Stopping Migraines Before They Start

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“It feels like my head is just getting crushed!” That’s how Julianne Hertz, an art therapist, describes the excruciating pain of a migraine. While most people with migraines suffer attacks one or two times a month, chronic migraine sufferers experience pain at least 15 days per month. That’s Hertz. She experiences this pain nearly 20 days out of every month along with other symptoms like nausea and light and sound sensitivity. “It’s really terrible!

A migraine is much more than a bad headache. It is a condition that occurs from the hyper-excitability of cells that trigger many other symptoms, including nausea and/or vomiting, light and sound sensitivity, numbness, and tingling. For some, the migraine – a severe throbbing on one side of the head – can last anywhere from four to 72 hours of moderate to severe intensity.

Migraine pain affects roughly 36 million Americans a year – impacting family time, quality of life, and for some, the ability to work. It is a condition that often goes undiagnosed. “A lot of people have migraines and never actually seek medical attention,” says Dr. Carolyn Bernstein,  a neurologist specializing in headache medicine in the Department of Anesthesia, Critical Care and Pain Medicine and Neurology as well as the Clinical Director of the Comprehensive Headache Center at Beth Israel Deaconess Medical Center in Boston. “For some people, they really can’t function. They are just completely down for the count,” says Dr. Bernstein. “Other people will push through because they really have no choice.  But, they are quite incapacitated.”

Hertz says living with migraines is hard. “It can make me feel more isolated. At times I do get depressed, angry and frustrated. At times I feel like I’m not doing my part and that I’m not a whole person,” she says. “Migraines can limit my ability to work, and I will sometimes need to cancel or reschedule social engagements, often at the last minute.”

Impact on Women

Migraines have a huge impact on women. They are disproportionately affected; three to one over men. Why? Dr. Bernstein says that up until about the age of twelve, the age of puberty, boys tend to outnumber girls in the frequency of migraines. But that changes when girls start their menstrual cycles. “Hormonal changes and fluctuations can be a profound trigger for a number of women,” says Dr. Bernstein.

The prevalence of migraines seems to drop off for women after menopause, when again, hormones fluctuate. However, it was quite the opposite for Hertz. She developed migraines after menopause and has been living with them for more than eight years.

Migraine Triggers

Some of the major migraine triggers include changes in, lack of or poor sleep; poor hydration; lack of or certain exercises; stress and tension; and even certain foods. It was once thought that cheese, chocolate, red wine and preservatives were the main causes. It turns out, there are variations among people. “There is no blanket set of food triggers that are true for everybody,” says Dr. Bernstein. “But, recognizing your own and trying to avoid those triggers can be really important.” She says even the most meticulous people can’t avoid migraines, but they can minimize them to some degree with medications and various treatments or therapies.

Treating the Pain

There are, of course, medications to ease the pain of a migraine. Triptans, which work on the neurotransmitters to stop the migraine process, may be prescribed. But, Dr. Bernstein cautions against using prescription medications too often – especially narcotics and painkillers.  She calls them the choice of last resort. “The problem is that if you use them too much, the headache begins to get used to the medicine and then it becomes harder to treat,” says Dr. Bernstein. “It’s kind of counterintuitive. It is a better choice to try and do something preventative.” And by preventative, she means identifying the triggers and using common and uncommon therapies, such as:

Dr. Bernstein also recommends that her patients try restorative yoga. The yoga poses used in restorative yoga focus on breathing and deep relaxation. They can help restore and revitalize a person’s body and mind in a passive, soothing way.

One of Dr. Bernstein’s favorite exercises is spinning. There’s no pounding, and there’s the camaraderie of the group, but everyone can go at their own pace. Because lights and loud sounds can be triggers for some, she suggests classes with a dark room and gentle music as a great way to release stress and get a great workout at the same time.

What to do if you think you are getting migraines

Migraines are more prevalent than first thought. If a person gets pain often, he or she should get it checked out.

Dr. Bernstein has a philosophy: First and worst, new and different. That’s when you want to run it by a medical professional. What she means is if you get pain that you’ve never experienced before and it is the worst you’ve ever had, it’s time to see a physician. “I really encourage people who think they get migraines to get a proper diagnosis and review treatment options with a medical provider as opposed to just trying to treat things with whatever they can procure over the counter or from the Internet.”

She says keeping track of the pain in a diary timeline or with an app can give a physician a much better way to diagnose the condition.

Hertz says the intensity of her migraines varies. With so many a month, she’s learned to work through some of them. Her advice to anyone who thinks they’re suffering from migraines is to see a specialist, track the suspected triggers, and talk to other people who experience migraine about what works for them.

You can learn more about migraines, the triggers and the treatments available by clicking on the BIDMC website here

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

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