A Comprehensive Guide to Migraine Care with Your GP

A Comprehensive Guide to Migraine Care with Your GP

For countless individuals worldwide, the word “migraine” signifies much more than just a headache. And those who are suffering from this headache, they know how it affects their daily activity. 

According to research, nearly 1 in 6 people globally have felt its grip. Yet, many remain unaware of what distinguishes a migraine from a typical headache and how to combat its symptoms effectively.  

With the right knowledge of migraine care, those affected can reclaim control and steer towards a lifeless hindered by this debilitating condition.


What Is a Migraine?

A migraine is more than just a headache. It’s a strong pain in the brain, often accompanied by nausea and sensitivity to light and sound. It can have warning signs before it starts and can be triggered by many things, like certain foods or changes in the weather.


Symptoms of Migraine


  • Intense, throbbing pain, often on one side of the head.


  • A feeling of sickness that may lead to actual vomiting.


  • Increased discomfort from light, sound, and sometimes even smells.


  • Visual disturbance, including blurring, shimmering, or seeing zig-zag patterns.


  • A feeling of extreme tiredness or weariness.


  • A sensation of spinning or losing balance.
  • Irritability, depression, or sudden mood swings.


  • Discomfort or stiffness in the neck area.


  • A range of neurological disturbances, like visual or sensory changes, can precede the headache phase.


What Are the Causes of Migraine?

1. Genetics

Migraines can run in families. If a close relative, like a parent or sibling, has migraines, there’s a higher likelihood you might have them, too.


2. Brain Chemicals

An imbalance in certain chemicals, especially serotonin, which helps regulate pain in the nervous system, might contribute to migraine symptoms.


3. Triggers

Certain external and internal factors can activate the onset of a migraine. These can include:


  • Dietary factors: Specific foods like aged cheeses, processed foods, red wines, and certain additives like monosodium glutamate (MSG) might trigger migraines in some people.


  • Environmental factors: Bright lights, loud noises, or drastic changes in weather conditions.


  • Hormonal changes: For many women, migraines can be linked to their menstrual cycle, suggesting that fluctuations in hormones play a role.


  • Stress: High levels of stress or sudden relaxation after extended stress can prompt a migraine.


  1. Neurological Factors

Migraine auras are believed to be caused by a wave of electrical activity that moves across the brain, followed by a period of reduced activity.


  1. Blood Vessel Constrictions

Shifts in the blood flow to the brain might initiate the pain.


Risk Factors for Migraine

While anyone can experience a migraine, certain factors can make some individuals more susceptible. Here are some of the predominant risk factors – 


  • Age

Migraines can begin at any age, though most people will experience their first migraine during adolescence. They are most common in individuals aged 30 to 40 but tend to become less severe as one age.


  • Gender

Women are three times more likely than men to suffer from migraines. This disparity is thought to be influenced by hormonal fluctuations, particularly estrogen.


  • Family History

Genetics plays a significant role. If a close family member, such as a parent or sibling, has migraines, you have a higher risk of developing them, too.


  • Hormonal Fluctuations

For many women, migraines are linked to their menstrual cycle. Moreover, other hormonal changes, like pregnancy or menopause, can also increase the risk of migraines. Hormone replacement therapy and certain birth control medications might intensify migraines in some women.


  • Previous Head Injury

A history of head trauma can elevate the risk of migraines.


  • Other Medical Conditions

Conditions like depression, anxiety, bipolar disorder, sleep disorders, and epilepsy can increase migraine risks.


  • Medications for Migraines 

Some medicines, especially vasodilators and hormone-based drugs like estrogen and oral contraceptives, can amplify the risk of migraines.


Diagnosis of Migraine

Here’s how healthcare professionals approach the diagnosis:


1. Medical History

The doctor will ask about your symptoms, their duration, and frequency. Knowing if anyone in your family has migraines can be a crucial piece of information, given the genetic link associated with the condition.


2. Detailed Symptom Description

You might be asked to describe the type, location, and severity of your pain, any associated symptoms, and any triggers you have identified. Maintaining a headache diary as part of your migraine care, noting when migraines start, what you were doing at the time, how long they last, and what, if anything, provides migraine relief, can be particularly useful.


