Migraine 101: Causes, Symptom, Diagnosis & Treatment

Migraines are complex neurological conditions that can cause multiple and varying symptoms. The term migraine is sometimes used interchangeably with headache, but they are two different things. Migraines are typically much more severe and disabling than regular headaches. Migraines can be complex, debilitating conditions that have serious impacts on how you live your life. It is not clear what exactly causes migraines, nor is there one singular treatment or cure. However, there are many things you can do to prevent and reduce the severity of migraines for yourself or a loved one. Knowing the signs and symptoms is the first step to successfully managing your migraines. It is also important to understand the wide range of treatment options. Read on to find out all you need to know about migraines.

What Are Migraines?

Migraines are a complex, invisible neurological condition. They can have a wide range of debilitating and distressing symptoms. The most common symptom of migraines is a severe, one-sided throbbing headache that usually lasts at least four hours and can last up to 72 hours. Migraine sufferers may also experience photophobia (sensitivity to light), aversion to certain noises and smells, nausea and vomiting. Migraines can be extremely painful and exacerbated by lifestyle factors including exercise or dietary habits like missing a meal. Migraines have serious impacts on the individual affected, their family, and even society more broadly.

Who Is Affected by Migraines?

Migraines impact around 20% of the Australian population at some stage in their lives. This equates to around 4.9 million Australians who regularly suffer the painful effects of migraines. Women are more likely to experience migraines than men, with 71% of migraine sufferers identifying as women. Women have a 22% lifetime prevalence of migraines, compared with 10% for men. Migraines can appear at any age but are less common among children. Migraines are most commonly first identified between the age of 35 and 45 years. People suffering from migraines frequently report having to cut back on social and work-related activities. Chronic migraines (meaning 15 or more migraine instances per month) affect around 400,000 people. Since 86% of migraine sufferers are of working age, migraines also impact the financial wellbeing of individuals and even entire communities and industries.

Recognising a Migraine: Signs and Symptoms

The most common effect of a migraine is a throbbing, pulsating headache that is often located on one side of your head. This is one way to tell the difference between a migraine and a tension headache, as tension headaches are usually felt on both sides of your head. Other migraine symptoms can vary widely between individuals. Knowing how to spot the signs of a migraine is the first step in better understanding and managing your condition. Since migraines are not curable, most treatment and management strategies are focused on controlling your symptoms so you can lead a normal and fulfilling life. Migraine sufferers often experience symptoms in stages, including the days leading up to a migraine attack and the days after the attack ends. Not everyone will experience all of these stages. If you experience any of these symptoms, consider speaking to your doctor to determine whether you are experiencing migraines.

Stage 1 – Prodrome Symptoms

Prodrome symptoms usually occur a day or two before you have a migraine attack. These can often be the first warning signs that you are about to have a migraine:

• Constipation 
• A wide range of mood changes, from depression to euphoria
• Cravings for specific foods
• Stiffness in your neck
• Urinating more frequently 
• Fluid retention and bloating
• Frequent yawning
• Generally feeling unwell.

Stage 2 – Aura Symptoms 

Some people get what is called an aura right before experiencing a migraine attack. You can also experience an aura during the onset of a migraine. Auras can have a range of symptoms which usually begin gradually and can last up to 60 minutes per episode. Auras are a result of neurological activity and often include visual symptoms. Some of the common symptoms of auras include the following.

• Seeing shapes, bright spots, light flashes and other visual phenomena 
• Vision loss
• Difficulty speaking
• Weakness or numbness in the face
• Weakness or numbness in one side of the body
• Tingling or pins and needles in an arm or leg.

Stage 3 – Attack Symptoms

Migraine attacks are usually characterised by a severe headache in one side of your head. They can be so painful and distressing that you cannot participate in your usual everyday activities. If untreated, migraines can last between 4 and 72 hours. Each migraine sufferer’s condition is different. Some people rarely have migraine attacks while others have several per month. Symptoms of a migraine attack can include the following.

• Intense pain on one side of your head (but it can be on both sides)
• Throbbing or pulsating sensations
• Sensitivity or aversion to light, sound, smells and sometimes physical touch
• Nausea and vomiting.

Stage 4 – Post Drome Symptoms

Once your migraine attack subsides, you may experience feeling exhausted, drained or confused for up to 24 hours. Sudden movement, especially of the head, may bring back temporary migraine attack symptoms. Some individuals feel elated that the pain has passed. 

Serious Symptoms: When to See a Doctor

Many people live with the debilitating effects of migraines without diagnosis or treatment. If you experience any of the above migraine symptoms, keep notes about your symptoms, when they occur and how you manage them. Take these notes with you to visit your doctor to address your headaches. It is particularly important to seek medical advice if your symptoms change or become more severe. 

Some symptoms common in migraine sufferers can also be signs of more serious medical issues. If you have any of the following symptoms, see your doctor immediately or seek emergency medical care.

• Sudden, severe headache.
• Headache accompanied by fever, stiff neck, double vision, seizures, confusion, numbness or weakness in the body. These can be signs of a stroke.
• Headache after a head injury.
• New headache pain that presents after age 50.
• Lingering headache that is worse after coughing, sudden movement or exertion.
• You are sensitive to light and have a new rash.

