What To Know- K Health

Migraines can come on suddenly, or may start showing early warning signs.

If you’ve had a migraine before, you know that once a painful, throbbing migraine attack begins, one of the most important questions on your mind is when it will end so you can feel better.

In this article, I’ll explain more about migraines, including how to know if you’re having one, the stages of migraine, how they’re triggered, and how long migraines can last.

I’ll also talk about treatments for migraine, and when to see a doctor or consider prescription medication.

Experiencing migraines? Chat with a provider through K Health.

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What is a Migraine Attack?

People sometimes use the term “migraine” to mean any bad headache.

But a migraine headache is only one of the four main types of headache—the others are tension-type, cluster, and sinus headaches.

Migraine is more than just a headache, though: It is a recurrent neurological disorder that affects 1 out of every 7 Americans.

Migraines happen when specific changes in the brain occur, leading to the moderate to severe pain that they are known for, as well as other specific symptoms that separate them from other headache types.

How to know if you’re having a migraine?

Symptoms of a migraine tend to be felt on only one side of the head (in about 60-70% of people) or behind the eyes.

They are usually described as pulsating, pounding, or throbbing. Unlike other headache types, migraines may make it hard to function and may even prevent the ability to work, go to school, or drive. 

If you have a very bad headache on one side, have sensitivity to light and sound, and you also feel nauseated or are vomiting, it is likely a migraine attack versus a different headache type.

Migraine stages

There are four migraine stages.

• Prodrome: Also known as pre-migraine, this occurs in about 75% of individuals experiencing migraines. The prodrome stage happens 24-48 hours before a migraine occurs. It may include light and sound sensitivity, along with other symptoms such as yawning, fatigue, mood changes, sugar cravings, poor concentration, neck pain, constipation or diarrhea, and an increased urge to urinate. A person may experience some, all, or none of these symptoms leading up to a migraine.

• Aura: An aura is a neurological disturbance that may appear a few hours before a migraine, or may happen at the same time a migraine attack starts. Auras can involve changes to your vision (seeing flickering lights, bright lines, blind spots), hearing (tinnitus, noises, music), other senses (numbness, tingling, pins and needles, problems speaking or finding the right word), and motor problems (jerking motions, repetitive motions, weakness on one side of the body, balance problems). Around 25% of migraine patients will also experience aura. If you have never experienced a migraine aura before and these are new symptoms, seek emergency medical care. A physician should examine you to make sure there are no other neurological changes that may indicate more serious diseases, like stroke.

• Headache/Attack: During this phase, the head pain sets in, typically on one side or behind the eyes. It can feel like throbbing, pulsating, or pounding and may worsen with movement, light, sounds, or smells. Attacks may last from a few hours to 3 days. Migraines typically involve other symptoms such as nausea, vomiting, neck pain, and sleep problems.

• Postdrome: After the headache has ended, the post-migraine, or postdrome, stage sets in. It may last a few hours or a few days. The postdrome stage may include symptoms like fatigue. Sudden movements can cause pain where the headache was previously felt. Continue avoiding migraine triggers or overexertion during this time. Some people refer to this as having a “migraine hangover.” It may still be hard to return to normal function until the postdrome phase has ended.

Causes

There are many potential causes for migraines. Research has not identified a single factor.

Genetics and environmental exposures play a role. Some people are more prone to migraine than others, or may be more sensitive to certain triggers. 

Common triggers 

There are many different types of migraine triggers.

Most people who suffer from migraine can identify one or more that seem to set off migraine attacks for them.

Common migraine triggers include:

• Stress: Any type of stress or anxiety can induce a migraine if you are prone to them. In a retrospective study, 80% of those experiencing a migraine could attribute increased stress as their trigger.

• Menstrual cycle changes: Hormone changes associated with the menstrual cycle can lead to migraine. Typically they are triggered in the days leading up to a period or during a period. They are sometimes associated with symptoms of PMS (premenstrual syndrome).

• Foods: Skipping meals is actually more commonly known to trigger migraines than certain foods. But some foods are associated with a stronger risk for triggering a migraine. These include aged cheeses, red wine, MSG (monosodium glutamate), chocolate, dairy products, alcohol, smoked meats, and artificial sweeteners. For people who have celiac disease, gluten exposure can trigger a migraine.

• Sensory stimulation: Sudden sensory changes to the environment can trigger migraine. These include bright lights, strong smells (like perfumes), and loud noises.

• Weather changes: Barometric pressure shifts can trigger migraine headaches. This can include a sudden temperature change, a storm, or traveling somewhere with a different altitude.

• Sleep changes: Getting too much or too little sleep, compared to what you are used to, can trigger a migraine.

