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Migraine pain relief: How to identify triggers?
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Migraine pain relief: How to identify triggers?

The most effective approach to preventing migraine headaches is to identify and steer clear of the triggering factors, say experts
Photo by Anantha Subramanyam K / Happiest Health

During bouts of intense headaches where the pain radiated to her eyes and the back of her ears leading to nausea, Roshni Roy found solace sitting in a quiet, dark room. She hoped that the migraine pain would subside quickly because enduring it seemed to be the only way open to her.

Roy, a 24-year-old MSW student from Kottayam, Kerala, was diagnosed with migraine when she was in eighth grade. Although she suffered from severe headaches and associated symptoms for a year, she and her parents initially attributed them to her previously diagnosed vision problems. As the headaches became increasingly unbearable, particularly when exposed to intense light and sound, Roy and her parents sought medical advice. It was only with the doctor’s intervention that they came to understand it was not a regular headache but rather a migraine triggered by intense light and loud noise.

How migraines vary from regular headaches?

While a normal headache is usually accompanied by mild to moderate pain, migraine is a recurrent problem characterized by acute, episodic pain that usually occurs in two or three episodes within a week. Chronic migraine lasts for more than 15 days in a month.

According to Dr Shubha Subramanian, a neurologist in Kauvery Hospital Vadapalani, Chennai, a migraine is a type of headache that generally has a pattern. It usually begins as a prodromal complaint — early, vague symptoms that may occur before the onset of an illness. In migraine episodes, it appears as excessive tiredness, frequent yawning, neck pain, etc., followed by an ‘aura.’

“Not everyone experiences aura before a migraine episode,” says Dr Subramanian. “Aura could show up as speech arrest, numbness around the mouth, transient numbness or weakness in a limb, eye flashes, zigzag lines or floating objects in the field of vision before the onset of the migraine.

“After the aura, within 30 to 60 minutes, people can end up having severe headaches, sometimes associated with nausea and vomiting. They might also experience photosensitivity or phono sensitivity, in which they cannot tolerate bright lights or intense noise,” adds Dr Subramanian.

While symptoms vary from person to person, the above-mentioned scenario is the most prevalent way migraines occur.

What triggers migraine?

From a strong odor of perfume or fuel to exposure to sunlight, a migraine trigger is a particular stimulus or factor that can cause the onset of a migraine episode. It can be anything, including hormonal changes, certain foods or dietary habits, irregularities in sleep, stress, changes in weather, etc.

Everybody with migraine may not have each of these triggers, but it is possible to identify their own triggers,” says Dr Subramanian. “Migraines are commonly brought on by sleeplessness, but in certain cases, migraines can also be caused by excessive sleep. When some people experience migraines from caffeine exposure after drinking coffee, others experience migraines from caffeine withdrawal.”

By altering changes in the brain and blood vessels, varied triggers can cause the onset of a migraine episode based on individual thresholds.

The importance of identifying migraine triggers

Migraine is a self-limiting condition and there is no known cure for it. Fortunately, they are manageable and their frequency can be reduced with treatments and lifestyle changes. Finding out your migraine triggers is a crucial part of it.

“Finding one’s migraine triggers is even more important than the treatment itself,” says Dr Mithilesh Kumar, consultant anaesthesiology, pain and palliative care, Sir Ganga Ram Hospital, Delhi. “Even though we try to reduce the frequency and severity of headaches by putting them on anti-migraine agents, we cannot say one specific medicine will solve the problem completely. Something triggers migraines. Half the battle is won if you can identify the trigger and avoid it. If you can avoid the triggers completely, it is possible to prevent migraines and improve quality of life.”

How to identify your migraine trigger

People usually experience the onset of migraines due to multiple factors. As a result, they struggle to identify their triggers. Experts advise keeping a migraine diary or chart where you can track your migraine pattern, which makes it easier for you to identify the triggers.

“In the migraine diary, you must track details about what caused your headache, how long it lasted, how severe it was, how often you had to take medication to manage it, how often you had headaches after taking medicine, etc.,” says Dr Kumar.

It also significantly helps doctors in deciding when to escalate or de-escalate treatment when a migraine chart is maintained,” says Dr Subramanian.

“For instance, I might prescribe an individual both an SOS medication and a preventative medication initially,” adds Dr Subramanian. “If, after the course, I notice from the diary that the frequency and severity of the complaints have not decreased as much as they should, I change the prescription. Hence, it is beneficial if the person keeps an organized headache diary.”

Takeaways

  • Acute episodic migraine, which occurs in two or three episodes per week, and chronic migraine, which lasts continuously for more than 15 days per month, are the two types of migraine.
  • A specific stimulus or factor known as a migraine trigger can set off a migraine attack in people who are vulnerable to it.
  • A trigger can be anything, including changes in hormones, dietary preferences or foods, abnormal sleep patterns, stress, weather conditions, etc.
  • According to experts, keeping a migraine diary or chart might help you track your migraine patterns and identify your triggers. Avoiding one’s trigger is essential to preventing the episodes.

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