Please call triple zero (000) and ask for an ambulance, or go to the hospital emergency department if you experience these symptoms.

Migraine Causes and Triggers: What Causes a Migraine?

It is unknown what causes migraines. Genetic, hormonal and environmental factors may be influencing factors. Migraines can run in families, but having a relative with migraines does not guarantee you will get them. Migraines are thought to be a result of temporary chemical and blood vessel changes within the brain. If you are prone to migraines, certain factors may trigger the onset of an attack. These can include the following.

• Missing meals (the strongest dietary trigger)
• Consuming certain foods – including cheese, chocolate, citrus, red wine and monosodium glutamate (MSG) or other food additives
• Sleeping too much or too little
• Weather changes
• Alcohol consumption, especially beer and red wine
• Hormonal changes (including menstruation and oral contraception).

Headache vs. Migraines: How Are Migraines Diagnosed?

There is no one specific test to determine if you have migraines. If you have a family history of migraines, a neurologist will usually diagnose you by going over your symptoms and medical history and by doing a physical and neurological examination. If your headaches are unexplained or severe, they may do tests to rule out other causes of the headache. These include Magnetic Resonance Imaging (MRI) and Computerised Tomography (CT) Scans. 

Migraine Management: How Are Migraines Treated?

There is no cure for migraines. There are effective medical options that can control your symptoms, alleviate your pain and enable you to lead a more normal life. Note that some of the medications used to relieve migraines are not safe to take if pregnant or for those at risk of heart attacks. Always consult your doctor and notify them if you have a family history of heart attack, or if you are pregnant or trying to conceive before taking a new medication for the first time.

The right medication for you will depend on the type and severity of your symptoms. Medication is usually most effective when taken as soon as the first signs of a migraine attack appear. Migraine medications can be categorised broadly into two types: pain-relieving medications and preventative medications.

Pain-Relieving Medications

• Pain relievers (e.g. ibuprofen, aspirin)
• Triptans
• Dihydroergotamine (D.H.E. 45, Migranal)
• Lasmiditan (Reyvow)
• Ubrogepant (Ubrelvy)
• CGRP antagonists
• Opioid medications
• Anti-nausea drugs.

Preventive medications

• Blood pressure-lowering medications
• Antidepressants
• Anti-seizure drugs
• Botox injections
• CGRP monoclonal antibodies.

In addition to medication, certain lifestyle and complementary medical options which can help to prevent or manage your migraine symptoms. These include regular exercise, acupuncture, yoga and meditation and psychological counselling including cognitive behavioural therapy (CBT).

More on Migraines: Where to Find Additional Resources

The more you understand your specific migraines, the better you will be able to manage and control your symptoms. A new category of treatments to prevent migraine attacks has been developed in early 2022. Migraine & Headache Australia is the national peak body for information, resources and support for migraine and headache sufferers. They have provided an overview of these new treatment options, including how they work and how to access them. The new types of treatments are called Calcitonin Gene-Related Peptides (CGRP) monoclonal antibodies. This exciting medical innovation is the first type of preventative medication designed specifically for migraines. Migraine attacks have been shown to coincide with elevated levels of CGRP, so this new class of medications are designed to inhibit CGRP and prevent migraine symptoms from occurring.

Finding the right kind of treatment is essential to effectively manage your migraines. This often starts with finding an experienced and understanding doctor with an interest in headaches and migraines. Migraine & Headache Australia offer a useful directory of doctors across Australia that may be able to support you in your treatment journey. You can also find a list of headache and pain clinics in your State or Territory to start accessing specialised care. Reading about the range of treatment options available before your appointment may help you to understand your choices and ask informed questions about the treatment proposed for you.

Peer Support Groups: Migraine Warriors Australia

Migraine Australia launched the Migraine Warrior Support Network in 2020 and it has been growing ever since. The support network has judgement-free, compassionate support groups across Australia with meetings both online and in person. These groups are a great source of moral and emotional support, information and advice from people who know what it is like to live with migraines. They can also give you recommendations on local issues, migraine-friendly businesses and healthcare professionals to empower you to manage your migraines with confidence. If there is no support group in your area, you can sign up as a volunteer to start one yourself. With so many Australians living with migraines, there is no need to manage it alone. 

Headache-Free Home Care with Homage: How Homage Can Help

Migraines have a debilitating impact on your own life, as well as that of your family, friends and loved ones. When you experience a migraine attack, you may find yourself unable to perform your usual daily living activities. This is where Homage’s team of expert Care Professionals can help. We can support you or a loved one living with migraines to lead a normal, fulfilling life even when migraines make your usual activities painful or difficult. 

Staying at home is a huge comfort when you are in the midst of a migraine. Feeling safe and relaxed in your home environment can help alleviate the anxiety and stress of dealing with the symptoms of a migraine attack. Whether you need support with light domestic care, home nursing, or transport, we are here to help. We tailor all of our services to your unique needs and situation, with bookings starting from just one hour. There is no need to suffer the painful and distressing effects of migraine on your own. 

Reach out to find out more about how Homage can help you or a loved one managing lupus by speaking with our Care Advisory team via our website or by calling us on 0480 093 788. Our Care Hotline is operational from 9 am to 5 pm (weekdays) and 9am to 1 pm (weekends and PH).