June is National Migraine and Headache Awareness Month. Medical Myths this week will focus on some of the myths that surround migraine.
Our Medical Myths series tackles medical misinformation head-on. MNT provides clarity in the complex world of health journalism by using peer-reviewed research and expert insight.
Migraine is a common condition. It affects more than 37,000,000 people in the United States, and as many as 148 million globally. Some evidence suggests that the prevalence of migraines may be rising globally.
According to the World Health Organization, migraines are around twice commonTrusted Source for women than it is for men.
A migraine is often characterized by a severe to moderate headache. Around 85% of migraine sufferers experience throbbing headaches. Around 60% experience pain that is not symmetrical, while 30% of sufferers experience nausea. A majority of migraine sufferers have an increased sensitivity to light (90%), and sound (80%).
We will address 11 myths about migraine. We will discuss medications, caffeine, nutritional, as well as other topics. We enlisted three experts to help us dispel these myths.
- Dr. Vernon Williams, a board-certified neurologist/sports neurologist and director at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute Los Angeles, CA.
- Dr. Medhat Mikhael, a pain management specialist, is the medical director for the non-operative program at Memorial Care Orange Coast Medical Center Fountain Valley.
- Dr. Jennifer McVige is board-certified as a pediatric neurologist, pediatric and adult headaches, and in neuroimaging. She is also the director of DENT Neurologic Institute’s Concussion Center, Amherst NY.
“Most migraines aren’t serious, but they can become chronic and sometimes debilitating if not properly treated,” said Dr. Mikhael.
One review examining the effects of migraine on quality-of-life, found that migraine sufferers often experience decreased productivity at work, disruptions to their family, social, or leisure activities, according to the authors.
Not all migraines are created equal. Dr. Mikhael explained that hemiplegic migraine is a type of migraine that can be associated with familial symptoms, aura symptoms and migraine symptoms. It can also lead to stroke.
He is quick to note that hemiplegic headaches that cause paralysis or weakness on one side of your body is very rare and only 0.01%Trusted source of the population. Paralysis usually resolves in a matter of hours or days. Rarely, it may take up to 4 weeks. In rare cases, however, hemiplegic headaches can lead to permanent paralysis.
It is false. And it is important to note that not all migraines are caused by headaches. Dr. McVige stated that migraine is a primary headache disorder. It is more than just a headache. Actually, headaches are just one symptom of migraine. Some migraines don’t even have headaches at all.
Dr. Williams explains that a migraine is a type of headache that a person feels more intensely and often has associated symptoms.
A migraine can cause severe pain and disrupt daily activities. Migraines can last for a few hours or can last several days.
– Dr. Vernon Williams
Dr. Williams says that a migraine sufferer will not experience headaches but a migraine.
- A pounding, throbbing or moderately severe pain that can feel like it is engulfing your entire head or shifting from one side to the next.
- Sensitivity to light, sounds, and smells increased
- Vision problems include blurriness, flashing or bright dots, jagged lines, and/or bright spots.
- Abdominal problems can include nausea, vomiting, loss of appetite and an uneasy stomach.
Dr. Williams also explained the differences between migraines and headaches. He explained that certain people may experience the so-called prodrome phase.
He explained to MNT, that people suffering from migraines might notice changes in their daily life up until a day or two before they start — a kind of warning period.
These changes can vary from person to person, but he stated that the most common signs of prodromal symptoms are excessive yawning, Depression and irritability.
A migraine sufferer may also feel migraine aura. Dr. Williams stated:
The migraine aura is a neurological symptom that precedes the headache. It could include visual disturbances such as flashing lights, partial loss of sight or tingling that slowly spreads down the arm or face.
According to Dr. Williams, although these symptoms may indicate that a migraine headache could be coming on, there are upsides.
These warning signs can be used to help you start treatment early on in your migraine episode. This greatly increases the chance of success.
Dr. Williams advised us to not wait for the pain to go away and that the best way to get the most out of the medication is to take it as soon as possible.
It is a myth that caffeine causes migraines. However, it can trigger some people. The relationship between coffee and migraine is complex.
Dr. Mikhael explained to us that excessive caffeine use can cause migraines. But, caffeine can be used to alleviate headaches.
Dr. McVige says that some people find that drinking caffeine at the onset an attack can lower the intensity and help to alleviate some pain. However, regular use of caffeine is not recommended.
McVige explained to MNT that caffeinated drinks can trigger migraine attacks, but that withdrawalTrusted Source is a more common migraine trigger.
Recent research on the interactions between caffeine and migraine led to the following conclusion:
“All things considered, the evidence is not sufficient to recommend that caffeine be stopped for all patients suffering from migraines, according to our review of the literature.It is important to note that excessive caffeine use can lead to migraine chronification.Migraine attacks can be triggered by sudden caffeine withdrawal.
