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The head of all aches

Navigating the trials and tribulations of migraines.

Article Author: Kyndal Rock

Article Date:

Image of a woman bent over the sink clutching her head with her eyes closed.

When you get a headache, you may wonder about what caused it. Am I dehydrated? Have I had too much or not enough caffeine? Is it stress, lack of sleep or staring at my computer screen for too long? Or could it be a migraine?

According to the National Headache Foundation, almost 40 million Americans (one in every four U.S. households) suffer from migraines, with attacks typically starting during adolescence or in people in their 20s.

The pain of a migraine 

So, what is a migraine, exactly?

Migraines are a neurological disorder caused by the activation of a mechanism deep in the brain that leads to the release of pain-producing inflammatory substances around the nerves and blood vessels of the head, according to the World Health Organization.

Usually located on one side of the head, migraines are characterized by throbbing head pain and sensitivity to light and/or sound. This combination of pulsating pain and sensitivity often prevents individuals from performing daily activities such as their work, schoolwork or household chores.

“Migraines are a disease of our brain,” said Steven Toenjes, MD, a board-certified neurologist with Baptist Neurology Group. “In many cases, a migraine is an event for people that can last up to an entire week with symptoms ranging from moderate to severe.” 

Calm before the storm

Many different factors can trigger a migraine, and they are not the same for everyone. What causes a migraine in one person may relieve it in another.  

“There are a variety of things a migraine patient will do as a reliable way to kickoff what happens in a migraine, these are triggers the person will often notice,” said Dr. Toenjes.

Some notable triggers for migraines include: 

  • Light
  • Smell
  • Stress
  • Caffeine
  • Alcohol
  • Weather
  • Lack of sleep, changes to sleep patterns
  • Barometric pressure changes
  • Dehydration

“For the most part, triggers are going to be pretty obvious to a migraine patient,” said Dr. Toenjes. “Most of the time, patients are going to tell us what their triggers are, though some can be difficult to notice, such as caffeine overuse and changes to sleep patterns.”

Migraine forecast 

According to the American Migraine Foundation, migraines have distinct phases and understanding which phase you are in can help you identify and treat the migraines early on or help you prevent or minimize the side effects.

Phase one

The beginning of a migraine attack is called the prodrome phase and can last anywhere from a few hours to a couple of days, said Dr. Toenjes.

This phase is categorized by fatigue, irritability, sensitivity to light and sound, nausea, excessive sleepiness, lack of concentration and aphasia (difficulty reading and speaking).

Phase two

The aura phase is spread over a period of minutes, tends to last less than an hour, and will most likely be followed by the pain “attack” phase shortly after.

This phase is not always present in people who suffer from migraines.

“Aura symptoms can be quite variable, but most commonly will include visual disturbances, temporary loss of sight, and the spreading of numbness or tingling over the body,” said Dr. Toenjes. 

Phase three

The next stage of the migraine is known as the “attack phase” and can last anywhere from four to 72 hours.  

“This is the obvious pain phase when your head hurts,” said Dr. Toenjes. The attack phase can be categorized by sharp, searing pain, throbbing or pulsating pain, nausea or vomiting, as well as sensitivity to light, smell or sound. 

Final phase

Known as the “migraine hangover,” this last phase can last anywhere from 24 to 48 hours. 

“Once the attack phase is over, there can be this hangover type of effect following the attack phase that can go on for another day or two,” said Dr. Toenjes. "It is often categorized by symptoms such as fatigue, mental fogginess, rundown, insomnia and irritability."

Light at the end of the rainbow  

Treatment options for migraines vary with each person, but there are several strategies and preventive medications a person can take. These may include taking medicine each day or activities one can do consistently that help reduce migraine frequency.  

It’s important to take care of ourselves and know how to cope with migraines when they unexpectedly strike. Healthy lifestyle habits such as establishing a sleep routine, eating a healthy diet, exercising regularly and finding the time to relax during stressful days can help.

“How we might behave to mitigate or minimize the way triggers affect us can significantly influence the headache syndrome,” said Dr. Toenjes.  

When to consult with a doctor

When migraine episodes start to negatively impact your everyday life and ability to function, it is important to go to see a professional to make sure it is not a medical emergency. 

“If you’re avoiding activities, missing work, experiencing reduced productivity and avoiding social engagements, you should seek the advice of a medical expert,” said Dr. Toenjes. “The name of the game is reducing the headache-related impact on a migraine patient’s life.”  


If you or a loved one suffers from frequent migraines, you are not alone. Medical specialists with Baptist Neurology Group are highly qualified to treat conditions of the spine, brain and nervous system.

Sources: National Headache FoundationWorld Health OrganizationAmerican Migraine Foundation

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