Catching—and treating—a migraine early could mean faster relief.
If you’re prone to migraines, you know just how debilitating the syndrome can be. When a migraine strikes, you’d probably do just about anything to find relief, and prevent it from happening again.
Aside from taking your prescribed migraine medication regularly and maintaining a healthy lifestyle—that means getting enough sleep, managing your stress levels, and eating a well-rounded diet—it’s also helpful to be able to detect migraine symptoms early, which may help you find faster relief when a migraine does strike.
“If you can treat migraines early, they’re more likely to respond to treatment,” says Mark Green, MD, a neurologist at the Mount Sinai Hospital in New York City. “We try to get people to identify the earliest symptoms of their migraine attack.”
Migraine pain is more difficult to treat once it sets in, because as the migraine advances, more of the brain is “recruited” in the migraine attack, says Dr. Green.
The Migraine Symptom Timeline
A migraine is divided into four phases, all of which may be present during the attack.
Prodrome is the first phase, when a person might feel subtle signs hinting that a migraine is coming. These symptoms occur up to 48 hours prior to developing a migraine. During this phase, a person may feel:
- Food cravings
- Unexplained mood changes (depression or euphoria)
- Uncontrollable yawning
- Fluid retention
- Increased urination
- Mild pain
“That [mild] pain is often one-sided, it’s often around the eye, and may begin as a pressure-like feeling, particularly if that’s the side where people experience their more severe attacks,” says Dr. Green.
Aura is the second phase, for some people—only 20 percent of people who suffer from migraines have aura. During an aura, a person may see flashing or bright lights, zig-zag lines, or what looks like heat waves immediately prior to or during the migraine.
The migraine headache is the third, which usually starts gradually and builds in intensity.
Postdrome is the feeling people get following the headache. People are often exhausted or confused following their migraine episode.
How to Treat a Migraine Early
“Migraine warning signs vary from person to person, and can vary within the same person as well,” says Dr. Green.
To help you detect migraine symptoms early, it may be helpful to keep a headache diary. This can help you pinpoint your triggers and how you’re feeling each day so you can start to learn what symptoms may be alerting you to a migraine.
When you feel a migraine coming on, track your headache pain from 0 (no pain) to 3 (worst pain) in the morning, afternoon, and evening each day until you find relief. You can also write down any lifestyle changes (good or bad), such as your sleep habits, what foods you ate, or if you smoked, and what medicine you took and whether or not it helped.
If you suspect a migraine coming on, here’s what you can do to help relieve it:
For mild migraines, your doctor might have suggested an over-the-counter (OTC) medicine, like acetaminophen (example brand name: Tylenol), ibuprofen (example brand names: Advil, Motrin), naproxen (example brand name: Aleve), or OTC meds that combine acetaminophen, aspirin, and caffeine (example brand name: Excedrin).
For more severe migraines, your doctor may have given you a prescription medicine. Doctors often prescribe medications to help treat individual migraine attacks, as well as medications to reduce the number of attacks, says Dr. Green.
Important: It’s a myth that you should treat frequent migraines on your own with non-prescription pain medicines. Taking non-prescription pain medicines too often may actually cause more headaches later. “So the earlier [you take your meds] the better, as long as it’s not very often, where you’re at risk of developing medication overuse headache,” says Dr. Green. Learn about more common migraine myths.
Whether you feel a migraine coming on or you’re already experiencing an attack, there are certain things you can do at home that may also make you feel better, such as:
- Resting with your eyes closed in a quiet, darkened room
- Placing a cool cloth or ice pack on your forehead
- Drinking fluids
- Trying these science-backed migraine home remedies
Dr. Green is a neurologist at the Mount Sinai Hospital in New York City. He is the director of the Center for Headache and Pain Medicine and professor of Neurology, Anesthesiology, and Rehabilitation at the Icahn School of Medicine at Mount Sinai.
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And migraine warning signs
vary from person to person and
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can vary within the same person as well.
00:00:08,623 --> 00:00:09,229
So we try and
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get people to identify the earliest
symptoms of their migraine attack.
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00:00:19,633 --> 00:00:23,970
The most common warning sign
of an attack is mild pain and
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that pain is often one-sided.
00:00:26,476 --> 00:00:31,523
It's often around the eye, and may begin
as a pressure-like feeling, particularly
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if that's the side that people
experience their more severe attacks.
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They often have the same
side all the time, but
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they can switch to the other side,
and often people will say,
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my left-sided ones are different
from my right-sided ones.
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Another very common early sign
of a migraine is you begin to
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If you're one of the 20% of people
with migraine or have an aura,
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they're more dramatic because it can be
bright flashing lights or zigzag lines,
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and people with migraine recognize
that that's part of the attack.
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The time from the beginning to the time
of maximal disability varies very widely.
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And often we change our therapy
based on how long it takes.
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Most commonly, someone develops an early
symptom and will tell me that it reaches
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full intensity a few hours later, but
sometimes it'll occur minutes later.
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If you can treat migraines early, they're
more likely to respond to treatment.
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That's true with every agent we have for
the acute treatment of migraine.
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So the earlier, the better, as long as
it's not very often where you're at risk
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of developing medication overuse headache.
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As the migraine advances, more of the
brain is recruited in the migraine attack.
00:01:39,628 --> 00:01:44,599
So if you can catch it early, you may stop
a variety of bad events that occur in
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parts of the brain that will lead to a
very prolonged and more refractory attack.
00:01:49,898 --> 00:01:54,772
Migraine Headaches in Adults (The Basics). UpToDate. (Accessed on August 15, 2018 at https://www.uptodate.com/contents/migraine-headaches-in-adults-the-basics)
Migraine Headaches in Adults (Beyond the Basics). UpToDate. (Accessed on August 15, 2018 at https://www.uptodate.com/contents/migraine-headaches-in-adults-beyond-the-basics)
What Is a Migraine? National Institutes of Health. MedlinePlus magazine. Fall 2015. (Accessed on August 15, 2018 at https://medlineplus.gov/magazine/issues/fall15/articles/fall15pg4-5.html)