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Think you know all about migraines? Check out these common myths

Michael Nelson, MD

Migraines cause severe, pulsating head pain along with other symptoms. The condition is extremely common and can be debilitating, yet it often goes undiagnosed. Confusion about what migraines are and the treatments available mean many patients try to manage any headache-like pain on their own. But they don’t have to. A primary care doctor or a neurologist can help get migraines under control. Check out the myths and facts below to learn more about this condition and how doctors can treat it.

Myth: Migraines are just really severe headaches.

Fact: Headaches and migraines have different symptoms. A regular headache occurs on both sides of the head and may also include neck pain. A migraine usually occurs on one side of the head and is frequently accompanied by nausea, sensitivity to light and sound, or even shimmering lights.

Myth: Migraines are the result of something wrong with the brain.

Fact: Migraines are diagnosed based on a person’s symptoms, rather than MRIs or lab tests. That’s because there’s nothing physically wrong with the brain of a migraine sufferer. Susceptibility to migraines is usually a result of genetics and gender. Migraines run in families. Those who have one first-degree relative with migraines have a 40 percent chance of having migraines themselves. Some 18 percent of women in the U.S. have migraines, and migraine episodes often correlate with a woman’s menstrual cycle.

Myth: Migraines aren’t that bad.

Fact: Migraines can force patients to miss work and events with friends and family. Unless they themselves have migraines, managers may not realize how incapacitating the diagnosis can be and presume employees just need to toughen up. In fact, the vast majority of people with migraines can’t function normally during an episode, making work nearly impossible.

Myth: There aren’t many solutions to migraines, so it’s best to power through them.

Fact: A lot of patients needlessly suffer through migraines or use over-the-counter medications because they aren’t aware of all the options that can help. Once a migraine attack is underway, a fast-acting group of prescription drugs called “triptans” can help reduce head pain in just two hours.

For patients who get migraines regularly, several drugs that were originally developed for other conditions have been FDA approved for migraine use. Certain antidepressants, seizure medications, and blood pressure pills can reduce the frequency and severity of migraines. Botox injections in the forehead, temples, and neck can help some patients.

Finally, a promising new class of drugs—calcitonin gene-related peptide inhibitors—have just come to market. These are the first drugs specifically developed to prevent migraines. They’re generally prescribed to patients who have 15 or more migraine days a month and who haven’t responded to other medications.

Myth: Prescription drugs are the only way to help migraines.

Fact: There are many ineffective treatments for migraines and headaches. Ear piercings, devices that are applied to the forehead, and most supplements don’t help. However, a few things can make a difference: Magnesium and riboflavin (vitamin B2) pills help some individuals, as does acupuncture. Physical therapy can be beneficial for patients whose migraines are triggered by tight neck muscles.

Eliminating triggers can also reduce migraine frequency. Certain foods—caffeine, chocolate, wine, cheeses, and cured meats—can start a migraine attack. Environmental conditions, including fluorescent lights, computer monitors, perfumes, and even changes in the weather can play a role. Taking patients off certain medications can also make a difference.

Myth: Caffeine can solve migraines.

Fact: Caffeine is a double-edged sword. While caffeine-containing pain relievers may help people who get the occasional migraine, the caffeine itself can cause a headache. It’s usually better for migraine and headache sufferers to reduce or eliminate caffeine intake overall. Those who do consume caffeine should strive to have the same amount every day because variations can lead to migraines.

Dr. Michael Nelson is a neurologist at Vancouver Clinic. He cares for patients with a broad range of neurologic conditions, but has a special interest in helping individuals dealing with migraines and headaches.