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Migraine Headaches

Migraines are extremely painful, recurring headaches that are sometimes accompanied by other symptoms such as visual disturbances — seeing an aura — or nausea. There are two types of migraine — migraine with aura, formerly called common migraines, and migraine without aura, formerly called classic migraines.

If you have a migraine with aura, you may see things such as stars or zigzag lines or have a temporary blind spot about 30 minutes before the headache starts. Even if you don’t experience an aura, you may have other warning signs in the period before the headaches starts, such as a craving for sweets, thirst, sleepiness, or depression.

Although there is no cure for migraines, you can manage the condition by reducing the frequency of attacks and reducing pain once an attack starts.

Signs and Symptoms:

The headache from a migraine, with or without aura, has the following characteristics:

  • Throbbing, pounding, or pulsating pain
  • Often begins on one side of your head and may spread to both or stay on one side
  • Most intense pain is often concentrated around the sides of the forehead
  • Can last from 4 – 72 hours

These symptoms may happen at the same time or before the headache:

  • Nausea and vomiting
  • Dizziness, lightheadedness, or even vertigo (feeling like the room is spinning)
  • Loss of appetite
  • Fatigue
  • Visual disturbances, like seeing flashing lights or zigzag lines, temporary blind spots, or blurred vision
  • Parts of your body may feel numb, weak, or tingly
  • Light, noise, and movement — especially bending over — make your head hurt worse; you want to lie down in a dark, quiet room
  • Irritability

Symptoms that may linger even after the headache is gone:

  • Feeling mentally dull, like your thinking is not clear or sharp
  • Sleepiness
  • Neck pain

Causes:

Researchers aren’t sure what causes a migraine, although they know it involves changes in the blood flow in the brain. At first, blood vessels narrow or constrict, reducing blood flow and leading to visual disturbances, difficulty speaking, weakness, numbness, or tingling sensation in one area of the body, or other similar symptoms. Later, the blood vessels dilate or enlarge, leading to increased blood flow and a severe headache.

There also seems to be a genetic link to migraine headaches. More than half of migraine patients have an affected family member.

Migraine triggers can include the following:

  • Alcohol, especially beer and red wine
  • Certain foods, such as aged cheeses, chocolate, nuts, peanut butter, some fruits (like avocado, banana, and citrus), foods with monosodium glutamate (MSG), onions, dairy products, meats containing nitrates (bacon, hot dogs, salami, cured meats) fermented or pickled foods
  • Skipping meals
  • Crying
  • Fluctuations in hormones — for example, during pregnancy, before and during your period, and menopause
  • Certain odors, such as perfume or smoke
  • Bright lights
  • Loud noises
  • Stress, physical or emotional — often, the headache happens when a person is relaxing after a particularly stressful time
  • Sleeping too little or too much
  • Caffeine
  • Smoking or exposure to tobacco smoke
  • Some medications
  • Heat, high humidity, and high altitude

Risk Factors:

  • Gender — women are nearly 3 times more likely to get migraines than men
  • Having other family members with migraine headaches
  • Being under age 40; migraines tend to get better as you age
  • Taking birth control pills, if your migraines are affected by changes in estrogen levelsExposure and sensitivity to any of the potential triggers listed above

Diet:

The following foods may trigger migraine headaches:

  • Chocolate
  • Cheese
  • Monosodium glutamate (MSG), a flavor enhancer found often in food from Chinese restaurants
  • Foods containing the amino acid tyramine, found in red wine, aged cheese, smoked fish, chicken livers, figs, and some beans
  • Nuts
  • Peanut butter
  • Some fruits, like avocado, banana, and citrus
  • Onions
  • Dairy product
  • Meats containing nitrates, such as bacon, hot dogs, salami, cured meats
  • Fermented or pickled foods

 

If you think that any of these foods cause your migraines, try eliminating all the items on this list from your diet and then reintroducing them one at a time. Pay close attention to when the number of headaches increases after eating certain foods. Then you know which trigger foods to avoid. You may also want to consider food allergy testing to determine your specific sensitivities or triggers.

Courtesy of University of Maryland Medical Center