3. Physical Examination 

A doctor will check for any neurological issues that might be causing the headaches. This examination often includes checking your vision, strength, reflexes, and sensation.


4. Exclusion of Other Conditions

To rule out other potential causes for your headaches, like sinusitis or a brain tumor, a doctor may recommend:


  • Blood Tests: These can identify medical conditions that might be causing the headaches, such as infections or metabolic disorders.


  • MRI or CT Scans: These imaging tests can diagnose tumors, strokes, infections, and other brain and nervous system (neurological) conditions.


  • Spinal Tap (Lumbar Puncture): If an infection, bleeding in the brain, or another underlying condition is suspected, a small amount of fluid is removed from the spinal canal for testing.


5. Criteria-Based Diagnosis

The International Headache Society criteria for migraines are commonly used to confirm a diagnosis. A patient usually needs to have experienced at least five previous episodes of headache lasting 4-72 hours, among other symptoms, to meet the criteria.


Treatment of Migraine

Managing and treating migraines is a multifaceted approach that aims to relieve immediate symptoms and prevent future attacks. Treatment strategies can be categorized into acute treatments, preventive treatments, and managing triggers.


1. Acute Treatment of Migraines

Acute or abortive treatments are part of migraine care and intended to stop a migraine attack once it starts. They help relieve the pain and other symptoms and are most effective when taken early in the course of the migraine – 


Over-the-Counter Medications:


  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Drugs like ibuprofen and naproxen can help reduce pain and inflammation.


  • Aspirin: Alone or in combination with other drugs, can help with mild to moderate migraine pain.


  • Acetaminophen: Though not an NSAID, it can be effective against migraine pain for some people.


2. Prescription Medications


  • Triptans: These include sumatriptan and rizatriptan, among others. They target serotonin receptors and can effectively relieve the pain, light sensitivity, and nausea associated with migraines.


  • Ergotamines: Such as ergotamine and caffeine combination drugs, are less commonly used but can be effective.


  • Opioid Medications Are sometimes prescribed, but they come with risks of side effects and dependence


3. Non-Medication Treatments:


  • Biofeedback: Uses electronic monitoring to convey information about physiological processes.


  • Acupuncture: Some people find relief from migraines through this traditional Chinese therapy, which can be an integral part of migriane care. 


  • Cognitive Behavioral Therapy (CBT): Can help with the management of migraine pain.


4. Preventive Treatment of Migraines

The goal of preventive therapy is to lower the severity, frequency, and length of migraines:




  • Cardiovascular Drugs: Like beta-blockers or calcium channel blockers.


  • Antidepressants: Tricyclic antidepressants can be effective in migraine prevention.


  • Antiseizure Drugs: Such as valproate and topiramate, can reduce the frequency of migraines.


  • Botox: OnabotulinumtoxinA injections can be useful for chronic migraine management. 


Lifestyle Changes:


  • Consistent Sleep Patterns: Going to bed and waking up at the same time, even on weekends.


  • Dietary Considerations: Avoiding foods and drinks known to trigger migraines.


  • Regular Physical Activity: This can reduce the frequency and severity of migraines.


  • Stress Management: Techniques like meditation, deep-breathing exercises, and journaling can help.


5. Managing Migraine Triggers

Identifying and managing triggers is a vital aspect of migraine treatment:


Identifying Migraine Triggers:


  • Keep a Headache Diary: Note when your migraines start, what you were eating, the amount of sleep you had, etc., to detect patterns.


  • Consider Caffeine Intake: Both excess and withdrawal can be problematic.


Avoiding Migraine Triggers:


  • Stay Hydrated: Drink water according to your body’s needs throughout the day.


  • Limit Stimulants: Such as bright lights and loud noises.


  • Monitor Diet: Avoid foods and drinks you’ve identified as triggers.


Wrapping Up

Migraines can deeply affect our daily lives. Knowledge is key, but finding the right treatment and migraine care is equally crucial. At EraHealth, we combine expert knowledge with personalized care. If you’re seeking relief and a better understanding of your migraines, we’re here to guide and support you. Let’s work together for a brighter, migraine-free future.