National Migraine and Headache Awareness Month

woman with migraine

Differentiating Between Headache and Migraine

Headaches are the most common form of pain experienced by people of all ages, according to the National Institutes of Health (NIH). In just last year alone, the World Health Organization (WHO) reports more than half of all adults globally ages 18 to 65 years experienced headache, with 30%-plus reporting migraine. Headache on 15+ days every month affects between 1.7% to 4% of the world’s total adult population.

Headache disorders are a worldwide problem, affecting people of all ages, races, and backgrounds.

Migraine, a severe type of head pain, is less commonly experienced. Only 12% of American adults experience migraine, according to the American Migraine Foundation (AMF.)

Before puberty, boys are affected more than girls, but during adolescence, the risk of migraine and its severity rises in girls. This risk continues to rise for girls as they head toward adulthood.

In the U.S. 28 million women are afflicted with migraine. Roughly 1 in 4 women will experience migraine during their lives. About 50% of female migraine sufferers have more than 1 attack each month, and 25% experience 4+ severe attacks each month. Of all U.S. chronic migraine sufferers, 85% are women.

June is National Migraine and Headache Awareness Month. Your Capital Women’s Care team wants to help you understand headache and migraine underlying causes and symptoms; distinguish and differentiate recurring headache and migraine symptoms and understand when to seek professional treatment; monitor headache and migraine patterns and triggers; and preventive measures and practices you can initiate to avoid headache and migraine attacks.

Headache or Migraine?

There is more to it than just distinguishing head pain as either a headache or migraine. Both migraine and non-migraine types of head pain can be placed into 150+ primary and secondary headache subtypes, each with its own unique underlying symptoms and causes.

Headache is used as a catch-all term for head-related pain resulting from a wide variety of issues.

Headache Characteristics

Tension headache is the most common complaint related to head pain, according to the Mayo Clinic. Headache can last from 30 minutes to 1 full week. Symptoms of tension headache includes:

  • mild to moderate pain on both sides of the head, forehead, temples and/or back of neck
  • pressing, tightening sensations around the head
  • and pain does not increase with movement or after exposure to bright lights or loud sounds.

The International Headache Society elaborates tension headaches do not throb or pulse and these types of headaches may be much more painful than those characteristic of migraine attacks.

Other classifications of headache include:

  • cluster headaches occur usually in one side of the head, with multiple cycles of pain followed by pain-free periods.
  • sinus headaches co-occur with sinus infections, usually accompanied with fever, stuffy nose, cough, nasal congestion, and facial pressure.
  • Chiari headaches are caused by Chiari malformation, a birth defect in which the skull pushes against parts of the brain, causing pain in the back of the head.
  • Thunderclap headache is an extremely serious form of headache requiring immediate medical attention. These headaches come on suddenly, with very severe pain. Thunderclap headache could be a symptom of serious complications, including subarachnoid hemorrhage, aneurysm, stroke, or other serious, potentially life-threatening injury.

Headache Triggers

There are many identifiable common triggers that cause headaches, including:

  • stress or emotional conflict
  • jaw clenching while asleep
  • insomnia
  • skipping meals
  • depression
  • anxiety
  • muscle strain
  • dehydration
  • certain foods containing nitrites, MSG, or aspartame
  • weather-related changes in barometric pressure
  • and caffeine withdrawal.

Headache Treatment

Most often, non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen and ibuprofen are recommended.

Managing stress and getting plenty of sleep while avoiding certain foods or substances with known headache triggers help to avoid headaches. Heat therapy via applying warm compresses or taking a warm shower can also help alleviate headache pain.

Other ways to reduce headache pain include massage, meditation and relaxation exercises and stretching the neck gently to relieve muscle tension and pain.

Migraine Characteristics

Migraine is a chronic neurological disease, oftentimes beginning during childhood, adolescence, or early adulthood. You are more likely to suffer migraine attack if you:

  • are a woman. Women are three times more likely than men to get migraines.
  • have a family history of migraines. Most people with migraines have family members who have migraines.
  • have other medical conditions, like depression, anxiety, bipolar disorder, sleep disorders, and epilepsy.