• Caffeine: Suddenly changing your usual caffeine intake, like having a lot more or stopping suddenly, can trigger migraines.

How Long Do Migraine Attacks Last?

Migraine attacks may last for a few hours or up to 3 days. Taking over-the-counter (OTC) pain medications or prescribed migraine medications may shorten the duration.

Taking action during the prodrome phase, such as reducing trigger exposure, may shorten how long the migraine lasts or prevent it all together.

Treatment

Treatment for migraine depends on what a patient’s triggers are, other health conditions, and frequency of attacks.

Home remedies

If you have developed a migraine, there are some things you can do at home to address pain and decrease the length of the attack:

• Practice relaxation techniques (deep breathing, meditation)
• Rest in a dark, quiet room
• Take a nap or go to bed early
• Place a warm or cool compress on your head— warm compresses help relax tense muscles, while cool compresses having a numbing effect to dull pain
• Drink water

Keep track of the things that seem to trigger migraines.

You can use a journal or an app on your phone to write down what was happening or what you were doing when migraine symptoms started to come on.

This may help you identify and more proactively avoid migraine triggers.

Some supplements may be beneficial for people who get migraines, though they may not work to stop a migraine attack that is already happening.

These include:

• Vitamin B2 (riboflavin)
• Magnesium
• Coenzyme Q10
• Feverfew
• Butterbur

Never start taking supplements until you have checked with your doctor.

Even though they are OTC, supplemental nutrients and herbs can still have significant effects and interactions with foods, medications, and even other supplements.

OTC medication

OTC pain relievers may be able to shorten the duration of migraines or help relieve pain.

These include:

• Acetaminophen (Tylenol)
• Naproxen (Aleve)
• Aspirin
• Ibuprofen (Advil, Motrin)
• Excedrin, which combines acetaminophen, aspirin, and caffeine

If you take other prescription medications for migraine or other health conditions, check with your doctor about which OTC pain relievers are safe for you to take.

Prescription medication

Certain prescription medications can either prevent migraines or treat them once they have started.

Your doctor may prescribe medication if you have severe migraines or if they happen frequently.

Medications that are stronger than OTC pain relief and may help with migraine attacks include:

• Triptans (sumatriptan, rizatriptan)
• Anti-nausea drugs (chlorpromazine, metoclopramide, others)
• Dihydroergotamine
• Opioids

Medications that can prevent migraines include:

• CGRP antagonists (erenumab, fremanezumab)
• Calcium channel blockers (diltiazem, nimodipine, verapamil)
• Beta-blockers (atenolol, metoprolol, propranolol, others)
• Anticonvulsants (gabapentin, levetiracetam, pregabalin)
• Antidepressants (amitriptyline, fluoxetine, paroxetine, sertraline, others)
• Botox injections

Prevention 

There are ways to prevent migraines that don’t involve prescription or OTC medications.

Doctors sometimes recommend lifestyle changes represented by the acronym “SEEDS”:

• S: Sleep—make sure you get enough, but not too much
• E: Exercise—moderate, but not too intense, 3-5 times per week for 30-60 minutes
• E: Eating—regular, healthy meals along with normal water intake and low or consistent caffeine intake
• D: Diary—keep track of how you feel and the things that tend to trigger migraines, so you can avoid them
• S: Stress relief—mindfulness, relaxation, therapy, or other things that help you avoid stress or anxiety

Acupuncture is an alternative therapy that may also help prevent migraines.

If your migraines are triggered by PMS or menstrual cycle changes, your healthcare provider may recommend hormone therapy or birth control to stabilize levels.

Experiencing migraines? Chat with a provider through K Health.

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When to See a Medical Provider

Seek immediate medical attention if you experience any of the following:

• A sudden, new, severe headache that is felt all over

• Severe headache with other symptoms like stiff neck, disorientation, confusion, seizures, double vision, weakness, paralysis on one side of the body, or problems speaking

• Headache after a fall or head injury

Talk with a healthcare provider if you start having migraines, or have them more frequently.

If you are over age 50 and start having headaches, contact a healthcare provider.

Not all headaches are migraines, and there are many health conditions that can cause headaches.

A healthcare provider can help distinguish between the type of headache you are having and how to treat them.

Sometimes your healthcare provider may refer you to a neurologist or other specialist if you require additional testing.

Migraine Treatment Online

Manage and treat your migraine online using K Health for just $29 per month.

Just three easy steps:

1. Answer a few simple questions.
2. Meet your primary care provider.
3. Get the care you need.

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Frequently Asked Questions

How long is too long for a migraine?

