The truth about migraines and 7 simple ways to help you overcome them

By Dr Adel Baluch

Have you ever had a really bad headache?

If you’re reading this article, chances are you probably have and it may have been a migraine.

At Ada Health, our data shows that headache and migraine are amongst the most common conditions for our users and consistently feature in the top 10 conditions. We’ve also found that if you’re young and female, then you’re more likely to suffer from headaches and migraines.

So if the answer to the question was “yes”, then it’s good to know that you’re not alone and that there are many treatment options and simple things that you can do to help manage your symptoms.

What’s the difference between a headache and a migraine?

First of all, it’s important to get the diagnosis right. Often my patients talk about headaches and migraines like they’re the same thing. The truth is, migraine isn’t just another headache. It’s a complex neurological condition. It can affect the whole body, not just the brain, and can present in many different ways — sometimes, even without a headache. Often it goes undiagnosed and therefore it’s under reported around the world, both by doctors and patients.

What does a migraine feel like?

There are many different types of migraine but symptoms commonly include:

• Headache. Often this is intense, one sided and throbbing (though not always)
• Feeling sick or vomiting
• Irritation to loud noise, bright lights or even smells
• Vague feelings, like going off your food, feeling tired, diarrhoea, going pale, tummy pains, sweating, blurring of vision and poor concentration can also be potential symptoms
• “Aura”. Around a quarter of sufferers get this. It’s when you have some of the symptoms listed above but also get a warning, usually before the attack. These can be visual (loss of some of your vision or other disturbances), numbness or tingling (in the arm, leg or face). Rarely there can be associated disturbances in your speech and even food cravings.

There are also other types of migraine, such as those that occur only in women at or around the time of their periods and in children (which often present as tummy pain).

It can even present with weakness on one side of the body alongside the headache or with visual disturbances without any headache. In these cases, you should urgently see a doctor to make sure there isn’t a more serious cause.

The technical bit

We don’t fully understand what migraines are. Research has shown there’s a complex interplay between the blood vessels and chemicals in the brain. It’s not considered a genetic condition but if you have it, chances are several other people in your family will also have it. We also know that migraines are more common in women and can develop in childhood.

How to know if your headache is really a migraine

Are you unsure if the pain you’re experiencing is a headache or migraine? Why not try entering your symptoms into Ada?

Ultimately though, you may need to see your primary care doctor (GP) or a specialist (neurologist). Usually, the diagnosis is clinical (i.e. made by taking a good history and examination), although sometimes further tests are needed. For example, if there is any doubt or other serious conditions need to be excluded.

What can I do about them?

Whilst there isn’t a cure for migraine, there are many effective treatment options available to help you manage your symptoms. These can include simple things you can do yourself like:

1. Keep a diary. This is can be really helpful for you and your doctor to help diagnose the condition. It can also be useful for monitoring your symptoms and looking for potential triggers. There are many online headache diaries available online (e.g. patient.co.uk).
2. Drink right. Avoid drinking too much alcohol, caffeine, sweet or sugary drinks. Also make sure you drink plenty of water (at least 2 litres a day or less depending on your circumstances).
3. Sleep right. Sometimes not sleeping enough or even sleeping too much can be a cause. Everyone’s sleep requirements are different so get to know what’s right for you.
4. Eat right. Dietary triggers are thought to be an issue in around a fifth of cases. Commonly these can include chocolate, alcohol and even citrus fruits but also missing or skipping meals can sometimes be a cause.
5. Work right. Make sure you take regular breaks, adjust your posture at work and try using an anti-glare cover for your computer screen. Make sure the temperature where you work is consistent as sometimes being very hot or cold can also be a cause.
6. Relax right. Sometimes a migraine can be triggered after the stress has gone as well as during a stressful event. Other “stresses” like being anxious or low in mood, being exposed to loud noises or bright lights, reflective surface or even flickering lights can be triggers. A strong smell can sometimes be enough. In these cases, it’s worth looking at ways to deal with the cause like trying relaxation techniques, wearing sunglasses or lying down in a dark and quiet room, for example.
7. This list is not meant to be exhaustive. Almost anything can be a trigger, so most of all, it’s important to look after yourself. Many of the above triggers are your bodies’ way of telling you to stop or slow down and take a break.

There are other drug-based treatments too. Broadly, these can be divided into treatments to treat attacks (which you take when you’re having a migraine or just before) and those that prevent attacks (which you take on a regular basis all the time). Many of these can be bought from a pharmacy without seeing a doctor but be careful as some of them can have unwanted side effects (always read the label). Also avoid “opiate based” painkillers like codeine, as they can sometimes make your headaches worse or even cause them.

There is also some evidence for other forms of non-drug based treatments as well, such as acupuncture and even Botox, to name a few.

Ultimately, migraine affects people very differently, so you have to find a treatment that works for you. This might take a little trial and error. The key message is that for most people, there are treatment options and lifestyle changes that you can make that can really help, so please don’t give up hope!