What is Migraine?

Migraine is generally a severe, one-sided headache, which may be accompanied by visual disturbances, neurological symptoms and/or nausea and vomiting. Visual disturbances can include flashing lights, zig-zagging, double vision, blind spots and blurring.

Neurological symptoms can include tingling in the limbs, pins and needles, facial numbness, loss of sensation or numbness in the arms and legs, confusion, dizziness and loss of speech.

Some patients get ‘just’ the headache and others get some of the other symptoms and this may vary from attack to attack.

It is also possible to have a silent migraine where you get the other symptoms without the headache.

Children can get a stomach migraine which makes them vomit rather than necessarily having a headache.

It is thought to affect around 6 million people in the UK  with 190,000 people having a migraine on any given day. So if you suffer with migraines, you’re not alone.

What causes migraine?

Whilst the causes of migraine are not yet fully understood it is widely thought that it may be linked to abnormal activity in the brain which in turn has an effect on the way the brain functions. Certain types of migraine (for example Hemiplegic migraine) may be hereditary and due to a genetic factor. 

There are a range of well-known triggers which seem to either spark off a migraine or to exacerbate them. Everyone is different so it’s useful to isolate what is likely to trigger yours and to avoid that as much as possible.

Migraine Triggers

Migraines can be triggered by a range of stimuli including:

• Skipping meals or eating in a rush,
• Being dehydrated,
• Drinking alcohol especially red wine and darker spirits
• Eating certain foods including cheese, tomatoes, chocolate, citrus fruits
• Additives in diet, slimline and processed foods such as artificial sweeteners,nitrates, MSG and preservatives
• Drinking caffeine
• Hunger/Thirst
• Stress at home, school, university or work
• Weather and environmental factors (such as thundery weather or a high pollen count)
• Hormones
• Working environment, especially when sitting in the same position all day
• Lack of or too much sleep!
• Strong perfumes
• Strong sunlight/bright lights/loud noises
• Tension in the neck and shoulders
• Some medications/contraceptive pills
• Overusing painkillers. Having too many headache tablets can give you a rebound headache!

Hormonal Migraines

There may be a hormonal element to migraines in women. Some women note that they have migraines during the 2-3 days in the run up to their period and in the first 3 days of their period. It is thought that a drop in oestrogen levels can contribute to headaches.  A period tracking app like Clue may also be useful.

Pregnancy can also have an effect on migraines although this does vary from person to person.

Whilst migraines are fairly common in pregnancy, if you do suddenly get a severe headache after 20+ weeks (especially from week 24 onwards) which is accompanied by visual problems, pain in the rib cage, vomiting, fluid retention or sudden swelling in your hands, feet or face, contact your Midwife or 111 urgently.

The perimenopause, menopause and HRT medication can all exacerbate migraines in some women.

How to manage a migraine

For occasional migraines the best solution would be to take a couple of over the counter painkillers, having a drink and a snack and going to bed in a darkened room until it passes.

If you feel nauseous you can buy anti-sickness tablets from your local pharmacy. There are also special migraine relief tablets that have an anti-sickness medication built-in.

Double check that you’re having the correct amount of paracetamol in total as many of them already contain paracetamol so DON’T take them with paracetamol! If  you’re in any doubt ask your pharmacist for advice.

Having an ice-pack might help (if carefully wrapped in a tea-towel)

Try to stay hydrated and if you feel up to it, having regular snacks or small meals. Sipping drinks can be kinder to the stomach than gulping them down.

 When to get help from your GP

If you find that you’re having more than 5-8 migraines a month speak to your GP who may be able to prescribe a preventative medication or take a blood sample as sometimes migraines can be linked to a deficiency of a vitamin or mineral.

There are also medications (often triptans) you can be prescribed to stave off an attack as soon as it happens, including injections and nasal sprays.

If you have migraines a lot and other things haven’t worked, you might be referred to a specialist Headache nurse or to the Neurology department for further tests and treatment if necessary. 

What else can help?

Reducing Stress

As migraines are often triggered or exacerbated by stress it is important to be as stress-free as possible.

Finding ways of releasing stress and tension are very helpful in preventing or minimising migraines. Think of any areas of your life that might be particularly stressful.

Is there anything you can do to make them less stressful? Any meetings you don’t need to attend?

Children’s activities that they no longer enjoy? Feel free to say no to anything you find stressful if you’re not contracted to be there!

Set up new systems

Sometimes setting up a new system can reduce stress right down. Like having something in the slow cooker ready for when you get back from football practise rather than having to start cooking from scratch when you’re tired and hungry. Or laying out clothes the night before. 

Take time out. Do some exercise. Enjoy your hobbies

Taking a little time out for yourself can be really powerful.

Gentle exercise such as walking, swimming or yoga can be useful as can mindfulness classes. Or ensuring you take part in hobbies that you love. 

Have Reflexology/ Massages / Acupuncture

Having a regular reflexology treatment or massage can be helpful as it helps to balance the body and to relieve stress and tension and to allows you to have some time to yourself.

Reflexology uses a firm but gentle pressure on specific points on the foot or face which is combined with massage techniques and holding specific points and is usually deeply relaxing and nurturing.

Acupuncture is also thought to be effective for managing migraines. This involves having tiny needles inserted into different areas of your body (and surprisingly doesn’t hurt!)

The key is to have a series of regular treatments over a period of about 6-8 weeks for best effect.

If you have health insurance cover double check to see if this is covered in your policy as some do cover things like Reflexology or Acupuncture.

Additional Resources

• Migraine Trust
•  NHS Choices
•  Migraine Buddy App

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