DOse of clinical
Migraines: More Than “Just a Bad Headache”
If you suffer from migraine headaches, you're a member of a club no one wants to be in. This neurological disorder is the third most prevalent disease in the world and the most common reason that people visit a neurologist. Even if you are not a migraine sufferer yourself, you likely know at least one person who suffers from this debilitating condition.
How common are migraine headaches?
In a word? VERY. One billion people worldwide struggle with migraine headaches, including 39 million people in the United States. Migraine headaches tend to run in families with 90 percent of current sufferers having at least one close family member who also deals with migraines. The most typical age range for migraine headaches to begin is between 18 and 44 years old.
The impact on healthcare costs and productivity
The term migraine headache can be misleading because the pain associated with a migraine is nothing like a typical headache. Healthcare statistics indicate that a migraine sufferer visits the ER every 10 seconds in the United States. That amounts to a staggering 1.2 million visits each year and the combined total cost of healthcare and decreased work productivity is approximately $36 billion dollars annually in the US. These statistics underscore the enormous impact migraine headaches have on healthcare expenses and lost productivity:
- Families with one or more migraine sufferers spend up to 70 percent more on healthcare expenses than families with no migraine sufferers.
- Typically, the medical cost associated with treating chronic migraines exceeds $5 billion dollars annually.
- From a productivity standpoint, migraine pain causes American workers to miss more than 157 million days of work each year.
The symptoms and phases of migraine headaches
People with this common neurological disorder typically experience symptoms lasting at least four hours or as long as three days. These symptoms include:
- Extreme sensitivity to light, sound, smell, and touch
- Numbness or tingling in face or extremities
- Throbbing head pain that usually starts on one side of the head
- Visual disturbances
Neurological symptoms occur before head pain begins in some cases. Migraine attacks often follow a similar pattern, beginning with the “prodrome” phase. The prodrome phase starts one or two days before the onset of pain and provides a warning of an upcoming migraine headache. Typical symptoms include:
- Food cravings
- Frequent yawning
- Increased thirst and urination
- Mood changes
- Neck stiffness
Some migraine sufferers experience “aura”, or sensory disturbances, before the pain of the migraine attack. These people will experience this within a few hours of the attack. They may see flashing lights, wavy lines, or dots, or they may have blurry vision or blind spots.
Once the pain subsides after an attack, it is common to feel exhausted, confused, and experience an elevated mood for up to 24 hours. Some people also report feeling elated. This is called the “postdrome” phase of a migraine episode.
Migraine causes and risk factors
Neurologists don’t fully understand the cause of migraines. Some speculate that brainstem changes, especially as they relate to the trigeminal nerve pain pathway, are to blame. Chemical imbalances can also play a role. Migraine sufferers have reported that the following can trigger an attack:
- Some foods
- Food additives such as aspartame
- Caffeine or alcohol
- Hormonal changes and medications
- Sensory stimuli
- Physical exertion
- Weather changes
- Sleep changes
Family history, age, and gender are the three biggest risk factors for migraines. Women experience migraines three times as often as men, and migraine pain tends to peak in the 30s.
Diagnosis, treatment, and when to see a doctor
Medical providers can usually diagnose migraines by medical history, family history, and symptoms, however, your doctor may refer you to a neurologist for further workup. If your doctor suspects something else is causing your head pain, he or she may order a CT or MRI to rule out other causes.
Two types of medication are currently available for the treatment of migraine headaches, abortive and preventive. With abortive treatment, you take prescription drugs during the migraine attack to combat the pain. Your doctor or neurologist may recommend that you take preventive medication daily to reduce the severity of migraine attacks.
Be sure to talk to your medical provider about other prescription and non-prescription medications you take since some could interfere with migraine medication. When that happens, your abortive or preventive migraine medication could stop working altogether or require you to take stronger doses to achieve the same effect.
Some situations involving head pain require you to see a doctor immediately. These include:
- Developing a headache after a head injury
- New pattern of headache pain after age 50
- You have a stiff neck, seizures, double vision, difficulty speaking, numbness, or weakness
- Your chronic headaches grow worse after exertion, coughing, or sudden movements
These symptoms could indicate a serious health emergency, such as a stroke, which requires urgent medical attention.
Your Firefly care team is here to help!
Your Firefly care team should be the first place you go with any questions about migraines or to get urgent migraine care (even before heading to the ER!). You can chat with us or schedule a visit in the app today.
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