People deal with headaches every day – tension headaches, sinus headaches and then there are migraines. A migraine can be disabling, and 28 million Americans have them. Up to 17 percent of women and six percent of men have experienced these headaches. Migraine pain can be excruciating, incapacitating people for hours or even days.

In some cases, they are preceded by a sensory warning sign (aura), such as flashes of light, blind spots or tingling in an arm or leg.  There are other signs and symptoms, such as nausea, vomiting, severe pain confined to one side of the head or both sides, head pain with a pulsating or throbbing quality, pain that worsens with physical activity and sensitivity to light and sound.

Some researchers think migraines may be caused by functional changes in the trigeminal nerve system, a major pain pathway in your nervous system, and by imbalances in brain chemicals including serotonin, which plays a regulatory role for pain messages going through this pathway.

During a headache, serotonin drops. Researchers believe this causes a nerve to release substances called neuropeptides. They travel to your brain’s outer covering (meninges) and cause blood vessels to dilate. The result is pain.

Fortunately, migraine pain management has improved dramatically over the years. A variety of drugs have been specifically designed to treat migraines. In addition, some drugs commonly used to treat other conditions have been shown to treat or prevent migraines, such as cardiovascular drugs, antidepressants and anti-seizure drugs. Some of these prescriptions are pain-relieving medicines and some are preventative. If someone has migraines and is not getting medical attention, then they do not need to suffer alone. We have more ways to help than ever.

Migraine triggers
Hormonal changes – Estrogen fluctuations trigger headaches in many women. Contraceptives and hormone replacement therapy also may worsen them.
Foods – In some people, foods are triggers. Common offenders include alcohol; aged cheeses; chocolate; fermented, pickled or marinated foods; aspartame; MSG; and caffeine overuse. Skipping meals also can trigger migraines.
Stress – A hard week at work may lead to a weekend migraine. Stress at work or home also can instigate migraines.
Sensory stimuli – Bright lights and sun glare can produce head pain. So can unusual smells — including pleasant scents such as perfume and unpleasant odors such as paint thinner.
Changes in wake-sleep pattern – Missing sleep or getting too much sleep can trigger attacks in some individuals.
Physical factors – Intense physical exertion, including sexual activity, may provoke migraines.
Changes in the environment – A change of weather, season, altitude level, barometric pressure or time zone can prompt a migraine.
Medications – Certain medications aggravate migraines.

Shankar Natarajan, M.D. - Shankar Natarajan, M.D., with Memphis Neurology since 1999, is an adult and child neurologist specializing in epilepsy, migraine and neuromuscular diseases. He is board-certified by the American Board of Psychiatry and Neurology. He graduated from Nilratan Sirar Medical College, Calcutta, India, and performed his residency in internal medicine and neurology at the University of Pittsburgh. Dr. Natarajan treats patients at his Germantown, Tenn., Southaven, Miss., Tupelo, Miss. and Brighton, Tenn. offices.