Migraines are a common yet often debilitating type of headache that affect millions of people worldwide. They are not just a “bad headache,” but a complex neurological condition with a range of symptoms, including severe, throbbing head pain, nausea, vomiting, and heightened sensitivity to light and sound. From a neurological perspective, migraines are not just about pain but involve intricate changes in the brain’s chemistry, blood flow, and electrical activity.
A migraine is a type of headache that is typically more intense and longer-lasting than regular headaches. Unlike tension headaches, which tend to cause a dull ache, migraines are often characterised by throbbing or pulsating pain, usually on one side of the head. Migraine attacks can last anywhere from 4 to 72 hours and can be accompanied by additional symptoms such as nausea, vomiting, dizziness, and increased sensitivity to light (photophobia) or sound (phonophobia). Some people also experience an aura before the headache begins, which can involve visual disturbances such as flashing lights or blind spots.
While anyone can experience a migraine, they are more common in women and typically begin in adolescence or early adulthood. Migraines tend to run in families, suggesting a genetic component to the condition.
Migraines are not fully understood, but researchers believe they are caused by a combination of genetic, environmental, and neurological factors. Several key mechanisms play a role in the development of migraines:
Brain Chemicals and Blood Flow
One of the main theories behind migraines is that changes in brain chemicals, particularly serotonin, are involved. Serotonin helps regulate mood, pain, and other bodily functions, and during a migraine attack, levels of serotonin can drop significantly. This drop may cause blood vessels in the brain to constrict, which can lead to the initial phase of a migraine. Later, the blood vessels dilate (expand), causing the throbbing pain typical of migraines.
Neurovascular Mechanisms
Migraines are considered a neurovascular disorder, meaning both the nervous system (brain) and blood vessels are involved. The headache pain in a migraine is thought to be caused by changes in blood flow to the brain. Blood vessels in the brain constrict and then dilate, triggering pain. This is believed to be linked to the activation of pain pathways in the brain, particularly in an area called the trigeminal nerve. This nerve is involved in sensation in the face and head, and when it is activated during a migraine, it can release chemicals that cause inflammation and pain.
Cortical Spreading Depression (CSD)
One important neurological process in migraines is a phenomenon called cortical spreading depression. CSD refers to a wave of electrical activity that spreads across the brain’s cortex (the outer layer of the brain). This wave causes temporary changes in brain activity, including a decrease in blood flow. Researchers believe that this process can trigger the onset of a migraine and may also explain the visual disturbances (aura) that some people experience before the pain begins.
Genetic Factors
There is strong evidence that genetics plays a significant role in migraines. Studies have shown that migraines tend to run in families, and certain genetic mutations have been identified that make individuals more likely to experience migraines. For example, mutations in genes related to serotonin function and vascular regulation have been found in people with migraines. These genetic factors may make the brain more sensitive to triggers that can lead to a migraine attack.
The neurological processes behind a migraine attack are complex and involve multiple changes in brain activity. A typical migraine attack can be divided into four phases:
Prodrome Phase (Pre-headache Phase)
This phase occurs hours or even days before the headache begins. People often experience subtle changes in mood, appetite, or energy levels. Some may also notice yawning or increased sensitivity to light or sound. This phase is thought to be linked to changes in the brain’s chemical balance, particularly serotonin levels.
Aura Phase
Not everyone with migraines experiences an aura, but for those who do, it usually occurs just before or during the onset of the headache. The aura is typically characterised by visual disturbances, such as seeing flashing lights, zigzag patterns, or blind spots. In some cases, a person might experience sensory disturbances, such as tingling or numbness in the face or limbs. These symptoms are thought to be the result of cortical spreading depression (CSD), the wave of electrical activity mentioned earlier, which temporarily disrupts brain function in areas responsible for sensory processing.
Headache Phase
This is the phase most people associate with a migraine. The throbbing or pulsating pain is often located on one side of the head, although it can affect both sides. The pain is usually accompanied by nausea, vomiting, and heightened sensitivity to light, sound, or smells. The pain is thought to result from the activation of the trigeminal nerve and the changes in blood flow that occur during the attack.
Postdrome Phase (Recovery Phase)
After the headache subsides, many people experience a postdrome phase, which can last for several hours. During this phase, the person may feel exhausted, mentally foggy, or “washed out.” This phase may be the result of the brain trying to recover from the changes in blood flow and electrical activity that occurred during the migraine.
Migraines are often triggered by certain environmental or lifestyle factors. These triggers vary from person to person, but some common ones include:
A reduction in the quantity and intensity of migraines for many people suffering from them, can be life changing. For those seeking a natural solution which doesn’t involve an over-reliance on pain medications there are some useful strategies with exploring.
Chiropractic
If you suffer from migraines and haven’t explored chiropractic care, it is well worth doing. There is evidence that chiropractic care can reduce the frequency and intensity of migraines significantly and many patients report that ongoing regular treatment really keeps their migraines at bay.
Lifestyle Changes
Lifestyle changes can also help manage migraines. These include maintaining a regular sleep schedule, reducing stress, avoiding known triggers including food intolerances, and staying well hydrated. Cognitive-behavioral therapy (CBT) and relaxation techniques like mindfulness meditation can also be helpful for managing the emotional aspects of migraines.
If you are struggling with migraines that are having a significant impact on your life and well-being, it is advisable to seek a healthcare practitioner who can guide you towards finding the solutions. Getting your symptoms under control can be a game-changer for your life, and you’ll wish you’d done it sooner!
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