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Migraine Causes, Symptoms, and Treatments

Migraine is a disease with no cure. It affects the brain, spinal cord, and nerves.

Migraine symptoms often include a throbbing headache, nausea, and vomiting.

About 39 million people in the U.S. live with migraines, and 3 out of 4 are women.

Migraine pain is genetic. A migraine attack can last hours or days.

When that headache in front of your head starts to throb, seek relief from the UPMC Headache Center. Our board-certified doctors are here to help you.

We provide migraine medicine you can take at home and less-invasive, long-lasting treatments in our center.

On this page:



What Is A Migraine?

A migraine headache is pulsing pain caused by swollen blood vessels around the head's tissues. It may also cause other symptoms.

Migraine attacks make it hard to keep up with your day-to-day life.

What are the types of migraines?

Types of migraines include:

  • Episodic. These happen 15 days a month or less.
  • Chronic. These occurmore than 15 days a month for three months. They affect about 4 million Americans.

Some migraines have auras, which are sensory disturbances that accompany headaches.

Auras affect 1 in 5 people and are more common in men. Aura symptoms often start 10 to 30 minutes before a migraine.

A migraine without aura, or a common migraine, doesn't have sensory changes.

Another type of migraine is menstrual-related. These come right before, during, or after a person's period starts.

This menstrual migraine may be due to changes in hormone levels.

What causes migraines?

It's unclear what causes migraine.

Researchers think it may be due to changes in natural substances in the brain. When levels of these substances increase, they can cause the blood vessels in the brain to swell. This swelling presses on nerves, causing pain.

Also linked to migraine disease are faulty genes that control certain brain cell functions.

Migraine triggers are things likely to set off a migraine.

They vary from person to person and may include:

  • Weather changes.
  • Alcohol.
  • Caffeine.
  • Stress.
  • Anxiety.
  • Hormone changes.
  • Medicine.
  • Tobacco.
  • Not enough or too much sleep.
  • Skipping meals.

What are migraine risk factors?

You're more at risk for migraine disease if it runs in your family.

Migraine is also a greater risk for those who are:

  • Female.
  • Stressed.
  • Obese.
  • Smokers.
  • Anxious.
  • Depressed.

Can I prevent migraines?

At UPMC, we'll guide you through lifestyle and diet choices to manage your migraines. Migraine self-care can help you feel better.

Lifestyle changes that help prevent migraine attacks may include:

  • Drinking lots of water.
  • Keeping a set sleep schedule.
  • Eating healthy meals and snacks.
  • Not skipping meals.
  • Being active.
  • Limiting stress.
  • Deep breathing.
  • Reducing your sugar, alcohol, and caffeine intake.
  • Avoiding tobacco products.

Supplements can sometimes help with migraine symptoms, such as:

  • Magnesium.
  • Riboflavin.
  • Vitamin D.
  • Coenzyme Q10.

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Migraine Symptoms and Diagnosis

What are the signs and symptoms of migraines?

Migraine symptoms include pain in your temples, ears, eye, or any part of your head.

The pain is typically throbbing or pulsing. At times it's severe. It can be on one or both sides of the head.

Other migraine symptoms include:

  • Sensitivity to light, noise, and smell.
  • Nausea and vomiting.
  • Visual (auras) of zigzag or flashing lights before migraine.
  • A runny or stuffed nose.
  • Sinus pressure.
  • Feeling mentally foggy.
  • Numb or tingling face or hands.

How do you diagnose migraines?

Your doctor may ask you to keep a headache journal.

In it, track:

  • How often you get migraines.
  • Where you have pain.
  • What medicines you take.

This can help them make a diagnosis and decide on a treatment plan.

There's no test for migraine disease. Your doctor looks at your symptoms and family history and does a physical exam.

You may need imaging tests to rule out other health issues causing your headaches.

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What Are the Treatment Options for Migraines?

The UPMC Headache Center has the expertise to manage your migraine disease.

Our advanced treatments and cutting-edge drugs can relieve your acute pain without a trip to the ER.

Contact us to learn more about the UPMC Headache Center or plan a visit.

Pain relief and anti-nausea drugs

For migraine symptom relief, your doctor may suggest pain relievers and anti-nausea drugs. The first step may be taking over-the-counter drugs.

The prescription-strength versions of these same medicines may help if those don't work.

They include:

  • Nonsteroidal anti-inflammatory drugs.
  • Medicine that mixes pain relievers with caffeine.

If those don't help, they may suggest migraine medications.

Triptans to treat migraines

Triptans are migraine drugs that:

  • Help balance chemicals in the brain and block pain.
  • Shrink the brain's blood vessels.
  • Reduce swelling and block pain.

The side effects are:

  • Feeling flushed and warm.
  • Chest tightness.
  • Fast heartbeat.

Do not take these drugs if you smoke or have heart issues.

Triptans come in tablets, nasal sprays, and shots.

Sumatriptan shots to treat migraine headaches

Sumatriptan is a type of triptan doctors commonly use to treat migraines.

You inject the medicine just under your skin using the pre-filled auto-injection device. You can also get sumatriptan shots at the UPMC Headache Center.

Nerve block shots to treat migraines

Nerve block shots stop pain from reaching the brain by numbing the nerves.

To treat migraine, your doctor may target the seven main branches of the pericranial nerves in the scalp.

Your doctor will give you shots in your head and neck every three months. They inject a numbing solution and sometimes add anti-inflammatory medicine called corticosteroids.

Side effects of nerve blocks for migraines may include:

  • Bleeding.
  • Infection.
  • An allergic reaction.
  • Temporary numbness.

Trigger point shots for migraines

Trigger point shots help reduce migraine pain coming from muscles.

The shots are like nerve block shots. Your doctor may use the same solution for both.

They can give these shots at the same time to target both muscle and nerve pain with one treatment.

BOTOX® shots to treat chronic migraines

Botox shots can prevent chronic migraine attacks. Botox blocks the pain messages in the nerves coming from the muscles, turning off migraine pain.

Your doctor gives you a series of shots in your scalp every three months.

The risks are bleeding, bruising, or infection. Side effects may include neck pain and eyelid droop.

Calcitonin gene-related peptide (CGRP) receptor antagonists for migraines

CGRP receptor antagonists (gepants) are a newer class of migraine drugs. Doctors often use them on people who can't take triptans or when triptans haven't worked.

CGRP is a compound in the brain that causes inflammation. The medicine blocks inflammation caused by CGRP, reducing pain.

Gepants come in pill form or as a nasal spray. You take this drug when a migraine attack starts to reduce your symptoms. Side effects are nausea and constipation.

Some of these drugs also help to prevent migraines, too. In this case, you take the drug every day.

CGRP monoclonal antibodies

Monoclonal antibodies block CGRP or the CGRP receptor. They stop this compound from sending inflammation signals.

These antibodies are available as a self-injection pen. They do not work as quickly as acute migraine treatments but can help prevent migraines.

Some of these antibodies are available as a monthly shot. Others require a visit every three months for an infusion clinic. There are no major side effects.

Other medicines to help treat or prevent migraines

Your doctor may suggest other medicines to prevent migraine attacks. Some prescription drugs for other health issues can help treat or prevent migraines.

These include:

  • Antiseizure drugs.
  • Antidepressants.
  • Blood pressure medicine.

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