Head off a Big Headache (Migraine) Before it Hurts


By paying attention to common warning signs you may be able to head off migraine pain before your head even hurts. 

Head off a Big Headache (Migraine) Before it Hurts
By paying attention to the signs of migraine you may be able to head off that migraine pain with medication or lifestyle changes before your head even hurts.

You’ve been working in the office all day and can’t seem to shake this nagging, throbbing pain. Then you notice that lights and sounds are starting to affect your every thought.  Is it just a headache, or could it be a migraine?

As John Rothrock, MD director of the Renown Institute for the Neurosciences, emphasizes, migraine is “not just a headache.”

Along with head pain that may vary in intensity from mild to absolutely excruciating, the symptoms of a migraine attack may include nausea, vomiting, sensitivity to light and sound, along with a myriad of neurologic problems such as impaired vision or speech, abnormalities of sensation and changes in behavior.  Individual attacks usually last between four and 72 hours.

“But migraine is far from stereotyped,” Dr. Rothrock explains. “Migraine symptoms differ from person to person, and even in a given individual afflicted by migraine the attack symptoms typically vary from attack to attack.”

While some symptoms take place along with the migraine, there’s another set of warning signs that can begin days before. By paying attention to the signs of migraine you may be able to head off that migraine pain with medication or lifestyle changes before your head even hurts.

Migraine typically occurs in four stages, although each individual is different and may not experience all four.

The very first stage, the Prodrome Stage, can start anywhere from 12 to 24 hours before you notice any head pain.

Common symptoms can include:

  • Constipation and diarrhea
  • Food cravings
  • Thirst
  • Irritability
  • Muscle stiffness, especially in the neck
  • Uncontrollable yawning
  • Increased urination
  • Sleepiness with frequent yawning
  • Depression or euphoria

According to Dr. Rothrock, “the majority of migraineurs experience prodromal symptoms at the onset of an attack. Given that early treatment is critical to effective control of acute migraine, recognition of these symptoms may assist in averting the more disabling symptoms that migraine may provoke.”

Before the pain starts, or at the beginning, people experience the second phase of migraine, the Aura Phase.  According to Web MD, about one in five people with migraine develop an “aura.”  An aura may not occur with every headache.

Symptoms in this phase are different from person-to-person but most people experience visual changes such as spots or flashes of light, vision loss, shimmering spots or stars.  Other symptoms can include numbness or tingling, speech problems or confusion.

In the third phase of migraine, the Pain Phase, virtually all migraine sufferers have moderate to severe throbbing head pain, usually on one side that last up to 72 hours.  Following this phase, in the Postdrome Phase, you may feel tired, sluggish, or even depressed anywhere from a day to a few days.

By keeping a log of when your headaches occur, what you ate, drank and did several days in advance, as well as early symptoms experienced, you may be able to help notice patterns or warning signs.

“This “headache diary” may assist you in identifying obvious factors that trigger your migraine attacks and enabling you to reduce the frequency of your attacks by avoiding those triggers. Recording the frequency and intensity of the headaches you experience over a given period of time will assist your doctor in developing a treatment program appropriate to your unique needs,” says Rothrock.

You should see a doctor if:

  • You experience an abnormally severe headache or one that lasts more than a couple of days.
  • Your headaches are significantly affecting your quality of life.
  • Your headaches are progressively increasing in frequency.

Dr. Rothrock recommends seeking “evaluation and treatment from a provider with expertise and experience in headache medicine.”