Migraines last a few hours to 3 days. If you have severe head pain that lasts longer, seek medical care.

Can a migraine last for a week?

A migraine lasts 3-72 hours. If you have chronic migraines, you may experience them more frequently. If you have frequent migraines, see a healthcare provider.

When should you go to the ER for a migraine?

If you have a sudden onset of head pain that is severe, or you have any of these other symptoms, go to an ER: problems speaking, seizures, numbness or weakness on one side of the body, fainting, or changes to your vision.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

• The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. (2015).
  https://pubmed.ncbi.nlm.nih.gov/25600719/

• Headache disorders: Differentiating and managing the common subtypes. (2012).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590146/

• Migraine with aura. (2021).
  https://www.ncbi.nlm.nih.gov/books/NBK554611/

• Analysis of trigger factors in episodic migraineurs using a smartphone headache diary applications. (2016).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764678/

• Gluten-free diet and migraine. (2020).
  https://pubmed.ncbi.nlm.nih.gov/33022759/

• Migraine. (2018).
  https://medlineplus.gov/migraine.html

• Treating severe migraine headaches in the emergency room. (2013).
  https://www.ncbi.nlm.nih.gov/books/NBK164538/

• CGRP antagonists in the acute treatment of migraine. (2004).
  https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(04)00764-1/fulltext

• Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis. (2019).
  https://pubmed.ncbi.nlm.nih.gov/30893319/

• Antiepileptic drugs in migraine prevention. (2001).
  https://pubmed.ncbi.nlm.nih.gov/11903536/

• Botulinum toxin in the management of chronic migraine: clinical evidence and experience. (2017).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367647/

• SEEDS for success: lifestyle management in migraine. (2019).
  https://www.ccjm.org/content/86/11/741

• Acupuncture for the prevention of episodic migraine. (2016).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977344/

• Menstruation. (2017).
  https://medlineplus.gov/menstruation.html

• The Triggers or Precipitants of the Acute Migraine Attack. (2007).
  https://pubmed.ncbi.nlm.nih.gov/17403039/

• Dietary Supplements for Headaches: What the Science Says. (2021).
  https://www.nccih.nih.gov/health/providers/digest/dietary-supplements-for-headaches-science

Stages of a migraine attack

There are well defined stages of migraine attacks

What’s on this page?

Migraine is much more than “just a headache”

Stages of a migraine attack

Premonitory stage

Aura

The headache or main attack stage

Resolution

Recovery or Postdrome stage

Stages of a migraine attack factsheet

Migraine is much more than “just a headache”

There are different types of migraine that involve different symptoms. There are many features or symptoms that are a part of migraine. There are also differences in how severe a symptom might be.

The most common symptoms of a migraine attack include:

• throbbing headache
• sensitivity to light, noise and smell
• nausea (feeling sick)
• vomiting (being sick)
• lethargy (lack of energy)

Stages of a migraine attack

It is often difficult to know when a migraine attack is going to happen. However, you can often tell the pattern of each attack as there are well defined stages.

It is these stages and their symptoms that distinguish a migraine from a headache.

However, not everyone will experience all of the symptoms of each stage and the stages can overlap. In adults, we can divide a migraine attack into four or five stages that lead on from each other.

Learning to recognise the different stages of a migraine attack can be useful. You might get one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Each stage can vary in how long and how bad it is. Recognising different symptoms at different times during your attack can give your doctor information which may help them make a diagnosis. Taking medication as soon as you notice the pain may stop or shorten an attack.

Migraine attacks in children are often much shorter than in an adult. It may be easier to tell the different headache stages in a child.

Premonitory stage

This is sometimes described as the warning stage in which certain physical and mental changes occur. These can include:

• feeling tired
• excessive yawning
• food cravings
• changes in your mood such as feeling down or irritable (high or low)
• Feeling thirsty
• neck stiffness
• passing more urine (wee)

These feelings can last up to 24 hours.

Aura

Around a quarter of people with migraine have aura. Migraine without aura does not include this stage.

The aura of migraine includes a wide range of neurological symptoms. These symptoms include:

• changes in sight (visual disturbances) such as dark spots, coloured spots, sparkles or ‘stars’, and zigzag lines
• numbness or pins and needles
• weakness
• dizziness or vertigo (sensation of spinning and poor balance)
• speech and hearing changes

Some people experience memory changes, feelings of fear and confusion, and more rarely, partial paralysis or fainting.

Aura is the result of a wave of nerve activity that spreads over the brain (known as cortical spreading depression).

As this electrical wave spreads, the nerves fire in an abnormal way and this range of reversible neurological symptoms (aura) develop.

This stage can last from five to 60 minutes, and usually happens before the headache.

