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Migraine

Migraine is common. It affects around 1 in 5 adult women in the UK and is the second most common cause of headache world wide. It is often described as throbbing or pulsating and is associated with moderate or severe pain on one side of the head.

The pain characteristically lasts from 4-72 hours and, unlike TTH, is associated with some specific features. It is often accompanied by nausea, vomiting and sensitivity to light or sound.  One third of patients also report an “aura” prior to the headache pain. This often manifests as zigzag lines in the vision or difficulty forming words, or less commonly as short lived tingling sensations on one side of the body.

 Fortunately, migraines are well studied and effective treatments are available. Below is a list of the top ten steps to control migraines produced by migraine experts.

 

Top ten migraine tips:

  1. Know your headaches. Headache is a symptom that can have many causes. Recurrent, disabling headaches are usually migraines.
  2. Find a good doctor who understands your headaches and is willing to work with you to find the best treatment. In most cases migraine can be diagnosed without the need for expensive tests such as CTs or MRIs.
  3. Tell your doctor, family etc about your migraines and how they affect your life. Migraine often causes temporary disability. The frequency and extent of your disability is an important guide to treatment.
  4. Avoid triggers. Once migraine has been diagnosed, reduce or avoid factors that trigger your migraine. Possibilities include foods (cheese, chocolate) changes in sleeping pattern or the weather.
  5. Find appropriate medication for your attacks and tailor it accordingly.  Severe migraines that interfere with your ability to function may need a prescription medication such as a triptan from your GP. Less disabling migraines can be dealt with over the counter medications. In decreasing order of effectiveness, aspirin at a dose of 900mg with metoclopramide, 1 gram of paracetamol and 400-800 milligrams of ibuprofen are all effective for migraines.
  6. Do not overuse medication. Overusing medication can make migraines worse. Be sensible with your pills.
  7. Have at least two treatment options available in case the first fails. You can ask your doctor for a “rescue medication” to take if you get a bad attacks that would otherwise mean you may miss a day at work or school.
  8. If one medicine doesn’t work for you, try another one. You can even treat several attacks with different medications to find out which works best for you. If no medication is working, ask for help.
  9. Ask your doctor about preventative drugs. This can reduce the total number of migraines you get if they become frequent and regular.
  10. Use treatments other than drugs. Some people find rest or caffeine helpful for their headaches

 Links

The Migraine Trust

Migraine - patient.co.uk site

 

 

 

 

 

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 15/02/2016