They’re one of the most common causes of productivity losses due to disability in the world. Globally, the WHO estimates that roughly one in seven adults suffer from them, forming over 30% of all headache sufferers. In moderate to severe cases, they can make it profoundly difficult for people to work or have a satisfying life.
Migraines are no trivial matter. Yet, there is still little widespread awareness about this type of headache disorder. This means that many people who live with migraines don’t receive timely guidance on how to deal with this sometimes-debilitating condition. Taking us through five important things to know about migraines is Dr U Meenakshisundaram, Senior Neurologist, Apollo Hospitals.
Not always one-sided
One of the most commonly known facts about migraines is that they are most often aches affecting only one side of the head. Yet, explains Dr Meenakshisundaram, this is not always the case. “The characteristic migraine is one-sided, but you can have a headache that affects both sides too,” he explains. Instead, experts advise, migraines should be diagnosed based on the nature and intensity of the pain, as well as additional symptoms like pulsating quality, aura, nausea, and dizziness.
Head baths can trigger migraines
For those prone to googling their symptoms, experts warn that much of the information on migraines available online is geared towards US or European readers. This may not cover some of the triggers more common in Indian conditions. “For some people, especially women, a head bath can trigger migraines. This is more peculiar to our country. It has not been reported from other countries,” explains Dr Meenakshisundaram.
He adds that dehydration and exposure to the sun are other very common triggers for migraines in Indian conditions. High humidity, travel fatigue, and fasting practices are some of the other triggers that have been identified.
Dr. U Meenakshisundaram
Migraines peak between ages 30 to 40
Migraines follow a cycle that peaks between ages 30 to 40 for many patients, and then falls away by age 50, explains Dr Meenakshisundaram. For many, migraines start in adolescence, and become severe by age 25 to 30. Between ages 30 to 40, the headaches hit a peak. But one advantage of aging is that after 50, the frequency and intensity of headaches go down for many, but not all, patients. “If someone experiences a new headache after age 50, that’s usually a red flag to look for other causes,” explains the doctor.
Not just over-the-counter painkillers
There have been a great many advances in the treatment of migraines, both in terms of acute and preventive medication. While over-the-counter analgesics, including paracetamol, can work for some people with episodic migraines, they do not produce relief for all. For such patients, triptans, a class of drugs developed specifically for migraines, can provide great relief when a headache episode sets in. Triptans work by stimulating the neurotransmitter serotonin to constrict blood vessels and reduce inflammation.
However, relying on only acute medications is not an option for those suffering from three to four migraines a week. After all, says Dr Meenakshisundaram, “We must remember that even paracetamol, though it is considered an innocuous drug, is one of the common causes of liver failure,” he says. For such patients, prophylactic or preventive medications can come to the rescue. These are medications taken over an extended period of time, between six to 12 months, and can have a significant effect on the frequency and severity of migraines.
Not just a headache
Besides dealing with the condition itself, one of the significant difficulties most people with migraines face is to explain the severity of their condition to those without the condition. What these people fail to understand is that in terms of duration, intensity and frequency, migraines can be much more disruptive than other types of headaches. “Migraines generally last from four to 72 hours,” explains Dr Meenakshisundaram. Besides the pain itself, migraines are often associated with symptoms such as nausea and vomiting, dizziness, sensitivity to light and sound, and so on. And migraines can occur over three times a week, in extreme cases going up to more than 20 days a month. All of this means that migraines can be a significant burden in education and the workplace, and can significantly hamper a person’s social and emotional life.
This article has been produced by TNM Brand Studio in association with Apollo Hospitals and not by TNM Editorial.