When most people think of what a migraine is, they think of a brutal headache that can last for a long time. However, a migraine is much more than just a headache. In fact, it’s not a headache at all — it’s a neurological disorder that causes various physical and psychological symptoms. Therefore, to effectively manage your condition, it is essential to understand the different types of migraines and their associated symptoms.

The following guide will help you better understand what a migraine is, the different types, and how they can be managed to help prevent them from impacting your quality of life.

Four Stages Of Migraine Attacks

Regular headaches tend to occur right away, which is one of the reasons why a migraine is not considered a headache. A migraine is a condition that can affect the whole body. Migraines come in four different stages with waves of symptoms — including headaches. The following are the four stages of a typical migraine:

Stage 1: Prodrome

The word “prodrome” means “warning.” Prodrome is the first stage of a migraine; symptoms can occur up to a day or two before an actual migraine attack. During the prodrome stage, you may experience subtle changes in mood and behavior. These may be signs of a migraine attack, typically occurring at least 24 hours before the headache. Common early signals include irritability, fatigue, food cravings, and constipation.

Stage 2: Aura

The second stage is the aura. “Aura” refers to a set of neurological symptoms that occur before or during a migraine episode. The symptoms of an aura are typically sensory in nature, such as changes in vision, hearing, or smell. Other common signs include pins and needles sensations, dizziness, and difficulty speaking. An aura typically lasts up to an hour before the headache itself begins.

Stage 3: Attack

The third stage is the actual migraine attack itself. This is when you experience a throbbing headache along with other symptoms, such as nausea and sensitivity to light and sound. Depending on the individual, the attack can last anywhere from 4-72 hours.

Stages 4: Postdrome

“Postdrome” is the fourth stage of a migraine, typically occurring after the headache has passed. The postdrome phase may last a couple of hours to a day or two after the migraine attack. It’s sometimes referred to as a “migraine hangover.” During this stage, you may experience confusion and exhaustion, as well as feel achy and weary.

Risk Factors

One of the challenges in treating migraines is that the underlying cause is unknown. However, various risk factors have been identified that can increase the likelihood of a migraine. The following are some of the common risk factors for migraines:

Genetics

Migraines can run in families, and studies have shown that if your parent or sibling has a history of migraines, you have an increased risk of developing them. In fact, 80 percent of people who experience migraines have reported a family history of migraines. Additionally, if one parent has a history of migraines, their child will have a 50 percent chance of developing migraines as well.

Age

Migraines are most common in adults aged 20 to 40. The reason is unknown, but it is thought to be related to changing hormone levels.

Gender

Women tend to be at greater risk than men when it comes to migraine attacks. This is thought to be the result of hormonal changes. For example, the hormonal changes that occur during menstruation, pregnancy, menopause, and oral contraceptives. 

It’s estimated that migraines are twice as prevalent in women than men. It’s also been shown that the prevalence of migraines increases once women go through puberty and decreases after menopause.

Triggers Of Migraines

Triggers” refer to environmental or lifestyle factors that can cause a migraine attack. These triggers vary from person to person and often depend on the type of migraines you’re experiencing. 

Understanding your triggers is vital to managing your migraines since avoiding those triggers can help you prevent migraine attacks. With this in mind, the following are some of the most common triggers of a migraine:

Stress

One of the most common triggers is stress. When you become stressed, the brain releases certain chemicals that help to combat whatever situation is causing the stress. These chemicals are responsible for the “fight or flight” response but can also trigger a migraine. 

Additionally, anxiety or emotional stress, in general, can increase your muscle tension and dilate blood vessels, thereby increasing the severity of your migraine.

Changes in Hormones

As previously mentioned, hormones can play a significant role in the onset of migraines. Changes in hormone levels, like those that occur during menstruation or menopause, can trigger a migraine attack. 

Additionally, some medications, such as oral contraceptives and hormone replacement therapy (HRT), can increase the likelihood of migraines.

Foods

Studies show that food is responsible for triggering upwards of 30 percent of all migraines. This is because certain foods, such as processed meats (e.g., hot dogs and bacon), aged cheeses, and chocolate, contain certain additives, such as nitrates and MSG (monosodium glutamate). These additives are thought to expand the blood vessels in the brain and make you more susceptible to a migraine attack.

Environmental Triggers

Environmental triggers, such as changes in barometric pressure, sudden changes in the weather, and extreme hot or cold temperatures, can also trigger a migraine. Other environmental factors include bright lights, loud noises, and strong smells (e.g., perfume).

Tobacco

Smoking and using other tobacco products can also trigger a migraine attack. This is because when nicotine enters the body, it constricts blood vessels, which can result in a tobacco migraine. Additionally, the chemicals found in cigarettes and other tobacco products are thought to increase a person’s sensitivity to pain.

Alcohol

The consumption of alcohol can also trigger a migraine attack. One study showed that alcohol was a common trigger for around a third of people who suffered from migraine attacks. This is thought to be because of the dehydrating effects of alcohol, which causes electrolyte and fluid imbalance in the body, thereby potentially triggering migraines. 

