By Jacquie Eubanks BSN, RN
Tension or stress headaches, with common symptoms of dull pressure, discomfort or tightness on both sides of the head, are generally of short duration and severity. Symptoms of this type of headache can usually be relieved by rest or over the counter medications. In contrast, migraines are intense, debilitating, often one sided headaches frequently accompanied by symptoms of nausea and extreme sensitivity to light and sound.
A migraine is a chronic neurological disorder involving the brain and blood vessels that surround the brain. Research shows that migraines arise from abnormally excitable neurons in the brain and their interaction with the trigeminal nerve, a major pain pathway, that begins in the brainstem. Messages sent through these nerves bring about dilation of the blood vessels and activate an abnormal release of brain chemicals, resulting in inflammation and the throbbing pain that so many experience.
Migraines rank in the top 20 of the world's most disabling medical illnesses. In the United States, this extraordinarily common disease affects 36 million men, women and children. For many migraine sufferers, this chronic disease significantly reduces the ability to function normally whether at home, work, school or social events, while experiencing a migraine.
Migraines often begin in childhood or adolescence and are most common during peak productive years between the ages of 25 and 55. Migraines are believed to be caused by both genetic and environmental factors. If one parent is affected, a child has a 40% chance of propensity for migraines. Fluctuating hormones are also thought to play a role, as migraines affect more women than men and may decrease during pregnancy and after menopause.
Migraines generally last between 4 and 72 hours and may progress through four stages:
- Prodrome - Subtle symptoms can occur a day or two before the onset of a migraine including mood fluctuations, digestive upset or food cravings.
- Aura - Approximately 20% of migraine sufferers experience neurological symptoms preceding their headaches. The most common symptoms are visual, such as flashes of light, bright spots, wavy lines, or tingling in the hands and feet. Auras typically last less than an hour and are usually, but not always, followed by a headache.
- Attack - The headache phase, typically experienced on one side of the head, is characterized by severe, throbbing pain. Symptoms can include nausea, vomiting, increased sensitivity or light, sound or odors, blurred vision and lightheadedness. Routine physical activity can aggravate the symptoms.
- Postdrome - Once the headache subsides, fatigue or muscle aches may last a day or two.
- Hormonal changes due to normal fluctuations in hormone levels, oral contraceptives, or hormone replacement therapy appear to be a factor.
- Foods such as caffeine, aged cheeses, chocolate, beer or wine, nitrates, preservatives and MSG can generate an attack.
- Bright lights and sensory stimulation, loud noises and strong odors may induce migraines and intensify the pain.
- Changes in altitude, barometric pressure or severe weather patterns can bring about migraines.
- Lack of restorative sleep may affect the severity and frequency of migraines.
- Stress is considered one of the most common triggers of migraines.
- Make your environment as calm, quiet and peaceful as possible. Turn down the lights and keep the temperature comfortable.
- Applying hot or cold compresses can help.
- Small amounts of caffeine can enhance pain relieving medications.
- Establishing regular bed times can promote more restful sleep.
- Be consistent with mealtimes and avoid known food triggers.
