What is a migraine headache?

An estimated 30 million Americans experience intense migraine headaches. These migraines can last for days. They can be painful to the point of keeping the person from being able to function.

Migraines often are described as a throbbing pain that begins on one side of the head and then spreads out. This kind of headache can also be accompanied by an increased sensitivity to light and can worsen with physical exertion. Those suffering migraines often lie down in the dark in an effort to reduce their pain.

Migraines also are often accompanied by gastrointestinal disturbances, which can include abdominal pains.

Migraines also are often preceded by warning signs, including depression, euphoria, depression or cravings for certain kinds of food.

About one-fifth of the people who suffer migraines experience an aura before the onset of their migraine. This aura can manifest as a disturbance to any of the five senses.

Not all headaches, even bad ones, are migraines.  Knowing which kind of headache you have helps you and your clinician find the most effective treatment and prevention strategies.

There is confusion in the medical community about the different kinds and causes of headaches.  Some doctors and other seem to feel that almost all headaches are "migraines."  However, the International Headache Society has created the International Classification Headache Disorders (ICHD) in order to standardize terminology for this common problem.  The Society is made up of specialists and experts in the study of headaches.

Terminology is important.  When doctors, researchers (and patients) use the same language to describe headaches, there is less confusion.   The ICHD describes 2 categories of headache: 1.) “secondary” headaches which are due to some other medical problem such as infection, drug side-effects, and concussion and the much more common “primary” headaches that have no apparent cause.

Primary headaches can be divided into 4 basic types: tension type, migraine, cluster and “other.”  Tension type headache (TTH) is by far the most common among headache suffers.  In my practice, many patients have come to me thinking that they have “migraine” headaches and may even have had migraine diagnosed incorrectly by a physician.  TTH can be quite severe.  The severity of head pain does not make a migraine.

A true migraine headache usually has certain features that set it apart from the “garden variety” TTH.  While the actual causes of migraine are not well understood, how migraines act is fairly consistent and usually makes the diagnosis without special tests, lab studies or imaging.

The typical migraine in adults happens 3 times as often in women.  The start of a migraine includes a “prodrome” in about 60% of patients.  A variety of prodrome symptoms occur from hours to days before the headache.  These include mood changes, visual disturbance, altered sensation and a sense of heaviness or weakness.

The headache itself can be moderate to severe and is often accompanied by nausea, vomiting, pale and clammy skin, extreme sensitivity to light and sound.  Most migraine sufferers (“migraineurs”) find relief only in a darkened, quite room, a period of rest and are often left feeling tired and weak.

People who suffer from migraine headaches usually seek medical attention; about 18 percent of women and 6 percent of men suffer from migraines. Migraine pain is characterized as a moderate-to-severe, pulsating, throbbing pain often focused on one side of the head. This pain is intensified by simple physical activity. Migraine pain can be managed by a combination of nonprescription and prescription medications and self-care approaches and by avoiding triggers that set off migraine attacks.

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Headaches are one of the most common problems for women of all ages. It is thought that the majority of headaches are migraines, experienced by about 20 percent women and 7 percent men. Migraines appear to be related to the spasms or contraction of blood vessels, which temporarily decreases blood flow to the brain. During the menopause transition, fluctuating hormones may aggravate existing migraines, cause migraines to recur after a period of respite, or cause migraines for the first time. After menopause, about two-thirds of women with migraines find that their headaches disappear or improve.

Headaches can vary in intensity and frequency, even for the same person. Sometimes, headaches are mild and easily treated with over-the-counter medication; but at other times, they are more severe. Migraines that are accompanied by a stiff or painful neck may be diagnosed as tension headaches. Nasal congestion or facial discomfort with a headache may be interpreted as a sinus headache. Some experts now think that all these headaches may be migraines.

A migraine is a vascular-type headache characterized by a sharp, pounding pain, usually located on one side of the head.

Migraine is the French derivation of the Greek word hemikrania, meaning "half a head," referring to the typical pattern of migraine distress—pain only on one side of the head, most often at the temple. The affected side can vary from one attack to the next or during a single episode.