Researchers continue investigating possible migraine causes. Changes in the brainstem and its interaction with the trigeminal nerve, a major pain pathway, may be involved. Brain chemical imbalances, including serotonin, which helps regulate pain in the nervous system, are also potential causes.

Migraine attack profoundly affects more women than men in the U.S. and globally.

Women are 3 times more likely to experience migraine attack than men, with women experiencing migraine attack usually before or shortly after onset of their monthly menstrual cycles, while using oral contraceptives, during the first trimester of pregnancy and at onset of perimenopause.

Once menopause is established, migraine attacks usually end for those afflicted women, particularly if the cause can be attributed to hormone imbalances. While research continues regarding migraine’s overall impact on women’s health, researchers do note women experience more severe and frequent attacks due to fluctuations in estrogen levels. The number of attacks can vary, from having few episodes a year to experiencing several attacks within a single week.

Migraine is often characterized by:

  • moderate to severe pain with pulsing, throbbing sensations usually experienced on 1 side of the head.
  • head pain that worsens with movement or activity.
  • exposure to bright lights and/or loud noises makes head pain worse.
  • waves of nausea or actual vomiting.

Aura symptoms, including short term vision issues that may include zig-zagging or blinking splotches, dark spots, or patches, may occur. Visual aura is experienced by approximately 30% of those diagnosed with migraine.

Other lesser-known aura symptoms include dizziness, speaking difficulties, weakening or numbness in one side/part of the body, hearing noises and/or music, or tingling sensations or jerking movements in one or more extremities (arm, hand, or leg), which occur before onset of migraine head pain.

There are 4 migraine stages:

  • Prodrome phase occurs 1 to 2 days before migraine pain. Symptoms include constipation, depression, frequent yawning, irritability, neck stiffness, unusual food cravings, increase in both thirst and urination.
  • Aura or without aura symptoms onset 10 to 30 minutes before migraine attack. Symptoms include diminished mental alertness, difficulty thinking, visual aura or other lesser-known aura symptoms, and unusual sense of smell, taste, or touch.
  • Migraine pain attack can last 4 to 72 hours if untreated and is characterized by throbbing, pulsing pain; sensitivity to light and sounds; nausea and/or vomiting.
  • Post-drome phase causes feelings of being drained, washed out and confused for about 1 day. Very rare post-drome phase experiences may include feelings of elation.

Migraine Triggers

There are many factors associated with migraine attacks. Knowing potential underlying causes that lead to your susceptibility of migraine attack can help you to pinpoint your personal triggers and avoid them to prevent migraine attack reoccurrence.

Some common migraine triggers include:

  • emotional anxiety
  • oral contraceptive use
  • alcohol consumption
  • excessive screen time
  • food additives
  • hunger
  • dehydration
  • odd smells
  • bright lights
  • and loud sounds.

Several foods are known to trigger migraine attack, including:

  • chocolate
  • red wine
  • cultured dairy products
  • foods with MSG additive
  • processed or smoked meats (lunch meat, hot dogs)
  • diet beverages, especially those with aspartame
  • alcohol
  • highly caffeinated beverages
  • pickled and fermented foods
  • yeast
  • onions
  • and aged cheeses.

Menstrual Migraine

More than half of migraines in women occur right before, during, or after a woman has her period. This often is called "menstrual migraine." But just a small fraction of women who have migraine around their period only have migraine during this time. Most have migraine headaches at other times of the month as well.

How the menstrual cycle and migraine are linked is still unclear. Just before the cycle begins, levels of the female hormones, estrogen, and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals within the brain that affect a woman's pain sensation.

Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.

Migraine Diagnosis

If you find yourself becoming so debilitated by frequent migraine attacks that the attacks interfere with your everyday life, schedule an appointment with your doctor, who will ask you about your medical history and perform a physical exam. Sometimes additional testing occurs, including imaging (especially in the event of thunderclap pain onset) via MRI or CT scan and/or bloodwork.

