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Exploring Migraines- Causes, Management and Recent Findings


A migraine is a neurological disorder that causes recurring, intense headaches. According to the Journal of Headache and Pain, migraines are the leading cause of disability among young women.


If you have a migraine, you may experience:

  • Nausea

  • Vomiting

  • Sensitivity to lights, sound, and smell

  • Throbbing headache


Migraines can be incredibly painful- even more than a normal headache. They

can cause disruptions in your daily life. Treatment measures can help limit your pain days and get you back to your daily routine.


What does a Migraine Headache feel like?

Differentiating a migraine from a regular headache is the first step towards diagnosing the problem. The two key factors that differentiate migraines from normal headaches are duration and pain.


Duration

A headache usually lasts anywhere between a few hours to a day. It usually resolves with sleeping. A migraine lasts up to five to six hours. Sometimes, it can last for days. It may not go away with sleep.


Pain

Headache pain is dull. The pain is usually at the back of the head.

Most headaches are usually diffuse, meaning that the sensation is spread out. This makes it hard to point out where exactly the pain is.


Migraine pain is focused around the eyes or on one side of the head. Migraine pain is usually a pulsating or pounding ache.


Causes: Why does a Migraine happen?


The exact reason behind why migraines happen is still unknown. The most plausible theory up until recently was the blood flow theory which stated that migraines are caused by changes of blood flow in the brain.


However, as of recently, this theory is no longer valid. The newest research suggests that migraines actually happen due to overactive nerve cells. This theory is called the “neural theory”.


According to neural theory, the pathology behind a migraine is abnormal serotonergic (serotonin making) cells. The theory states that abnormal cells cause

the inactivation and activation of different areas of the brain which triggers inflammation which then causes migraine pain.


Migraines can be influenced by a combination of genetic and environmental factors.


You may be more susceptible to migraines if you are:

  • female

  • 20 to 30 years of age

  • Have a family history of migraines

  • Sensitive to strong flashing lights, loud rooms, and stress

  • Experience hormonal issues

Management: Strategies to Alleviate Migraine Pain

There is no cure for migraines. However, there are a number of home remedies and over-the-counter medications to help manage an active attack.


Medication

There are several over-the-counter medications to help manage migraines. However, they do come with significant side-effects.


Pain Killers

Ibuprofen and Aspirin are common pain relief medications that can reduce migraine pain. Dosages may have to be adjusted depending on the severity of the attack. You shouldn't take these medications to treat every attack. They can cause internal bleeding, gastric ulcers, and medication-overuse headache.


Caffeine may reduce migraine pain. Some medications include caffeine as an active ingredient. A popular formula is a combination of caffeine and aspirin.


Triptans

Triptans are a class of medication that target serotonin receptors in the brain directly. Serotonin is a chemical that instructs brain cells by attaching to specific receptors on their surface.


Serotonin helps in constricting widened (dilated) blood vessels that cause pain. These drugs cancel out the inflammation in the blood vessels by constricting them. This reduces migraine pain.


Some examples of triptans are almotriptan, eletriptan, rizatriptan, sumatriptan. While effective, these drugs can cause dangerous side effects like

fevers, muscle rigidity and seizures. These are also not safe for people at risk of a stroke or heart attack.


Home Remedies

Home remedies are an alternative to pharmaceutical drugs. These are convenient and may have less side effects. Oftentimes, patients combine both medication and remedies as a part of a comprehensive plan to manage their migraines.


Scalp Massages

Studies have shown that when a significant amount of pressure is applied to the scalp muscles, it can help reduce tension and stress.


Doing a simple scalp massage using the base of your palms and thumbs can help improve blood circulation and provide relief. However, this can cause pain to people who are sensitive to touch during an active migraine.


Compresses

Cold compresses can help soothe some of the throbbing pain from a migraine.


In 2006, a study conducted by medical students in Turkey aimed to examine the impact of cold therapy on migraine pain. The trial included 26 middle-aged female patients who experienced frequent migraine attacks.


The patients in the study were instructed to keep a journal to track their symptoms. When a migraine attack occurred, they used a cold gel cap to help relieve the pain. At the end of the study, 50% of the patients saw an improvement after the first use of the cooling gel cap.


Alternative Methods

There are several alternative methods that have proven effective to managing migraine pain.


Relaxation Therapy

Biofeedback is a technique which uses special equipment to monitor physiological aspects like heart rate, blood pressure, and muscle tension.

Biofeedback has proven effective in managing conditions that cause chronic pain.

By evaluating feedback and matching it with stimuli, patients can create strategies to manage migraines. Biofeedback therapy starts by introducing the client to a trigger. An example may be an auditory or visual stimulus that may

cause an attack. After introducing the stimulus, changes in the psychological parameters are monitored. This may include increased muscle tension or blood pressure.


The patient can then identify triggers and formulate ways to control the frequency of the attacks. Some popular techniques include doing yoga, practicing mindfulness and practicing breathing techniques.


Herbal Supplements

While there is controversy regarding the effectiveness of herbal products, some patients have found them helpful in managing migraines. A popular example of this includes essential oils.


Essential oils are highly concentrated plant extracts that come with several benefits. Apart from their pleasant aroma, some can reduce anxiety, improve sleep, and reduce muscle aches.


An old study suggests that using a combination of peppermint, eucalyptus, and ethanol can provide relaxing effects to both the muscle and mind.


Recent Findings: What Do We Know about Migraines in 2023?

As of 2023, there have been many developments related to migraines and headaches.


Read on to learn about a few notable discoveries.


Gut-Brain Axis

Recent research suggests that there is a link between the gut microbiota and migraines. The effects of the excitatory neurotransmitter, glutamate, have been identified.

Evidence suggests that disturbances in the glutamate pathway may be implicated in the progression of a migraine. Diet and bowel habits may play a part in the occurrence of a migraine.


Neurostimulation

Transcranial magnetic stimulation is a non-invasive procedure that uses magnetic fields to create currents in the brain. TMS was approved by the US FDA

for acute treatments of migraine with aura.


Single pulse TMS has shown credible results in aborting a migraine attack. In future, this may become the mainstay for management of acute migraine pain.


CGRP and CGRP Receptor Antagonists

Calcitonin gene related polypeptide (CGRP) is a neurotransmitter that plays a role in the development of a migraine.Concentrations of CGRP are elevated in the blood during a migraine attack.

Recent clinical trials are being carried out on this theory. A newer class of medication has been approved to treat migraines based on this research.


Final Verdict


Migraines are a complex, multifactorial disorder that vary from person to person . No two patients show the exact same symptoms. So, the best management plan is different for every patient.


It's important to consult a healthcare professional to discuss an appropriate strategy rather than experimenting on your own. While there have been promising discoveries, there is still a lot to unravel about migraines.


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