Early interventions can keep severe symptoms at bay.
Most of us are no stranger to headaches. Migraines, a more severe form of headache, affect around 2.7 million Canadians. Our Vancouver Coastal Health Research Institute researcher Dr. Joshua Lai unpacks scientific knowledge about common forms of headache, and discusses interventions that could help reduce symptoms and improve quality of life.
Q: What are some indicators that my headache might be a migraine?
A: Almost everyone will experience a tension headache — characterized by mild to moderate pain in the area of the head or face — at some point in their lives. Among the hundreds of headache disorders listed in the International Classification of Headache Disorders, migraine is one of the most common. Migraine generally presents with pain that is moderate to severe in nature. It can cause auras of light, symptoms of nausea, vomiting and sensitivity to light, sound and smell, as well as neurologic symptoms, such as decreased concentration and severe fatigue. Waking up with a migraine frequently leads to worse symptoms overall compared to onset that occurs later in the day.
Q: How can I tell the difference between mild to severe symptoms?
A: While only a physician can properly diagnose a tension headache or migraine, I often judge the severity of symptoms based on how they impact a person’s function. For example, having to miss school or work is usually a sign of severe symptoms. Conversely, being able to continue with normal activity levels aligns with a mild to moderate headache or migraine.
Q: Who is most at risk of developing migraine?
A: People who experience migraine are more likely to have inherited a collection of genes associated with areas of the brain that process pain and balance homeostasis. This genetic predisposition can be exacerbated by a variety of often cumulative triggers, such as sleep deprivation, stress and eating certain foods. Women are also at a higher risk than men for developing migraines.
Q: When should I consider taking over-the-counter pain relievers for a tension headache or migraine, and how do I use them safely?
A: The first step is to visit a physician who can make a diagnosis. If someone is diagnosed with either a tension headache or migraine, it is important to take any prescribed or over-the-counter pain relievers at the onset of symptoms. Other conditions and potential medication interactions should be discussed with a health care provider before starting a medication regimen. For example, individuals with chronic kidney or liver disease will need to take extra precautions when taking prescription or over-the-counter pain medication.
Q: Are there relaxation techniques or stress management strategies that can help prevent migraines?
A: Migraine research has identified several relaxation techniques that can help alleviate symptoms, including mindfulness meditation, cognitive behavioural therapy, rhythmic breathing and biofeedback. These mind-body techniques should be applied at the beginning of a migraine attack and as a means to help reduce the triggers that can lead to a migraine, as well as the recurrence of migraine.
Q: Should I be concerned about recurring headaches, and when should I seek medical advice?
A: Most tension headaches will improve on their own. However, someone who experiences a tension headache or migraine together with neurological symptoms, such as numbness or weakness on one side of their body, should seek urgent hospital care. Individuals experiencing a gradual worsening of their headache or migraine symptoms, or symptoms that interfere with their everyday life, should consult a physician and possibly a neurologist — a specialist in conditions of the brain and nervous system.
Q: What are some techniques to prevent or reduce migraine?
A: A key reason why I entered the field of headache neurology was the number of treatments now available to help patients who experience migraine. With treatment, a person can go from experiencing migraines several times per week to only once in a while. This dramatic improvement can be accomplished by assessing a patient’s lifestyle and triggers. Many patients are asked to keep a migraine diary to identify these triggers and optimize the use of medications. Sometimes daily vitamins, oral medications or injectable medications are recommended to prevent migraines from starting.
Additional helpful information about different types of headache and treatments can be found at Migraine Canada and the American Migraine Foundation websites.