Your doctor will also note your recollection of experiences and symptoms during diagnosis. The National Institutes of Health (NIH) recommends keeping a health journal for headaches to help you identify a pattern and underlying triggers so your doctor may devise an effective course of treatment.

Important information to include in your health journal are:

  • symptoms occurring before, during and after each attack
  • the foods and beverages consumed prior to pain attack
  • whether you are sleep deprived or experiencing heightened stress levels
  • how often the head pain attack occurs
  • how long the pain lasts
  • and what activity you were doing just prior to the attack.

Migraine Treatment

There is no cure for migraines. Treatment focuses on relieving symptoms and preventing additional attacks.

There are different types of medicines to relieve symptoms, including triptan, ergotamine, antiemetic medications to reduce nausea and pain relievers. The sooner you take the medicine, the more effective it is. There has been noteworthy migraine attack relief with beta- or calcium-channel blockers, antidepressants, anti-seizure medications and botulinum toxin injections.

Taking these medications can also lead to complications known as “rebound headaches” or “overuse headaches,” which worsen the migraine condition rather than offering relief. This condition occurs in combination with taking painkillers for 10+ days a month, taking aspirin or ibuprofen for 15+ days a month or taking triptans for 9+ days per month.

Some ways to alleviate migraine attack are to lie down in a quiet, darkened room, place a cold cloth over your forehead or behind your neck and massage your scalp and temples.

Migraine Treatment and Pregnancy

Some migraine medicines should not be used during pregnancy because they can cause birth defects and other problems. This includes over-the-counter medicines, like aspirin and ibuprofen.

Talk with your doctor if migraine is a problem while you are pregnant or if you are planning to become pregnant. Your doctor might suggest a medicine that will help you and that is safe during pregnancy.

Home treatment methods, such as doing relaxation exercises and using cold packs, also might help ease your pain.

The good news is that for most women migraines improve or stop from about the third month of the pregnancy.

If you are breastfeeding, check with your doctor about what migraine medicines are safe to take, as some medicines can be passed through breast milk and might be harmful to your baby.

It is important to schedule an appointment with your doctor should you notice a difference or change in your migraine pattern or if the pain associated with an attack feels noticeably different.

When to Seek Immediate Treatment

If you experience any of the following, get to your ER as soon as possible for immediate medical treatment:

  • abrupt, severe headache like a thunderclap
  • headache with fever, stiff neck, mental confusion, seizures, double vision, weakness or numbness, and difficulty speaking
  • headache after experiencing a head injury, especially if pain worsens
  • chronic headache that feels worse after coughing, exertion, straining or sudden movement
  • and new headache pain experienced after age 50.

Other Preventive Measures

It is important to get plenty of sleep nightly, have a healthy lifestyle with regular exercise and healthy diet and be aware of stress and manage it effectively to reduce risk of headache or migraine attack.

Contact your local Capital Women’s Care team should you have any concerns or questions relating to headache or migraine attack or any other aspect of your health. Our team of knowledgeable, compassionate healthcare professionals can work with you to determine the best course of personalized treatment and care so you may achieve and enjoy optimal health.

Sources:

https://www.womenshealthmag.com/health/a25228512/migraine-vs-headache/
https://www.healthline.com/health/migraine/migraine-vs-headache
https://www.healthline.com/health/migraine-complications#treatments
https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptom...
https://pubmed.ncbi.nlm.nih.gov/29270933/
https://medlineplus.gov/migraine.html
Managing migraines at home: MedlinePlus Medical Encyclopedia
https://medlineplus.gov/headache.html
https://migraineresearchfoundation.org/about-migraine/migraine-facts/
https://migraineresearchfoundation.org/resources/
https://www.cdc.gov/mmwr/volumes/66/wr/mm6624a8.htm
https://www.statista.com/topics/1974/headache-and-migraine/
https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page
https://www.ninds.nih.gov/Disorders/All-Disorders/Migraine-Information-Page
https://www.womenshealth.gov/a-z-topics/migraine
https://www.womenshealth.gov/menstrual-cycle/period-problems
https://www.healthline.com/health/headache

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