Understanding migraine

An estimated three million Canadians suffer from migraine headaches, but only about half of them seek the medical treatment that could bring relief. There’s no reason to suffer in silence. Powerful new medicines offer hope for breaking the cycle of pain. The following guidelines will tell you more.

During a migraine, blood vessels in the brain deliver too little blood, causing irritation to the nerves around them. Migraines are now recognized as a chronic disease, not just painful head­aches. The excruciating, often debilitating pain is a symptom, not the underlying problem. This is a key distinction. Although the exact cause of migraines is uncertain, there’s a strong genetic link. If one of your parents has migraines, you have about a 50 percent chance of having them too. Changes in your body (diet, sleep, hormones or stress) or in your environment (weather or lighting) can "trigger" a migraine attack. Low levels of the brain chemical serotonin are also believed to play a role.

Usually, there are four stages to a migraine. During the pro­drome (the period before an attack), you may be sensitive to light, smell or sound. About 20 percent of people with a migraine experience an aura — bright, flashing lights or a partial loss of vision. During the attack, a throbbing or pulsating pain often starts on one side of the head and gradually worsens; sometimes it spreads to the other side as well.

You may also have vomiting, blurred vision, neck and shoulder pain, tingling or difficulty concentrating. An attack can last from a couple of hours to several days if untreated. Afterward, in the postdrome, you may feel drained, irritable and foggy, or refreshed and even euphoric.

Overall, about 17 percent of Canadians have been diagnosed with migraines. Women are three times more likely than men to have them, and an estimated 80 percent of people with migraines have a family history of the condition. It is estimated that 5.4 million workdays are lost each year in Canada due to migraines. First steps

• See your doctor to identify the best prescription medications for your symptoms.
• Lie down and rest in a dark, quiet room with an ice pack for immediate relief.
• Identify possible migraine triggers, such as food, drink, sleep patterns and stress.

• Have a strong, black cup of coffee at the first sign of an attack.
• Avoid the rebound. Over-using headache medications — even common over-the-counter products — can lead to a vicious cycle of rebound headaches. Your body becomes so dependent on the medication that you get a new headache as soon as the drug wears off.
• Eat more fish. Varieties high in omega-3 fatty acids (salmon, tuna, sardines) may help prevent migraines from recurring.
• Watch out for additives. The artificial sweetener aspartame, found in many diet sodas, may trigger migraines in some people. The food colouring FD & C yellow #5, found in candy, beverages, some cereals and ice cream, has also been known to trigger migraines in certain individuals.
• Keep a migraine diary. The best way to identify potential migraine triggers is to keep a diary of what happened immediately before an attack. The information will be invaluable in helping you and your doctor figure out the best course of treatment for your headaches.