In adults, they usually happen before the headache itself, but in children, they may happen at the same time as the headache.

It is possible to have the aura symptoms without the headache, this is often referred to as ‘silent migraine’.

The headache or main attack stage

This stage involves moderate to severe head pain. The headache is typically throbbing and is made worse by movement. It is usually on one side of the head, especially at the start of an attack. However, you can get pain on both sides, or all over the head.

Nausea (sickness) and vomiting (being sick) can happen at this stage, and you may feel sensitive to light, sound, smell and movement. Painkillers work best when taken early in this stage.

Resolution

Most attacks slowly fade away, but some stop suddenly after the person with migraine is sick, or cries a lot. Sleep seems to help many people, even an hour or two can be enough to end an attack. Many children find that sleeping for just a few minutes can stop their attack.

Recovery or Postdrome stage

This is the final stage of an attack, and it can take hours or days for a drained, fatigued or ‘hangover’ type feeling to disappear. Symptoms can be similar to those of the first stage (premonitory). Often, they mirror these symptoms. For example, if you lost your appetite at the beginning of the attack, you might be very hungry now. If you were tired, you might feel full of energy.

Being aware of the different stages of the migraine attack can be helpful. It can help you prepare for an attack, get a diagnosis and decide when to take acute treatment, such as painkillers or adapt your activities.

It is useful to have a rescue treatment plan for when attacks occur. This may include painkillers such as a triptan, a NSAID (e.g. ibuprofen) or paracetamol. It often also includes anti-sickness medication.

For other people, being aware of the stages and symptoms of a migraine attack can help their understanding. It may also help with the frustration and lack of understanding people often face around migraine, especially at work and in education.

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Stages of a migraine attack factsheet
(54.7KB pdf)

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What is migraine and where does it come from

Migraine is not just pain in the head. This is when it hurts so much that you can’t even move. Programmers are very familiar with this disease. In this article, I will tell you what causes migraines and how you can stop the pain.

Who writes: Anastasia Stelmakh, a neurologist who knows React and JavaScript. I thought about entering IT, but decided to stay in medicine. On her LinkedIn page and dev.by blogs, she talks about popular neurological ailments of our time.

How do you know if you have a migraine?

Ordinary headache is not as intense as migraine. With it, a person can function, and with a migraine, any action causes suffering. Some cannot even get out of bed – every movement only increases the pain.

Headache may go away on its own, for example after sleep. With migraine, this will not work – attacks are relieved only by pills.

More symptoms:

• Headache lasts 4 to 72 hours (yes, one migraine attack can last up to 3 days)
• Headache has at least 2 of 4 characteristics: unilateral, throbbing, moderate or high intensity (from 6 to 10 points on VAS – pain scale, where 0 is not at all, 10 is the most severe pain in your life), increases with physical activity,
• In addition, there may be light/sound intolerance or nausea/vomiting.

What can trigger a migraine attack?

• disruption of the daily routine – especially often migraine worsens on weekends or on vacation, when a person sleeps longer than usual,
• jet lag,
• tension in the neck muscles (including due to a long stay at the computer),
• external factors (weather changes, strong odors, flickering screen or bright lights),
• in women, migraine is associated with a cycle,
• Dietary factors (chocolate, cheese, nuts, coffee, etc. – there are many of them, I’m tormented to list),

Important: each patient has his own provocateur.

How to help yourself during attacks?

First aid – try to retire, lie down in a dark room.

❗ It must be remembered that with a migraine, the digestive tract slows down, so you need to take medication in the first 15-20 minutes of an attack (or after an aura), drinking plenty of water or soda (bubbles accelerate the absorption of everything)

💊 Depending on the symptoms, take the following drugs:

• Anti-inflammatory (ibuprofen, diclofenac, naproxen),
• combined analgesics, eg Citramon,
• triptans (unless contraindicated) – sumatriptan,
• for nausea – antiemetics (metoclopramide, domperidone).

I recommend keeping a headache diary. Note the localization of the headache, the assessment on the visual analog scale of pain: how often the head hurts, what provokes it, and how long it lasts, what other symptoms besides the pain (nausea, flies before the eyes, numbness of the face), what do you stop.

This information is very valuable for a doctor when making a diagnosis, and if you come with such a diary to an initial appointment, doctors will create legends about you as about the most conscious patient.

There are ready-made applications, or you can keep a paper diary in the old fashioned way.

If you have headaches more than 15 days a month, then we are talking about chronic migraine, which is treated with serious drugs. For example, antiepileptic, or even Botox injections. It’s a pity not in the nasolabial folds, but in special areas on the head, according to a certain pattern 😁.