Migraine pain ranges from moderate to severe. Unlike tension headache, migraine headaches can keep you from functioning or sleeping, and they can even rouse you from sound slumber. Most people describe the pain as pulsating or throbbing. It can also be sharp, almost as if a dagger is piercing your temple or eye.

Nausea and vomiting are common during a migraine headache. Likewise, tense head, neck, and shoulder muscles can accompany a migraine headache. In most cases, this is thought to be an involuntary response to the pain, rather than its cause (although tight muscles can trigger a migraine headache). Bright lights and loud noises worsen the pain and may prompt someone with a migraine headache to seek out quiet, dimly lit places. Similarly, smell may aggravate nausea and cause vomiting.

Your head is killing you, your stomach hurts and you'd turn off the light if only you could bear to move. What is this strange disorder called a migraine? In this video, integrative medicine expert and Dr. Oz Show guest Mosaraf Ali explains.

A practical definition, and one that many doctors use, is that migraine is a very common, controllable group of symptoms, in addition to headache, that is often inherited and clearly has a biological basis.

Let's break down the individual components of this definition of migraine. First, migraine is very common, affecting 12 percent of all adults -- 6 percent of men and 18 percent of women. That's one in every six women! These figures are remarkably consistent in countries around the world.

Next, migraine is very controllable, although not curable. With a proper diagnosis and an effective headache treatment plan, the vast majority of migraine sufferers can lead normal, productive lives. An effective treatment strategy that involves lifestyle changes, non-drug treatments, and medications can dramatically reduce lost time from work and family activities, and significantly improve quality of life.

A migraine is not just headache pain. Migraine is thought to be a genetic neurological disease characterized by flare-ups often called "migraine attacks" or "migraine episodes." A headache can be one symptom of a migraine attack. Some individuals with migraine disease often have migraine attacks without having a headache.

Migraine attacks, or episodes, occur in phases or parts. A typical migraine attack consists of four phases. Not every individual experiencing a migraine has all four phases. The four phases of a migraine attack are prodrome, aura, headache, and postdrome.

Individuals suffering from migraines tend to have recurring attacks triggered by a lack of food or sleep, certain food allergies, exposure to light, or hormonal changes in women, including puberty, menopause, and premenstrual syndrome (PMS). Anxiety, stress, or relaxation after stress can also be triggers. Exposure to a trigger does not always lead to a headache. Conversely, avoidance of triggers cannot completely prevent headaches. Different migraine sufferers respond to different triggers, and any one trigger will not induce a headache in every person who has migraine headaches.

Attacks tend to become less severe as the migraine sufferer ages. The uncertainty of when attacks may occur leads to additional patient anxiety. Symptoms, incidence, and severity of migraine headaches vary by individual.

Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience migraine headaches at one time in their lives.

In the United States, migraine headaches often go undiagnosed or are misdiagnosed as tension or sinus headaches. As a result, many migraine sufferers do not receive effective treatment.

Treatments for migraine attacks involve prevention of the attack and treatment of acute (immediate) symptoms such as the headache.

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Migraines cause an intense pain in one or more areas of the brain. The headache may be accompanied by other symptoms, including constipation, diarrhea, food cravings, depression, hyperactivity, irritability, neck stiffness, hallucinations, vision loss, or speech and language problems.

Migraine is a common neurological condition occurring in at least 15 to 20 percent of the population and in up to 50 percent of women.

Classic migraine starts with visual symptoms (often zigzag lines, colored lights or flashes of light expanding to one side of your vision over 10 to 30 minutes), followed by a single-sided pounding, severe headache. The headache may be associated with nausea, vomiting and light sensitivity. Sometimes visual symptoms and even neurologic dysfunction may occur without the headache. These are called “migraine variant.”

Common migraine may cause only a headache felt on both sides of the head. This form of migraine may be responsible for the headaches that many people may have attributed to tension, stress or sinus pain.

Migraines are throbbing headaches that last from 4 to 72 hours, usually on one side of your head. They may be triggered by certain foods or smells.

They may cause nausea and vomiting. And light may make the pain worse. Some people have an aura like seeing wavy lines or flashing lights before the headache starts.

Although migraines are painful, they can often be treated with pain medicines and sometimes with medicines to prevent the headaches.