Profoundly painful and infamously stubborn, migraines have probably been around as long as the human brain. Even the ancient Egyptians suffered from the wretched ache; they attributed it to an evil spirit and struggled to exorcise it with incantations. Today doctors know better. Migraines hit when the brain sends signals out to the nerves that cause inflammation of the blood vessels and sensitivity of nerve endings. The nerves then send electrical signals into the brain. What patients end up experiencing is a sharp, often one-sided pounding that lasts for hours or even days and a bevy of associated problems, such as queasiness, sensitivity to light and sound, and, in 20 to 30 percent of sufferers, an aura (a transient sensation, like flashes of light or tingling in one arm). Thirty-seven million Americans are all too familiar with migraines, and women are three times more likely to suffer from them than men, possibly due to monthly hormonal fluctuations that exacerbate pain. What’s worse, the headaches aren’t just rare occurrences. For many, they hit frequently: More than 2 million migraine patients suffer from chronic migraines (15 or more days with headaches each month). The rest experience the pain less often but still quite a lot. According to a 2004 American Migraine Prevalence and Prevention study, the average migraine sufferer has 8.3 episodes in a three-month period (in other words, almost three a month).
Fortunately, there are more options than ever to treat and prevent migraines. With recent innovations in functional magnetic imaging, doctors can now study exactly what happens in the brain in the midst of an episode. In addition, scientists are uncovering gene variations that raise a person’s likelihood of developing migraines. “The hope is that, with these recent discoveries, we’ll soon identify new therapies or find ways to use current therapies more effectively,” says Elizabeth Loder, M.D., the president of the American Headache Society. For now, read on to find the latest information on every doctor-approved weapon in the modern arsenal, so when your next migraine attacks, you’ll be ready to fight back.
What Causes Them
Migraines can be triggered by any number of things—some stranger than others. Sometimes they’re spurred on by chewing gum (as a 2013 Pediatric Neurology study found); sometimes by a colleague’s button-down shirt. (A 1989 Archives of Neurology paper identified 82 percent of migraine sufferers as “stripe sensitive.”) Keeping a journal of your daily habits, stress levels, and migraines for a few months may help to pinpoint flare-up patterns, says Jason D. Rosenberg, M.D., the director of the Johns Hopkins Headache Center at Bayview, in Baltimore. Here are the areas to monitor.
Migraine-sensitive brains relish routine. So, for many, going to bed and waking up at the same time, including on weekends, can keep episodes at bay. And don’t skimp on the shut-eye. A 2010 study conducted at Missouri State University, in Springfield, reported that a lack of REM sleep led to increased levels of proteins in nerve cells that contribute to migraine pain.
Food triggers vary, but for some a substance called tyramine may be a culprit. It’s produced by an amino acid in some foods as they mature, which explains why aged cheeses, dried fruit, fermented foods, and sometimes even leftovers can wreak havoc. As with sleep, a set eating regimen helps; skipped meals and heavy meals may promote attacks. Staying hydrated may be important, too. In a small 2005 study published in the European Journal of Neurology, migraine patients who increased their water intake by a little over six cups a day experienced 21 fewer hours of pain during the two-week study than did those who had taken placebo drugs.
Obesity increases your risk of certain migraines by 81 percent, according to a 2013 study published in the journal Neurology. While it’s still unclear why this is, one theory holds that fat cells release inflammatory particles into the bloodstream, which may contribute to the pain of migraines.