Migraines

Condition

Understanding Migraines: Causes, Triggers, and Ways to Manage Them

Migraines are a common but often debilitating neurological condition that affect millions of people worldwide. While they are frequently described as “severe headaches,” migraines are far more complex than ordinary head pain. They involve changes in brain chemistry, nerve signalling, and blood flow that can trigger a range of symptoms including intense head pain, nausea, visual disturbances, and extreme sensitivity to light or sound.

For those who suffer from them regularly, migraines can significantly impact quality of life, affecting work, relationships, and day-to-day functioning.

Understanding what migraines are, why they occur, and what can trigger them is an important step in managing the condition and reducing the frequency or intensity of attacks.

Migraine at a Glance

A migraine is a neurological condition characterised by recurring attacks of moderate to severe headache pain, often accompanied by a variety of additional symptoms. Common features of migraines include:

Migraine attacks can last anywhere from 4 to 72 hours, and many people experience several stages during an episode, including warning symptoms before the headache begins and lingering fatigue afterwards.

While some people only experience occasional migraines, others may suffer from frequent or chronic attacks that significantly interfere with everyday life.

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What Is a Migraine?

A migraine is a type of headache disorder that involves complex neurological processes within the brain and nervous system. Unlike tension headaches, which tend to cause a dull pressure around the head, migraines are often characterised by intense throbbing pain, typically affecting one side of the head.

However, migraines involve far more than just pain. Many people experience a range of additional symptoms including nausea, vomiting, visual disturbances, dizziness, and heightened sensitivity to sensory stimuli.

Migraines can affect people of all ages, although they often begin during adolescence or early adulthood. They are also significantly more common in women than in men, which is thought to be partly due to hormonal influences.

Research has shown that migraines often run in families, suggesting that genetics plays a role in determining who is more susceptible to them.

What Causes Migraines?

Migraines are not fully understood, but research suggests they arise from a combination of neurological, genetic, and environmental factors.

Several mechanisms are believed to contribute to migraine attacks.

One of the leading theories behind migraines involves changes in brain chemicals, particularly serotonin, which plays an important role in regulating pain signals and blood vessel function.

During a migraine attack, serotonin levels can fluctuate. This may cause blood vessels in the brain to constrict initially and then dilate, contributing to the throbbing pain associated with migraines.

These changes in brain chemistry can also influence nerve signalling and pain sensitivity within the nervous system.
Migraines are often described as a neurovascular disorder, meaning they involve both the nervous system and the brain’s blood vessels.

The trigeminal nerve, which is responsible for sensation in the face and head, appears to play a key role in migraine pain. When this nerve becomes activated, it can release inflammatory chemicals that irritate surrounding blood vessels and trigger pain signals in the brain.

This interaction between nerves and blood vessels helps explain why migraines can produce such intense and persistent pain.
Another important process involved in migraines is known as cortical spreading depression (CSD).

This refers to a wave of electrical activity that moves across the brain’s outer layer (the cortex). As this wave spreads, it temporarily disrupts normal brain activity and blood flow.

Researchers believe that cortical spreading depression may be responsible for the visual disturbances and sensory symptoms known as aura, which some people experience before the headache phase of a migraine.
There is strong evidence that genetics play a role in migraines. People with a family history of migraines are significantly more likely to experience them themselves.

Scientists have identified several genetic variations linked to migraine susceptibility, particularly those related to nerve signalling, serotonin regulation, and blood vessel function.

These genetic factors may make certain individuals more sensitive to environmental or physiological triggers.

The Phases of a Migraine

Migraine attacks often occur in distinct stages, although not everyone experiences all of them.

The prodrome phase can occur hours or even days before the headache begins. People may notice subtle changes such as:

These symptoms may indicate that changes are already occurring within the brain.
Around 20–30% of people with migraines experience aura. This stage usually occurs shortly before the headache phase.

Aura symptoms may include:
Aura symptoms are believed to be linked to cortical spreading depression affecting areas of the brain responsible for sensory processing.
This is the stage most people associate with migraines.

The pain is typically:
During this phase people may also experience:
This phase can last anywhere from 4 hours to several days.
After the headache subsides, many people experience a postdrome phase, sometimes described as a “migraine hangover”.

Symptoms may include:
This stage can last for several hours or even a full day while the brain recovers from the migraine attack.
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Common Migraine Triggers

Migraine attacks are often triggered by certain environmental or lifestyle factors. These triggers vary widely from person to person, but some of the most common include:

Understanding personal triggers can be a key step in preventing future attacks.

Managing Migraines

For many people living with migraines, reducing the frequency and severity of attacks can be life-changing. While medication can help manage acute symptoms, many individuals also benefit from addressing underlying triggers and lifestyle factors.

Some individuals find that chiropractic care can help reduce the frequency and intensity of migraine attacks. Improving spinal alignment and reducing tension in the neck and upper spine may help relieve pressure on the nervous system and improve overall neurological function.

Many migraine sufferers report that regular chiropractic treatment can help keep migraines under better control.
Certain lifestyle adjustments can also play a significant role in managing migraines.

Helpful strategies may include:

Techniques such as meditation, breathing exercises, and cognitive behavioural therapy (CBT) can also be beneficial in managing stress-related triggers.

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What is a Migraine?

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:
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What Causes Migraines?

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.

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.

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.

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.

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.

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What Happens in the Brain During a Migraine?

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:

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.

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.

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.

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.

Triggers of Migraines

Migraines are often triggered by certain environmental or lifestyle factors. These triggers vary from person to person, but some common ones include:

Emotional stress or anxiety is one of the most common migraine triggers.

Changes in hormone levels, especially in women, can trigger migraines. This is why migraines are more common in women, and they often occur around menstruation, pregnancy, or menopause.

Some foods, such as chocolate, cheese, caffeine, alcohol, and processed meats, can trigger migraines in some individuals.

Poor sleep quality or changes in sleep schedule can provoke a migraine attack.

Strong sensory stimuli, such as bright lights or loud sounds, can trigger migraines, especially in people who are already sensitive to light or sound.

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How Migraines Can Be Managed

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.

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 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!

If you would like any advice related to this article, please feel free to contact us here.

References

  • Goadsby, P. J., Lipton, R. B., & Ferrari, M. D. (2002). Migraine – current understanding and treatment. The Lancet, 360 (9344), 1831-1841.
  • Dodick, D. W. (2018). A review of the pathophysiology of migraine. Neurology, 91 (9), 110-119.
  • Pietrobon, D., & Moskowitz, M. A. (2013). Pathophysiology of migraine. Annual Review of Physiology, 75, 365-391.
  • Edvinsson, L., & Haanes, K. A. (2018). The role of CGRP in the pathophysiology of migraine. Neurotherapeutics, 15 (2), 305-311.
  • Chaibi A, Tuchin PJ. Chiropractic spinal manipulative treatment of migraine headache of 40-year duration using Gonstead method: a case study. J Chiropr Med. 2011 Sep;10(3):189-93. doi: 10.1016/j.jcm.2011.02.002. Epub 2011 Aug 6. PMID: 22014909; PMCID: PMC3259914.
  • Chaibi, A., Tuchin, P.J. & Russell, M.B. Manual therapies for migraine: a systematic review. J Headache Pain 12, 127–133 (2011). https://doi.org/10.1007/s10194-011-0296-6
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