Migraines are frequently attributed to stress and high blood pressure. But, blood vessel abnormalities in the brain or a central nervous system disorder may also be responsible. Unlike other headaches, migraines can be extremely disabling, start with rapid onset, and make the performance of job duties impossible. Over 20 percent of Americans suffer from migraines according to the National Institute of Neurological Disorders and Stroke, and prevalence is three times higher in women than men.
Migraine versus Non-Migraine Symptoms
The pulsing or throbbing pain from a migraine typically occurs on one side of the head (and often spreads), and may be accompanied by other symptoms such as visual disturbances preceding the attack, nausea, and sensitivity to light. Untreated, migraines generally last from four to 24 hours—and can even commence while resting or asleep. The attack is often followed by a feeling of fatigue and sleepiness. In contrast, non-migraine headaches are often described as dull pressure on both sides of the head, and normally resolve within a couple of hours.
Treatments for Migraine Headaches
Prevention is the main treatment approach of medical practitioners, and primarily includes a combination of behavioral changes (since stress can precipitate a migraine) and pharmaceutical drugs. The medications can be categorized as either for migraine prevention or treatment during the actual attack. Preventive medications include some of the same pharmaceutical agents prescribed for hypertension, hormone regulation, and epilepsy.
Triptans (selective serotonin receptor agonists) are often prescribed for use at the onset of an attack, and painkillers are prescribed to treat the symptoms of an attack. Complementary therapy treatments include acupuncture, chiropractic manipulation, biofeedback, and naturopathic remedies (such as magnesium supplements and calming herbal teas).
There is no “cure” for migraines, because the cause is still unknown (though recent studies have suggested an underlying CNS disorder triggering brain vasculature effects, per a New York Times report).
Common Migraine “Triggers”
Besides stress and anxiety, certain chemicals and preservatives in foods (as well as some foods) can trigger a migraine headache in some individuals. In particular, monosodium glutamate (MSG) and nitrates have been reported by many migraine patients as “triggering” an attack—as well as some analgesic medications. Healthcare providers of migraine patients often attempt to pinpoint the “triggers” for that individual to recommend avoiding that “trigger”.
Caffeine and alcohol—especially red wine—have also been identified as common triggers in people who experience migraine headaches (although caffeine has also been noted as an aid in preventing migraines, and is included in some preventive medications).
Burden of Cost to U.S. Economy
Absenteeism from employment and reduced work productivity are two of the indirect costs of migraines, according to an article published in Neurology (48 [3 Suppl 3]:S4-9; 1997). The American Headache Society presented research findings in 2013 at the International Headache Congress that individuals who experienced migraines on an occasional basis often progressed to chronic migraines without healthcare treatment.
Meanwhile, the American Association of Occupational Health Nurses reported that most persons who experience migraines do not receive treatment from a healthcare professional. However, the annualcost attributable to migraine-related disability exceeds $13 billion, according to the Mayo Clinic Proceedings [84(5):436; 2009]. Therefore, workplace health education in the prevention and management of migraines is needed.