience, whether it’s a bag of frozen peas, a steamy shower, or a heating pad for your head, neck, and shoulders.
- Take your pain medicine as recommended or prescribed by your doctor. This should be done at the first instance, not when your migraine has progressed — and it will — to the point of no return. The earlier you work to stave off the migraine, the higher likelihood of success and the more effective the treatment will be.
A comprehensive migraine treatment regimen may be highly personalized. The more you are aware of your triggers and what remedies work for you, the better off you are. Find out more about headache pain or make an appointment with us at Carolinas Pain Center. Get your migraine pain under control.