A migraine doesn't necessarily mean you have head pain. Weakness, flashing lights, even belly pain can be a sign you're suffering from this debilitating illness. Here's how you can take control of your symptoms.
By Jessica Migala
Your head hurts – that much you know.
But what sets a migraine apart from other types of headaches is that the pain is moderate to severe, often one-sided, throbbing, and accompanied by nausea, vomiting, and neurological symptoms like sensitivity to light, explains neurologist Stephen Silberstein.
But that’s just the beginning, Silberstein says.
There are many types of migraines – all of which are identified by their dominant symptom.
Knowing what’s going on with your head can put you on the road to being pain-free.
This type of migraine comes on fast and strong.
“If you have a sudden onset of an acute headache, consider it something bad until proven otherwise,” says Dr. Silberstein.
Not to scare you, but the “worst head pain of your life” can be a brain haemorrhage, for instance, he warns.
Seek emergency care, particularly if you’re a woman over 50 since you’re already at an increased risk for stroke.
If you feel like you’re off balance and couldn’t possibly walk a straight line, it may be a vestibular migraine.
This is characterized by symptoms of vertigo (dizziness) and very little headache, says Dr. Silberstein.
And it’s incredibly common – 40 percent of migraine sufferers have vestibular problems at one time, according to the nonprofit VeDA.
Unfortunately, in this case, it’s very easy to be misdiagnosed with vertigo (and not migraine). Make sure your doctor knows all of your symptoms.
The good news is that many of the medications that treat vertigo also treat migraines, says Dr. Silberstein.
Even if you have just one migraine a month, that can feel like too many.
But if you suffer headaches on 15 or more days a month, you have chronic migraines.
“These types of patients need to see a neurologist,” says Dr. Silberstein, adding that there are a number of medications and treatments that can restore comfort in your life (Botox being one of them).
It’s critical that you address the pain rather than live with it, as migraines affect everything from your social life to your romantic relationships, and your love life.
If you have kids, you may have heard them describe the symptoms of an abdominal migraine: moderate to severe soreness around the belly button, along with nausea, vomiting, and loss of appetite, according to the American Migraine Foundation.
It can last anywhere between two to 72 hours. Most children grow out of it, but it’s often an indication that they’ll develop migraines later in life.
Diagnosis is largely made by ruling out other conditions (like gastrointestinal problems).
Medications like NSAIDs or triptans may be recommended to control pain.
The first time you have it, it will be scary: You’ll see visual disturbances like flashing lights and, during that time, head pain will be minimal, says Dr. Silberstein.
Usually, it lasts about 30 minutes, and a headache may or may not follow.
If you know that this happens to you and it’s a warning sign that you’re about to get a migraine, that’s the time to take medication.
“Migraines spread like forest fires. Treat them early,” he says.
Of all the types of migraine (including thunderclap), this is one that’s likely to send you straight to the ER.
You could have weakness on one side of your body, vision changes, confusion, poor muscle coordination, and nausea – this will really feel like a stroke.
It’s actually a form of migraine aura or a “warning phase” of a migraine.
“The first time you have it, there will be no way to tell the difference between a hemiplegic migraine and a stroke,” says Dr. Silberstein.
For any headache that is new or different, seek urgent care.
If you already know you’re susceptible to them (hemiplegic migraines run in families), an ER visit isn’t likely needed, but wait until you get that OK from your doctor first.
Since this is a rare form of migraine, you’ll want to work with a headache specialist to come up with a treatment plan.
If you have a migraine, the last thing you’ll want to do is exercise – and that’s a good thing since physical activity makes an attack worse, says Dr. Silberstein.
But for some people, exercise is the trigger, which can certainly put a cramp in any future fitness goals.
If that’s you, Dr. Silberstein advises taking an ibuprofen and drinking a lot of water before hitting the gym.
It’s difficult to tell someone to remain calm when they’ve just gone blind in one eye – but this is exactly what can happen in a retinal migraine.
And get this: according to the American Migraine Foundation, this symptom (which is a type of aura and may precede a headache) can last from one minute to months.
Take a deep breath – your sight will come back, so let that reassure you.
However, it may be a sign of a serious underlying health problem.
Talk to your doctor asap.
Treating your migraine
Although there are many types of migraines, there are really two ways to manage or avoid your pain.
After being evaluated by a doctor, your options are: “prophylactic” – to prevent them; or “acute” – to make them go away, says Dr. Silberstein.
Preventatives are taken daily and may include beta blockers or antidepressants; NSAIDs, triptans, or ergotamines, which turn down the volume on pain pathways, can help squelch acute attacks.
And don’t forget non-drug treatments. Dr. Silberstein recommends patients try yoga, biofeedback, or meditation.
“There’s good evidence that they all help to control headaches, so you don’t have to pop a pill every time,” he says.