Migraine is not curable, but it is possible to control its attacks and improve the quality of life. And after 50 years, seizures become rare and not so strong.

The opinion of the author may not reflect the position of the editors.

What else to read?

• Living well: what is tunnel syndrome among programmers and how to deal with it
• Do everything. How to combine self-education with work, manager

advises

• IT specialist in the village. Part 3. How I survive in the village in the cold and prepare for the New Year

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Jakui, why are you with us.

How long does a migraine last? | Medical Insider

07.02.2021

Migraine is characterized by severe, recurring headaches that usually last from 4 to 72 hours. Typically, a migraine is accompanied by a feeling of nausea, increased sensitivity to light and sound, and sometimes sensitivity of the skin and muscles.

The duration and frequency of migraines varies from person to person. There is a particularly intense form of migraine called status migraine. With this migraine, symptoms last more than 72 hours, even with treatment. Although precise epidemiological data are not available, an 11-year study found that status migraine occurs in approximately 3% of patients with migraine.

Migraine has four phases:

• prodromal phase
• aura
• headache
• postdromal phase

Each phase lasts for a different time.

Understanding the different phases of a migraine attack can help manage the condition. If the patient recognizes the early symptoms of a migraine attack, they can take steps to prevent the situation from developing.

This phase is also called the anticipation or warning phase. The prodromal phase can begin a few days or just a couple of hours before the onset of the aura. At this stage, subtle changes can be noticed that are not necessarily associated with a headache. The symptoms serve as a warning of an upcoming migraine attack. Symptoms of the prodromal phase include:

• anxiety
• constipation
• tiredness
• food cravings
• increased thirst and urination
• mood changes
• neck stiffness 9 0020

Not every migraine patient has an aura with every attack. This phase occurs in about 25% of people with migraine. The aura phase usually occurs shortly before the main migraine attack and lasts 20-60 minutes. Auras are sensory disturbances that range from flashes of bright light to the inability to speak normally. Aura symptoms include:

• dizziness
• noises
• blurred vision or hearing
• numbness or tingling in limbs
• vision of bright or flashing lights, sparks, colored spots or zigzag lines
• slurred speech
• weakness in the face or body

Stage aura usually comes before the primary headache. However, in some adults and children, aura symptoms may occur along with the migraine itself.

The symptoms during the headache stage are usually the same whether the person had the aura stage or not. Headache symptoms include:

• blurred vision
• dizziness
• extreme sensitivity to light and noise
• irritability
• sensitivity to smells, touch and movement
• stiffness in shoulders and neck
• throbbing pain on one or both sides of the head, which is aggravated by movement or activity
• upset stomach, nausea or vomiting

This phase is the most acute, and more than 90% of people have fairly severe symptoms.

The postdromal phase develops in about 80% of people. The phase can last 24-48 hours and include the following symptoms:

• body pain
• confusion
• difficulty concentrating
• dizziness
• depression
• feeling empty
• weakness

Sudden head movement or return to strenuous activity can cause a headache, but not for long.

Identifying the causes and triggers of migraines can help people avoid them and prevent a migraine attack. Triggers are different for everyone, but some common ones include:

• alcohol and caffeine
• bright lights
• weather changes
• dehydration
• diet
• hormonal changes
• smells
• overuse medications
• stress

Migraine treatment may include medications and home remedies to reduce the severity of symptoms . Home remedies include:

• increased water intake
• sleep
• rest in a dark and quiet room
• cold compress
• taking pain medication such as aspirin, ibuprofen or naproxen

If home remedies do not relieve symptoms, see a neurologist who can recommend the following medicines:

• antiepileptic drugs 900 20
• antidepressants
• beta- blockers
• serotonin antagonists
• botulinum neurotoxins (Botox)
• CGRP receptor antagonists

Less than 50% of migraine patients seek medical attention. If a migraine attack lasts longer than usual, you should see a doctor. It is important to seek immediate medical attention if the following symptoms occur:

• extremely severe headache
• headache that comes on suddenly like a thunderclap, especially if the person is over 50 years of age
• headache accompanied by neck stiffness, fever, confusion , slurred speech or seizures
• problems with speech, vision, movement and balance that are different from the usual migraine

Always seek medical attention if you have a headache after a head injury.

Migraine prevention involves identifying and avoiding specific triggers. Keeping a headache diary can predict when a migraine attack might occur. If the person finds that the triggers are weather related, such as extreme cold and wind, then they should stay indoors for that amount of time. If stress plays a role in migraine patterns, relaxation can help prevent migraine attacks. In children, changing sleep habits and improving nighttime routine can reduce migraine attacks.