By Mr. Ronald W Wolf (Army Medicine)June 26, 2018
Almost everyone suffers from headaches. Estimates are that 90 percent of all people have a headache during their lifetime. Headache relief--especially migraine headaches--is a frustrating medical issue for those who suffer from them.
Headaches can be a special problem for Soldiers if the headache affects performance of duties. Effective relief is often illusive--just ask anyone who has migraine headaches.
For those of you who do not suffer from migraine headaches, here's the background. The pain is intense, often a pulsing or throbbing pain in one area of the head. The migraine may have a number of attacks, lasting up to 72 hours or more. Nausea or vomiting and sensitivity to both light and sound can make things even worse.
Although migraine is reported three times more often in women than in men, it affects more than 10 percent of people worldwide. One more thing, migraine often affects relatively young and healthy individuals well before retirement age, including children.
Individuals who suffer from migraine often know when it's coming. A migraine may be preceded by visual disturbances, such as seeing flashing lights, jagged lines, or even a temporary loss of vision. Sometimes, however, there is no warning at all.
It isn't always clear what triggers migraine headaches. A number of factors are usually cited, including stress or anxiety, hormonal changes, flashing lights, or lack of food or sleep. Some who have migraine attacks, however, say there is no obvious trigger.
Migraines may be associated with injuries associated with mild traumatic brain injury as a result of vehicle accident, military training or combat, and Soldiers should be aware of that.
According to the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, more and more investigators believe that migraine has a genetic cause.
Migraine headaches may severely affect individual performance and as a result may impact unit readiness. Migraines can also have a behavioral health impact. Soldiers never want the team to think he or she can't be counted on to complete the mission. Some migraine sufferers report bouts of depression from the effects of migraines on their personal and professional life. Migraines are very debilitating--physically and mentally--and anything that affects the resilience of Soldiers is of great concern.
You or someone you know have migraines. Now what?
No single cure for migraine exists because the factors that cause these headaches and how best to relieve pain are not fully understood.
Stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks. Some individuals have found relief with acupuncture.
The use of drugs aims to prevent the attacks or relieve the symptoms during the attacks, although prevention may involve both the use of medications and behavioral changes.
The U.S. Food and Drug Administration has approved a drug called erenumab (Aimovig) to prevent migraine in adults. The drug works by blocking the activity of calcitonin gene-related peptide (CGRP), a molecule that is involved in migraine attacks. Other similar-acting drugs (those that block CGRP) are under development.
Some drugs originally developed for epilepsy, depression or high blood pressure may improve in treating migraine. Botulinum toxin A (often referred to as Botox) has been shown to be effective in prevention of chronic migraine for some individuals. All of these choices involve discussions with your physician, and some of the potentially new options may be expensive.
If you have migraines, keeping a log of things that trigger your migraine may provide useful information for lifestyle changes that avoid the stimulus. Triggers cover a range including dietary factors, eating regular meals (including adequate hydration), stopping certain medications, and keeping a consistent sleep schedule.
You know all of this, you're thinking, and none of it works for your migraines. With the lack of a single effective treatment for migraines, the frustration levels can be through the roof.
Migraine research continues. Hopefully, soon, products and treatments that work effectively for you will be available.