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Published on June 04, 2009

Manage Migraines: Don't Let the Pain Take Over Your Life


SIOUX FALLS (June 1, 2009) - A headache is not "just a headache" for many sufferers of migraines. It's pain that keeps its victims in bed or in a dark room, away from work or fun, for hours or even days at a time.

"Migraine headaches are underdiagnosed, and therefore undertreated," said Dr. Carol Miles, neurologist with Neurology Associates, located in Avera Doctor's Plaza 2 in Sioux Falls. Migraines are a class of headaches characterized by one-sided, throbbing pain that's often accompanied by nausea and vomiting, and sensitivity to light and sound.

About 20 percent of migraine patients also experience an "aura," such as seeing black spots, colored flashing lights or jagged streaks of light. In rarer cases, aura can involve weakness or numbness on one side of the body.

Whereas muscle tension headaches tend to get better with activity, migraine headaches tend to get worse. "Migraines are more complex, having to do with neurotransmitter changes in your brain, vascular changes and perhaps some inflammation," Dr. Miles said.

Migraine headaches most often begin in the 20s, 30s and 40s, and are three times as common in women as in men, although men experience migraines, too. Since migraines have the stigma of being a "women's disease," migraines are even more likely to go undiagnosed in men, Dr. Miles said.

Family history is an underlying cause of migraines; other factors act as triggers. Common triggers include sleep deprivation, stress, or a change in the weather. Food triggers may include chocolate, caffeinated beverages, nuts, alcohol, citrus fruits, and highly-preserved foods such as bacon, pepperoni or aged cheeses. Another common trigger is MSG (monosodium glutamate), a flavor enhancer often found in Chinese foods, flavored chips or soups. "The label might not say MSG, but this ingredient can be lumped in under 'spices' or 'natural flavorings,'" Dr. Miles said. Triggers are often specific to each individual, and migraine sufferers quickly learn what these are.

Changes in hormone levels at menstruation also trigger migraines. "Most often, the migraine comes on one day before the period begins, when the estrogen level is quickly dropping, and also at the end of the period when the estrogen is going the other direction. Some women will have a more mild migraine with ovulation," Dr. Miles said.

For migraine headaches that happen one time a week or less often, Dr. Miles suggests trying over-the-counter pain remedies first. If those don't work, other pain relievers can be prescribed.

A class of medicine called triptans, such as Imitrex, Maxalt and Zomig, are specifically formulated for migraines. Preventative therapy might be added for those who have frequent headaches which happen two times a week or more often. If one headache kicks off another headache, the cycle can go on for days. "While medications may not completely eliminate headaches, it should be possible to shorten the duration of a six- to eight-hour headache to 30 minutes or less," Dr. Miles said.


Migraine headaches can be debilitating, but they are not life-threatening. However, a sudden, severe headache can be a sign of a dangerous condition like stroke or aneurysm, So if you suddenly experience the "worst headache of your life," seek help. It's also advisable to see a physician for any new headaches, a change in headaches or new symptoms such as numbness or weakness.
"It's important to go in, get diagnosed, and get treated so you can manage your life, rather than having the headaches manage your life," Dr. Miles said.