There is currently no treatment for migraines, but medications can be helpful.
“Cure is not what the word means, symptom control and prevention of headaches is the better term,” Dr. Mikhael explained MNT. “Migraine medications [aim] towards prevention of migraine episodes, and the use of ‘abortive medication’ if an episode does occur.”
Simply put, Dr. Mikhael stated MNT that “That is false statement; there are many medications available now to control and help migraine significantly.”
Dr. McVige provided a list of medications that can relieve migraine. These include triptansTrusted Source and calcitonin receptor peptide antagonistsTrusted Source. GepantsTrusted Source. Antidepressant medicines, antiseizure medicine, and beta-blockers.
There are also effective nonpharmaceutical options.
To avoid migraine triggers, it is important to make healthy lifestyle choices.
You can reduce your risk of developing a migraine by getting at least 8 hours sleep, drinking 8 glasses of fluid per day, eating healthy food, and getting 8 glasses of water each night. This means that even if you are exposed to a trigger, your chance of getting a migraine is reduced.
Dr. Williams said that a healthy lifestyle could eventually eliminate the need to take prescription headache medication.
This is good news, because Dr. McVige explained that “Medications can also lead to headaches (ironically), in a phenomenon known as “medication overuse headaches,” if too many rescue medications are being used.
Dr. Williams explained that there are many prescription medications that are effective in reducing migraine frequency, so-called prophylactic medication, and other medications that can stop a migraine from happening. It is important to consult a doctor if you have migraine headaches.
Dr. Mikhael says that this is a false statement. Migraine can be diagnosed clinically and doesn’t require imaging. If the symptoms are unclear or there are warning signs or neurological symptoms, imaging is not indicated. Imaging is warranted when there are warning signs or symptoms that could indicate a pathology.
Dr. McVige stated that there is no test that can diagnose migraines. “[To make an accurate diagnosis, a doctor must identify a pattern or recurring headaches and the associated symptoms for at least three months.”
Dr. Mikhael stated that migraine medications such as triptans are generally safe for pregnancy, especially after the first trimester. Acetaminophen, however, is not safe. However, some preventive anti-seizure medication should be avoided because of the possibility of a pregnancy being halted or a congenital malformation.
Dr. McVige added more details: “Before you get pregnant, it is important that people talk to their doctors about their migraine treatment plans, whether they are taking OTC, prescription medication, or both.”
She said that not all medications are safe for pregnancy. “Some medicines are off-limits while others can be added back in the first trimester.” Because they are noninvasive, wearable devices have a high efficacy and virtually no side effects.
While there are many diet plans that claim to cure every ill, not all of them work or have any evidence backing them up.
Dr. Mikhael doesn’t believe in the migraine diet. Dr. Mikhael explained that while eating healthy and avoiding trigger foods can help to prevent migraines, there are other factors that must be considered.
The migraine diet, for example, cannot treat “lack sleep, stress, and hormonal changes”.
Talking with MNT Dr. Mikhael refuted this myth, explaining that supplements can help prevent migraine headaches from triggering, but not cure them.
Although there is no cure, certain supplements can help to prevent migraines. Dr. McVige stated:
Supplements such as vitamin B2, vitamin D and magnesium are an important part of the migraine treatment market. However, no single vitamin or supplement has been shown to prevent or alleviate migraines for all people. Some people find them very helpful, while others are not so fortunate. Similar to pharmaceutical drugs, this variable response is also common.“
It is false. According to Dr. Mikhael “most migraines don’t have aura.”
The Migraine Trust states that 10-30% suffer from migraines.
“That’s completely false,” Dr. Mikhael said, “researchers never quit and they never will. There are many ongoing, important research initiatives to address the pathophysiology and treatment options for migraine.”
Dr. McVige replied with a similar enthusiasm, “There are […] innovation all the time in migraine scene, especially the last 4 years.” Recent developments in neuromodulation devices have been made. Theranica’s Nerivio, a new device for acute migraine treatment, has received clearance from the Food and Drug Administration.
“The device, which is controlled by a smartphone and discreetly worn on the upper arm of the patient, delivers a 45-minute treatment.”
Dr. McVige states that the device “modifies pain signals in brain and is an excellent alternative to medication.”
“We are constantly trying to find ways to deliver the therapy without exposing people for negative side effects.”
Migraine can cause severe discomfort and negatively impact your daily life. There are pharmaceutical treatments that can help. Changes in lifestyle and diet can help reduce migraines and ease the symptoms.
Scientists are certain to find better treatments and maybe a cure as they continue to research.