Additionally, certain types of alcohol, such as red wine and beer, contain additives that are thought to trigger a migraine.

Caffeine

Caffeine can also trigger a migraine attack. This is because caffeine can cause the blood vessels to constrict, which can trigger a migraine. In addition, if you drink too much caffeine, your body can become dehydrated, leading to an electrolyte and fluid imbalance, which can also trigger a migraine. Finally, the withdrawal from caffeine can also trigger a migraine, as your body is no longer receiving the regular doses of caffeine it has become used to.

Sleep Deprivation

Sleep deprivation can also contribute to the onset of a migraine attack. People with insomnia or who work long hours are at greater risk for migraines. Studies have shown that when a person doesn’t get enough sleep, their body increases the production of a specific type of protein. This protein can lower your pain threshold (making migraine attacks more severe) and trigger intense migraine attacks.

8 Types Of Migraines And Their Symptoms

Diagnosing what kind of migraine condition you have will go a long way toward finding the proper treatment. There are various types of migraines, each with its own symptoms. With that in mind, the following are the eight most common types of migraines:

1. Migraine With Aura

Migraines with aura occur when you experience a warning sign before the headache. These symptoms typically occur around 30 minutes before the headache begins and are often visual. 

Migraines with an aura tend to be less common than those without. It’s also worth mentioning that some people will experience the aura of a migraine with aura but won’t experience any more symptoms (such as the actual headache). Such experiences are more common in older people.

Symptoms

The following are a few of the symptoms that you may experience if you get migraines with an aura:

  • Dizziness and confusion during the aura stage
  • Vision changes, such as flashing lights or wavy lines
  • Numbness or tingling in different parts of the body
  • Difficulty speaking
  • Weakness in the extremities
  • Moderate to severe headache

2. Migraine Without Aura

Migraines without an aura are the most common type of migraine. They occur when you don’t experience any early signs or warning signals before the headache. To be diagnosed with migraines without aura, you must experience at least five attacks within a year.

Symptoms

The following are some of the symptoms that you may experience if you get migraines without an aura:

  • Throbbing pain located on one side of the head
  • Nausea and vomiting
  • Sensitivity to sound and light
  • Fatigue

3. Chronic Migraines

Chronic migraines are a type of migraine that happens more than 15 times per month for at least three months. People who experience episodic migraines may develop them more and more over time due to various risk factors and triggers. The more headaches you have, the lower the threshold for new headaches becomes. 

As a result, your migraines will become less responsive to medication and may become chronic.

Symptoms

Chronic migraines can occur with or without an aura. The symptoms are generally similar to migraines with or without an aura. The only difference is that they happen much more regularly. As such, the following are some of the common symptoms of chronic migraines:

  • Dizziness and confusion during the aura stage
  • Vision changes, such as flashing lights or wavy lines
  • Numbness or tingling in various parts of the body
  • Throbbing pain located on one side of the head
  • Nausea and vomiting
  • Sensitivity to sound and light
  • Fatigue

4. Vestibular Migraine

The vestibular system is the body’s balance and coordination system. A vestibular migraine occurs when this system is affected by a migraine attack, which can lead to vertigo or dizziness and a feeling of unsteadiness or motion sickness. The reason this occurs is thought to be a change in how you interpret your senses caused by abnormal brainstem activity.

It’s estimated that around 10 percent of people with migraines experience vestibular migraines. They also tend to occur more often in people with a history of migraines without an aura. To be diagnosed as having vestibular migraines, you must experience dizziness at least 50 percent of the time that you have a migraine.

Symptoms

Vestibular migraines are unique in that they come with various symptoms that regular migraines do not cause. The symptoms of a vestibular migraine include:

  • Vertigo (dizziness or a lack of balance)
  • Nausea
  • Throbbing headache pain
  • Sensitivity to sound or light
  • Hearing issues (such as tinnitus)
  • Motion sensitivity
  • Visual disturbance

5. Migraine With Brainstem Aura

Also known as a basilar-type migraine, this type of migraine is rare and originates from the brainstem. There are several theories as to what causes this type of migraine. When the condition was first identified, it was thought to be caused by a temporary narrowing of the basilar artery that supplies blood to the brainstem. 

Currently, most people believe it results from a genetic predisposition or an abnormality of the nerves or occipital lobes.

It’s estimated that only around 10 percent of people with migraines with an aura experience this type of attack. It’s most common in teenagers and young adults, and it can be triggered by physical activity or stress.

Symptoms

The symptoms of a migraine with a brainstem aura are unique in that they are very similar to the symptoms that a stroke victim might have. These symptoms tend to come during the aura stage before the onset of the headache and generally don’t last for more than an hour. 

