Chronic headaches are a very common and painful condition that impacts millions of Americans every day. Headaches can be absolutely debilitating when they strike and have the potential to affect an individual’s quality of life in a significant way, especially if they are left untreated. While most people tend to assume all chronic headaches are migraines, there are actually some critical differences between the two; to borrow a famous turn of phrase: all migraines are headaches, but not all headaches are migraines.
What is a Migraine?
A migraine is an extremely painful primary headache disorder, meaning it is not the symptom of another associated condition, but a serious disease in and of itself. While migraine headaches can vary in terms of severity and frequency, they are generally much more intense and long-lasting than a tension headache, and they have a higher rate of disability among sufferers.
The key distinction between a migraine and other primary or secondary headaches is the presenting symptoms. Migraines generally produce a throbbing, pulsating pain that is made worse with even mild physical exertion, while other headaches are generally milder and present with steady pain that doesn’t change markedly with activity levels. Migraines also can be accompanied by light and sound sensitivity, nausea, and vomiting, symptoms which do not generally accompany other primary headaches.
Phases of a Migraine Attack
Migraine attacks generally occur in four distinct phases: the premonitory phase, the aura phase, the headache phase, and the postdrome phase. In the premonitory phase, sufferers experience non-painful, but ominous, symptoms like mood changes, food cravings, stiffness in the neck and shoulders, and slight sensitivity to light, sound, and smell. This phase indicates that an attack is imminent. From the premonitory phase, the attack will generally move into the aura phase, where sufferers who experience auras will generally begin to see flashing lights, “floaters,” blurred vision, and expanding blind spots. They can also lose gross and fine motor control and experience mental fog that makes it difficult to communicate clearly and understand others.
The third phase of a migraine is the arrival of the actual headache. This phase is what people generally call a migraine: throbbing, severe pain in one or both sides of the head and sensitivity to light, sound, and smell. The final phase of a migraine attack is the postdrome phase, during which the headache subsides and the sufferer is left exhausted, confused, and unwell. While it doesn’t feel like it, this is the recovery phase of a migraine attack.
Types of Migraines
Migraines can generally be divided into some critically important subcategories, which differ from one another by the symptoms and severity with which they impact sufferers. The four main classes of migraine headaches are:
- Migraine without aura – the most common form of migraine headaches, these are throbbing, painful headaches that generally affect one side of the head. They do not generally present symptoms before an attack, but sometimes sufferers of this kind of migraine can experience some of the premonitory phase symptoms described above.
- Migraine with aura – a throbbing, painful headache that is generally presaged or accompanied by intense auditory and/or visual disturbances, which are called auras. Some scientific studies have estimated the likelihood of suffering an aura before or during a migraine attack as high as one in three.
- Abdominal migraine – migraines accompanied by severe nausea, vomiting and abdominal pain. Sometimes these migraines do not even include a severe headache. They are generally more common in children.
- Hemiplegic migraine – a very rare form of migraines that causes temporary paralysis before or during an attack. Often accompanied by other serious neurological symptoms like vertigo, vision problems, and difficulty speaking or swallowing.
What is a Headache?
Headaches can generally be divided into two categories: primary headaches, which are an isolated medical condition, and secondary headaches, which are a symptom of another related medical condition. For both types, headaches cause pain in the head, neck, and shoulders and, in extreme cases, can last for hours. However, headaches are generally less severe, less frequent, and shorter in duration than migraines.
Types of Headaches
There are over three hundred different known causes, or triggers, for primary and secondary headaches. However, the two most common types of headaches are tension headaches, which present as a band of pressure around the head, and cluster headaches, which generally affect the area right behind the eyes. While migraines are generally more severe than other types of headaches, these conditions can be just as disabling as migraines for some individuals.
Unfortunately, there is no single test or procedure that can diagnose the cause of an individual’s headaches. Rather, you will need to work with a trained medical professional over a period of time to help them understand your symptoms, triggers, and history with headaches to arrive at a diagnosis. Pain management providers are one of the top medical professionals you can trust to diagnose and treat migraines, as the condition is one of the central foci of their scope of practice.
While there is no universal cure for chronic headaches or migraines, there are a number of things that can be done to help limit their severity. There is a variety of medications that can be used to quell the symptoms of a migraine, including triptans, opioid and non-opioid pain medication, and over-the-counter medicines like Tylenol or non-steroidal anti-inflammatory drugs. There are also procedures that can be performed by a physical therapy qualified healthcare provider, including Botox and steroid injections, nerve blocks, and nerve ablations. Finally, many people find success with complementary lifestyle interventions like diet, exercise, and home remedies, but these generally work best in concert with trusted allopathic interventions.
In any case, if you are suffering from chronic headaches that impact your ability to live life, you should seek medical attention as soon as possible. A trained headache professional can help diagnose your condition and develop a treatment plan aimed at controlling your headaches and getting you back to living your best life!