A migraine is more than an ordinary headache. This neurological condition can cause debilitating symptoms that leave you in bed for days! Some migraine attacks can be “triggered.” A trigger is something that happens to you or that you do that seems to lead to a migraine attack. But what triggers a migraine headache? How can you treat them once they start? And can you prevent them before they erupt?

Migraine headaches

A migraine is considered a “primary headache” (a headache that is not caused by a different medical condition). The symptoms include:

  • Pain – Severe throbbing or a pulsing sensation, usually on one side of the head.
  • Nausea/vomiting
  • Aura – a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. An aura can last from 10 to 60 minutes. 
        • Seeing bright flashing dots, sparkles, or lights.
        • Blind spots in your vision.
        • Numb or tingling skin.
        • Speech changes.
        • Ringing in your ears (tinnitus).
        • Temporary vision loss.
        • Seeing wavy or jagged lines.
        • Changes in smell or taste.
        • A “funny” feeling.
  • Extreme sensitivity to light and sound


There are 8 generally accepted types of migraines. Their frequency and symptoms vary. These may also manifest slightly differently from person to person.

  1. Common migraine (Migraine without aura) – strikes without warning
  2. Complicated migraine (Migraine with aura) – like a common migraine but with aura symptoms acting like warning signs that a migraine is coming on.
  3. Silent migraine (or Acephalic migraine) – a migraine without the head pain. Includes the aura symptoms but not the headache that typically follows.
  4. Hemiplegic migraine – temporary paralysis (hemiplegia) or sensory changes such as a loss of sensation and dizziness or vision changes, temporary numbness, a tingling sensation or weakness on one side of your body. A headache may or may not occur.
  5. Ocular migraine (Retinal migraine) – temporary, partial or complete loss of vision in one eye A dull ache behind the eye can be expected and may spread to the rest of your head. The vision loss may last a few minutes, or as long as months. This symptom may be a sign of a more serious condition, such as a stroke, and should be reported to a doctor.
  6. Migraine with brainstem aura – headache pain felt in the back of your head. You may experience vertigo (a feeling that the room is spinning), double vision or loss of balance, slurred speech, ringing in the ears and vomiting.
  7. Chronic migraine – a migraine that occurs at least 15 days per month. They symptoms and severity of the pain may change frequently.
  8. Status migrainosus – a rare and severe type of migraine that doesn’t respond to usual treatments or lasts longer than 72 hours (5 days). Usually accompanied by headache pain and nausea.


Migraines have 4 stages. Although not everyone who has migraines goes through all 4.

  1. Prodrome – one or two days before a migraine, subtle changes may warn you of an upcoming migraine. You may notice constipation, mood changes, neck stiffness
  2. Aura – some people may experience aura symptoms such as vision disturbances (blurring, spots, tunnel vision) or pins and needles sensations in an arm or leg, weakness or numbness in the face or one side of the body, difficulty speaking
  3. Attack – a migraine usually lasts from 4 to 72 hours if untreated. During the attack you can expect pain (throbbing or pulses on one side of the face), nausea and vomiting, sensitivity to light, sound and sometimes smell and touch.
  4. Post-drome – after a migraine attack you may feel confused or drained for a day or so.


What triggers a migraine and why some people get them and others don’t isn’t fully understood, but there are a few factors that increase the risk of getting migraines. Everyone’s triggers may differ and keeping track of your personal triggers will help you avoid them and the resulting migraine.

Triggers include:

  • Genetics – up to 80% of people who get migraine headaches have a first-degree relative with the disease.
  • Hormones – women are more prone than men to experience migraines. It is believed that hormones are responsible for this statistic. Many women that experience migraines have their first one as teenagers when their periods start or they begin taking contraceptive pills. They later link their migraines to their menstrual cycles. Women going through menopause find their migraine attacks difficult to manage because they become more unpredictable.
  • Stress – you are more likely to get migraines if you are extremely stressed. Including other heightened emotions such as anxiety, excitement, tension and shock
  • Smoking – the nicotine in cigarettes cause blood vessels in your head to constrict, triggering migraines.
  • Sleep – getting too much or not enough deep sleep.
  • Changes in routine – including irrupted sleep patterns, or unusual traveling habits.
  • Caffeine – too much or suddenly cutting out caffeine. Including tea, coffee and cola, as well as chocolate and some over-the-counter painkillers. Slowly decreasing the amount that you consume is recommended.
  • Environmental changes – higher altitudes or humidity, as well weather changes.
  • Screen time – using computers or watching television for prolonged periods of time. The extended visual stimulus. The position of the body/neck/head may contribute.
  • Food – cravings may be an early sign that an attack is coming. Missing or skipping meals. Chemicals or additives may contribute. Example include:
    • Tyramine (red wine, soft cheeses)
    • MSG (processes foods)
    • Nitrates (naturally occurs in some vegetables or is added to some processed meats)
    • Aspatame (artificial sweetener found in some fizzy drinks)
  • Teeth grinding – while sleeping. A dentist may be able to advise on whether you could have a special mouth plate (called occlusal splints), which can reduce the teeth grinding.
  • Head injury – trauma to the head may increase your risk of experiencing migraines.
  • Coughing – excessive or continuous coughing decreases the amount of oxygen getting to your brain and may trigger a migraine.
  • Light and noise – sunlight, artificial, effervescent, or flashing lights. As well as prolonged or sudden loud noise.
  • Daily use of pain-relieving medications – If you use medicine meant to relieve headache pain too often, that can cause a rebound headache.


If your migraines are chronic, they cannot be cured, but you can manage and possible improve them:

  • Medication – There are two main treatment approaches that use medications: abortive and preventive.
        • Abortive medications: taken when the first symptoms of a migraine appear. Taking them before the pain manifests or when it is relatively mild may stop or decrease the pain and other symptoms, including nausea, light sensitivity, etc. Abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.
        • Preventive (prophylactic) medications: taken when headaches are severe, occur more than four times a month and are significantly interfering with normal activities. Preventive medications reduce the frequency and severity of the headaches. Medications are generally taken on a regular or daily basis to help prevent migraines.
        • Self-medication is strongly discouraged. See a doctor if you are prone to regular migraines.
  • Reduce stimulus – resting in a dark, quiet, cool room.
  • Change of temperature – applying a cold or warm compress or washcloth to your forehead or behind your neck.
  • Massage – massaging your scalp, temple, or neck.
  • Stretching – relieves muscle tension and increases blood flow. Yoga may be preventative.
  • Meditating – keeping yourself in a calm state and focusing on breathing.
  • Exercise – even light but regular exercise improves blood flow, develops good posture and body position, helps maintain a healthy body-weight, improves mood and relieves stress.
  • Keep track triggers – keep a trigger diary and avoid your specific triggers
  • Stay physically healthy – eat regularly, stay hydrated, get enough sleep


Migraine headaches often go undiagnosed and untreated. They can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your doctor to keep migraines from ruling your life. If your triggers include bad posture, injury, or muscle and joint pain, contact The Back Clinic on 063 097 5603 or via email at info@thebackclinic.co.za

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