Your Complete Guide to Headaches and Migraines
Knowing what kind of pain you have can help you find the right treatment faster. Here’s how to tell the difference.
Photo credit: Maridav/Shutterstock.com
Apr 21, 2020 • 4 min read
If you experience headaches or migraines, it can be, for lack of a better word, a headache! This is even more so true if you aren’t sure what’s causing your headaches, the type of headache you’re having, and don’t know how to treat it. If your normal over-the-counter medicine isn’t getting rid of the pain and the throbbing is just getting worse, has it become a migraine? Is that even how it works?
The more you know about headaches and migraines the better prepared you can be to not only treat them, but also to help prevent them from happening in general. We spoke with experts to create a comprehensive guide to help you understand headaches and migraines; their similarities and differences; what triggers each; and how to treat the symptoms.
A headache is pain above the neck of any intensity, most often in the forehead, but also in the temples, and back of head, explains Nadya Swedan, MD, FAAPMR, a physical medicine and rehabilitation specialist at Northwell Health in Manhasset, New York and Lenox Hill Hospital in New York City. “Stress, lack of sleep, hormonal fluctuations, alcohol intake, and illness are some of the main factors that contribute to headaches,” says Swedan. “Headache frequency can be lessened by managing these triggers.”
Headaches are broken down into two categories. “They can either be primary headaches or secondary headaches,” says Swedan.
Primary headaches are headaches related to a problem with the structure in the head that is pain sensitive, explains Steven Reisman, MD, a nationally recognized cardiologist and director of New York Cardiac Diagnostic Center in New York City. “It is not a headache that is secondary to an underlying disease,” Reisman explains. These types of headaches include:
Tension headache: most common; duller pain; aching around your head; generally caused by neck muscle or chewing muscle spasm; chronic or episodic.
Cluster headache: Less frequent; rare; intense pain around the eye that can be severe enough to wake you at night; sudden onset; occur in a cluster, or repetitive pattern.
Migraine: severe throbbing or pulsing on one side of the head (but can spread to both); accompanied by medical symptoms such as nausea, vomiting, light and sound sensitivity and visual disturbances; may occur with or without an aura; often repetitive; can happen infrequently or chronically, which is classified as 15 or more times a month, with 8 days of migraine symptoms, for 3 months.
Secondary headaches are due to medical complications, such as a neck injury or sinus infection. “Sinusitis, meningitis, dehydration, hypertension, concussion or stroke are among some of the causes of secondary headaches. Ice cream headaches, medication overuse and substance-related headaches, and headaches caused by dental pain or an ear infection are also known as secondary headaches,” says Swedan.
Migraines are a type of headache often classified by a severe throbbing or pulsing feeling on one side of the head. They usually have three phases. First is the prodrome phase, which leads up to the headache. This is when a person could experience an “aura,” or a warning that the migraine may not be far off. “An aura is a pre-headache sensation such as a flash of light, vision disturbance or tingling in the face or even numbness, weakness or trouble speaking,” explains Swedan. A person’s mood and appetite can be affected by the prodrome phase.
Next is the peak phase, and as its name states, is the height of the migraine (translation: severe pain). Then comes the last phase also known as the postdrome phase. This 24-hour period coming down from a migraine is usually a 24-hour following a migraine can be extremely difficult for some people. Depending on how bad the migraine was, some people may feel tired during this time and they may even experience some sadness, Reisman explains. Some individuals may choose to be alone until they’re feeling back to normal.
Many factors can trigger a migraine to strike. These include weather changes, lights, sounds and smells, and certain foods and food additives, explains Swedan. “A person may also experience nausea, vomiting, and sensitivity to light or sound during a migraine, too.”
Migraines can last from four to 72 hours, and are treated with two types of medication. “Pain relief medications work best if they’re taken right away when the migraine begins,” explains Reisman. “Preventive medications can reduce the frequency of migraines, the severity, and how long the migraine lasts.”
Migraines can occur chronically, too. Chronic migraines are classified as 15 headache days for a month, experiencing migraine symptoms for at least eight or more of the days, for three months, explains Swedan.
Here’s a further break down of the types of migraines and how they are classified:
Migraine with aura: typical migraine pain and accompanying symptoms, with either an aura warning or during that includes flashes of light, blind spots or other visual disturbances, difficulty speaking, or tingling on one side of the face or in the arm or leg.
Migraine without aura: typical migraine pain and accompanying symptoms, without either an aura warning or during.
Probable migraine with aura: doesn’t fit any other headache disorder, and fill all migraine criteria except one; accompanying aura warning or during that includes flashes of light, blind spots or other visual disturbances, difficulty speaking or tingling on one side of the face or in the arm or leg
Probable migraine without aura: doesn’t fit any other headache disorder, and fill all migraine criteria except one, without either an aura warning or during
All of the above can be chronic, or not.
If you’re experiencing more headaches than normal, and especially if the pain and other symptoms associated with them are worsening, don’t just ignore them. Speak with a doctor or medical professional to understand your condition, help diagnose it, and to come up with a treatment plan. If you’ve been prescribed a medication to help with your headaches or migraines, including aspirin, ibuprofen (Advil, Motrin IB), naproxen (Aleve), naproxen (Naprosyn), indomethacin (Indocin), amitriptyline (Elavil), protriptyline (Vivactyl), venlafaxine (Effexor XR), or mirtazapine (Remeron), fill it through Blink Health to check for savings and have your meds delivered free.
This article is not medical advice. It is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
Blink Health is not insurance. The discount prescription drug provider is Blink Health Administration, LLC, 1407 Broadway, Suite 2100, New York, NY 10018, 1 (844) 265-6444, www.blinkhealth.com.
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