Understanding Migraine
Explore the causes, symptoms, and triggers of migraines, and learn effective strategies for relief and prevention.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. M L Ezhilarasan MBBS
Last updated on 26th Sep, 2025
Introduction
If you’ve ever experienced a migraine, you know it’s far more than just a "bad headache." It's a complex neurological condition that can be utterly debilitating, disrupting work, social life, and overall well-being. Characterised by intense, throbbing pain, often on one side of the head, migraine attacks are frequently accompanied by a host of other symptoms like nausea, vomiting, and extreme sensitivity to light and sound. For many, the experience includes distinct warning signs and phases, making it a multi-day ordeal. This article aims to demystify migraine, providing a comprehensive guide to its stages, symptoms, causes, and most importantly, management strategies. Whether you’re seeking answers for yourself or a loved one, understanding the mechanics of a migraine is the first step toward reclaiming control. We will explore everything from identifying your unique triggers to the latest treatment options, empowering you with knowledge and practical advice.
What exactly is a Migraine?
A migraine is a primary headache disorder, meaning it’s a condition in itself, not a symptom of another underlying illness. It's a genuine neurological disease that involves nerve pathways and chemicals in the brain. The World Health Organisation ranks migraine as one of the most disabling illnesses globally. Attacks can last anywhere from a few hours to several days, and their frequency varies dramatically from person to person; some experience them rarely, while others have chronic migraines, defined as 15 or more headache days per month.
Migraine vs. Headache: Knowing the Difference
It's crucial to distinguish a migraine from a common tension headache. While both cause pain, their characteristics are different. A tension headache typically presents as a constant, dull pressure or ache around the entire head, like a tight band. It doesn't usually prevent you from going about your day. A migraine, however, is often a severe, pulsating pain localised to one side. It’s frequently aggravated by physical activity and paired with other debilitating migraine symptoms in adults like nausea, vomiting, and sensory sensitivities. Understanding this difference is key to seeking the right treatment.
The Four Stages of a Migraine Attack
A migraine attack can unfold in up to four distinct phases, though not everyone experiences all of them. Recognising these stages can help you identify an impending attack and take early action.
Stage 1: The Prodrome (The Warning Phase)
This subtle pre-headache phase can begin 24 to 48 hours before the pain hits. Often called the "premonitory" phase, it signals a migraine is on the way. Symptoms are diverse and can include:
- Mood changes (euphoria, depression, irritability)
- Food cravings
- Neck stiffness
- Increased yawning
- Fluid retention
- Fatigue
Stage 2: The Aura (Not Everyone Experiences This)
About 25-30% of people with migraines experience an aura, which typically occurs just before or during the headache.Migraine with aura symptoms are primarily visual but can involve other senses. They usually develop gradually over several minutes and can last up to an hour. Examples include:
- Seeing flashing lights, zigzag lines, or blind spots (scotomas)
- Tingling or numbness in the face or hands
- Speech difficulties (aphasia)
Stage 3: The Headache Attack
This is the most acute phase, characterised by intense, throbbing pain. The pain can be unilateral (one-sided) or
bilateral. It often comes with:
- Nausea and vomiting
- Extreme sensitivity to light (photophobia) and sound (phonophobia)
- Dizziness and lightheadedness
- The pain typically worsens with physical activity.
Stage 4: The Postdrome (The "Migraine Hangover")
After the main attack subsides, many people experience a postdrome phase that can last a day or two. People often feel drained, washed out, and confused. Some report feeling unusually refreshed or euphoric, while others continue to have a dull headache and sensitivity to light and sound.
Consult a Neurologist for the best advice
Common Migraine Symptoms: Beyond the Pain
While head pain is the hallmark, the symptoms of a migraine are multifaceted. The key is the combination of
symptoms. In addition to the phases above, the core symptoms during an attack include:
- Moderate to Severe Throbbing Pain: Often described as a pounding or pulsating sensation.
- Unilateral Pain: Although it can affect both sides, pain on one side of the head is classic.
- Nausea and Vomiting: These gastrointestinal symptoms are very common.
- Sensory Sensitivity: Bright lights, loud noises, and strong smells can become unbearable.
- Visual Disturbances: Even without a full aura, vision may be blurry.
What Causes a Migraine?
The exact causes of a migraine are still being researched, but it's understood to be a complex interplay of genetic and environmental factors.
The Neurological Basis
Researchers believe a migraine begins when overactive nerve cells send out impulses that trigger the trigeminal nerve, a major pain pathway. This leads to the release of neurotransmitters like serotonin and calcitonin gene-related peptide (CGRP), which cause inflammation and swelling of blood vessels in the brain, resulting in pain.
Identifying Your Personal Migraine Triggers
While the underlying cause is neurological, specific factors can trigger an attack. Triggers are highly individual, which is why keeping a headache diary is so valuable.
Common Trigger Categories
- Hormonal Changes: Fluctuations in estrogen, particularly in women, are a common trigger (menstrual migraines).
- Dietary Factors: Alcohol (especially red wine), caffeine, aged cheeses, processed foods, and skipping meals.
- Sensory Stimuli: Bright or flashing lights, loud sounds, strong smells.
- Stress: Both during stressful periods and during the "let-down" period after stress (weekend migraines).
- Sleep Changes: Both lack of sleep and oversleeping.
- Environmental Factors: Changes in weather or barometric pressure.
Effective Migraine Treatment Strategies
Managing migraine involves two main approaches: stopping attacks once they start and preventing them from occurring as often.
Acute Treatments: Stopping an Attack in Its Tracks
These are used at the first sign of a migraine to relieve pain and shorten the attack. How to get rid of a migraine fast often depends on acting quickly. Options include:
- Over-the-counter (OTC) pain relievers: Ibuprofen, aspirin, or naproxen. However, overuse can lead to medication-overuse headaches.