With that in mind, the following are the common symptoms of a migraine with a brainstem aura:

  • Double vision
  • Vertigo
  • Slurred speech
  • Numbness
  • Tinnitus
  • Partial hearing loss
  • Coordination problems
  • Pain in the back of the head on both sides

6. Menstrual Migraine

Considering that migraines, in general, are linked to hormones, it makes sense that some women experience migraines around the time of their period. In fact, migraines in women occur two to three times as often during menstruation than any other time. This type of migraine is called a menstrual migraine. Menstrual migraines are incredibly common in women. 

In fact, 60 percent of women with migraines experience menstrual migraines.

Symptoms

First, it’s important to note that there are two types of menstrual migraines: a menstrual-related migraine and a pure menstrual migraine. A menstrual-related migraine occurs when you experience a migraine without an aura for a day or two before your period and in more than 60 percent of your cycles. 

You may also experience migraines with or without an aura at various other times during your cycle.

A pure menstrual migraine occurs when you only experience migraines without an aura during the one or two days before your period or after the onset of your period for more than 60 percent of your cycles. These types are much less common than menstrual-related migraines. As far as the actual symptoms go, they are no different than regular migraines with or without auras.

7. Hemiplegic Migraine

Like a migraine with a brainstem aura, a hemiplegic migraine causes stroke-like symptoms during the aura stage. It’s one of the most serious types of migraines and also one of the rarest. There are two main types of hemiplegic migraines: familial and sporadic. 

Familial hemiplegic migraines are genetic and are passed down from generation to generation. Sporadic hemiplegic migraines, on the other hand, are not genetic in origin. Both forms typically develop in childhood and can last hours to weeks.

Symptoms

Because of how similar some of the symptoms are to a stroke, you must seek medical attention if you experience such symptoms to rule out other potential conditions (like a stroke). A complete neurological exam will likely need to be done to diagnose the issue. With that in mind, the symptoms of a hemiplegic migraine include the following:

  • Fever
  • Problems with coordination
  • Numbness or tingling sensations
  • Increased sensitivity to sound and light
  • Vision changes
  • Trouble speaking
  • Nausea or vomiting
  • Hemiplegia (paralysis or weakness on one side of the body)
  • Changes in consciousness, from confusion to profound coma

8. Abdominal Migraine

Abdominal migraines are much different than other types of migraines. First of all, they mainly occur in children. Secondly, unlike other migraines, they don’t cause headache pain. Instead, they are more known for causing abdominal pain (hence, the name “abdominal migraine”). 

Abdominal migraines last between four and 72 hours. It’s estimated that around one to four percent of school-aged children (primarily girls) suffer from abdominal migraines.

Fortunately, abdominal migraines will disappear as most children grow older. However, some studies indicate that anywhere from 50 to 70 percent of children with abdominal migraines will develop regular migraines later.

Symptoms

These are some of the common symptoms of an abdominal migraine:

  • Moderate to severe ache or soreness in the middle of the stomach
  • Light and noise sensitivity
  • A pale appearance
  • Loss of appetite
  • Nausea
  • Vomiting

How Long Is A Migraine Attack?

The duration of a migraine attack can vary significantly from person to person. Generally, most migraine attacks last between 4 and 72 hours, but some can last as long as a week. However, not all of your symptoms may last for the duration of the migraine. Usually, the headache pain will last the longest of the symptoms. 

It’s also worth repeating that some symptoms that occur during the aura stage (if your migraines have an aura stage) will often disappear with the onset of the headache. Additionally, some symptoms may last even after your headache disappears, such as fatigue.

When To Seek Medical Attention

If your migraine lasts more than 72 hours, you should seek medical attention. Additionally, if you are experiencing symptoms that are not normal for a common migraine with or without an aura, you should also seek medical attention. 

Although they may indicate that you have a different type of migraine, you’ll want to ensure that any other conditions that cause similar symptoms are ruled out (such as a stroke). 

That being said, if you experience any of the following symptoms during your migraine, you should go to a doctor to get a proper diagnosis:

  • Extremely severe head pain
  • Paralysis or partial paralysis
  • Severe confusion
  • Difficulty speaking
  • Vision changes that do not get better
  • Weakness or difficulty moving
  • High fever
  • Continuous and intense nausea and vomiting

Take The Best Strategy For Treating Your Migraine Pain

There’s no cure for migraines, and many people rely only on medications to try and relieve their migraine symptoms. However, some medications may not work for everyone. Managing migraine pain effectively goes beyond medication; it involves a comprehensive approach to pain management, which is precisely what NextPain Care provides.

We utilize a comprehensive three-step system to treat pain associated with migraine, ensuring each patient receives the most effective and personalized care. Our approach begins with non-invasive, non-opioid options, prioritizing treatments such as massage therapy, physiotherapy, electroanalgesia, and physical therapy to provide relief and improve functionality without the need for medication. 

If these initial methods are insufficient, we progress to in-office procedures, including injections, nerve blocks, and epidurals, designed to target pain more directly and provide significant relief. 

For patients requiring more advanced intervention, our third step involves more advanced treatment options, including minimally invasive surgical procedures. This structured, multi-step approach allows us to tailor treatments to the individual needs of our patients, ensuring the best possible outcomes at every stage.

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