- Triptans: Prescription drugs that block pain pathways in the brain. They are a cornerstone of acute migraine treatment.
- Anti-nausea medications: To relieve associated nausea and vomiting.
- Newer drugs: Gepants and ditans, which target different neurotransmitters like CGRP, offer options for those who can't take triptans.
Preventive Treatments: Reducing Frequency and Severity
If you have frequent or severe migraines, your doctor may recommend daily medication to reduce their occurrence. These chronic migraine treatment options include:
- Blood pressure medications: Beta-blockers like propranolol.
- Antidepressants: Certain types can help prevent migraines.
- Anti-seizure drugs: Topiramate or valproate.
- CGRP Monoclonal Antibodies: A newer class of drugs specifically designed for migraine prevention, administered via monthly or quarterly injections.
- Botox Injections: OnabotulinumtoxinA (Botox) is approved for preventing chronic migraines in adults.
Lifestyle and Home Remedies for Migraine Management
Alongside medication, lifestyle adjustments are a powerful tool for migraine prevention.
The Power of a Routine
Maintaining a consistent daily schedule can significantly reduce attacks. This includes:
- Regular Sleep: Go to bed and wake up at the same time every day, even on weekends.
- Balanced Meals: Eat at regular intervals and don't skip meals. Stay hydrated.
- Regular Exercise: Moderate, consistent exercise like walking or swimming can reduce stress and the frequency of migraines.
Relaxation Techniques and Complementary Therapies
Stress is a major trigger. Incorporating natural remedies for migraine relief like relaxation can be highly effective:
- Mindfulness and Meditation: These practices can help manage the stress that triggers migraines.
- Biofeedback: A technique that teaches you to control bodily functions like heart rate to reduce pain.
- Acupuncture: Some studies show acupuncture can be an effective preventive treatment.
When to Seek Professional Help for Your Migraines
While many manage migraines on their own, certain symptoms warrant immediate medical attention. You should consult a doctor if your headaches:
- Are sudden and extremely severe ("thunderclap" headache).
- Are accompanied by fever, stiff neck, confusion, seizures, double vision, or weakness/numbness.
- Start after a head injury.
- Worsen despite rest and OTC medication.
If your migraines are disrupting your life, it's essential to get a proper diagnosis and a personalised treatment plan. If your condition does not improve after trying these methods, consult a neurologist online with Apollo24|7 for further evaluation and to discuss preventive treatment options.
Conclusion
Living with migraine can be challenging, but it's important to remember that you are not powerless. By understanding the nature of your condition, recognizing the stages, identifying your unique triggers, and exploring a combination of medical and lifestyle strategies, you can significantly reduce the impact of migraines on your life. Effective management is a personalised journey, often involving trial and error to find what works best for you. Don't hesitate to seek support from healthcare professionals who can guide you toward the most advanced migraine treatment options available today. Taking proactive steps towards understanding and managing your migraine is the most powerful way to move from simply enduring attacks to actively controlling them and improving your quality of life. If you need help creating a management plan, consider booking a consultation with a specialist.
Consult a Neurologist for the best advice
Consult a Neurologist for the best advice
Dr Debnath Dwaipayan
Neurosurgeon
9 Years • MBBS, MS(Gen. Surgery), DrNB (Neurosurgery)
Delhi
Apollo Hospitals Indraprastha, Delhi
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS, MD(GENL.MED.),DM(NEUROLOGY)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
(25+ Patients)
Dr. Dhruv Zutshi
Neurologist
17 Years • D.M (Neurology), M.D (Medicine), MBBS
Delhi
Apollo Clinic East Of Kailash, Delhi
Dr. Avinash Gupta
Neurologist
12 Years • MBBS, DNB - Neurology
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(125+ Patients)
Consult a Neurologist for the best advice
Dr Debnath Dwaipayan
Neurosurgeon
9 Years • MBBS, MS(Gen. Surgery), DrNB (Neurosurgery)
Delhi
Apollo Hospitals Indraprastha, Delhi
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS, MD(GENL.MED.),DM(NEUROLOGY)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
(25+ Patients)
Dr. Dhruv Zutshi
Neurologist
17 Years • D.M (Neurology), M.D (Medicine), MBBS
Delhi
Apollo Clinic East Of Kailash, Delhi
Dr. Avinash Gupta
Neurologist
12 Years • MBBS, DNB - Neurology
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(125+ Patients)
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Frequently Asked Questions
1. What is the difference between a migraine and a sinus headache?
Migraines are often misdiagnosed as sinus headaches because both can cause facial pressure and pain. However, migraines are typically accompanied by nausea, vomiting, and sensitivity to light/sound, which are not features of a true sinus infection. If you're frequently treating 'sinus headaches' without success, you may be experiencing migraines.
2. Can children get migraines?
Yes, children can get migraines. Migraine symptoms in children may be slightly different; the pain is often bilateral (on both sides of the head), and attacks may be shorter. Abdominal pain and vomiting can be more prominent.
3. Are there specific foods I should avoid to prevent migraines?
Common dietary triggers include aged cheeses, processed meats (containing nitrates), artificial sweeteners, monosodium glutamate (MSG), alcohol (especially red wine), and excessive caffeine. However, triggers are highly individual, so keeping a food diary is the best way to identify your personal triggers.
4. What are some natural remedies for migraine relief?
Some people find relief with natural remedies for migraine relief such as applying a cold compress to the head or neck, resting in a dark, quiet room, practicing relaxation techniques like deep breathing, drinking water to combat dehydration, and using ginger to reduce nausea.
5. Can weather changes really trigger a migraine?
Yes, changes in weather or barometric pressure are a well-documented trigger for many people. Sudden shifts, such as before a storm, can precipitate a migraine attack.