Understanding migraines and how to manage chronic pain

migrain pain

Many Kenyans brave migraines that are so bad they can hardly keep their heads up.

Photo credit: File | Shutterstock

Nothing can disrupt the quality of your daily life like chronic pain.

For people with regular migraines, not only is the pain debilitating but it also not observable or detectable by others. Consequently, others may sometimes doubt whether your pain actually exists.
Many Kenyans brave migraines that are so bad they can hardly keep their heads up, despite attempts at managing with pain killers.

A migraine is a severe and painful long-term health condition that 1 in 7 people live with. It is the third most common disease in the world, more common than diabetes, epilepsy and asthma combined.

Although migraines can start at any age, they usually begin during puberty or young adulthood. After age 50, headaches often become significantly less severe or resolve entirely.

Migraines are three times more common in women.

People with the condition suffer from an intense pulsing or throbbing pain that usually occurs in 1 area of the head. It may cause severe, debilitating pain for hours to days, necessitating the need to retreat to a dark, quiet place.

The pain is generally made worse by physical activity and is often accompanied by additional symptoms, such as nausea, vomiting, and sensitivity to light and sound. Different people get different symptoms.

What causes migraines?

Researchers have identified possible causes, but they don’t have a definitive explanation. Potential theories include:

•Genetics play a big role in migraine. This means that it is often inherited in families. It is estimated that up to 60 per cent of the reason people get migraine is because of their genes.

•Underlying nervous system disorder - Migraines occur in people whose nervous system is more sensitive than that of other people. In these people, nerve cells in the brain are easily stimulated, producing electrical activity.

As electrical activity spreads over the brain, various functions, such as vision, sensation, balance, muscle coordination, and speech, are temporarily disturbed. These disturbances cause the symptoms that occur before the headache (called the aura). The headache occurs when trigeminal nerve, the nerve responsible for sending pain, touch, and temperature sensations from your face to your brain, is stimulated.

•Oestrogen, the main female hormone, appears to trigger migraines, possibly explaining why they're more common in women than men.

Oral contraceptives (which contain oestrogen) and oestrogen therapy may make migraines worse and may increase the risk of stroke in women with migraines.

What triggers a migraine?

Migraine attacks can be triggered by a variety of factors. Common triggers include:

•Emotional stress as has been caused to many by the Covid-19 pandemic is one of the most common triggers of migraine headaches.

•Certain foods and beverages including aged cheese, alcoholic beverages, caffeine (including that in chocolate) and food additives such as nitrates (found in pepperoni and hot dogs) and fermented or pickled foods may be responsible for triggering up to 30 per cent of migraines.
•Hunger (as when meals are skipped)
•Lack of sleep
•Changes in the weather, particularly barometric pressure
•Excessive stimulation of the senses (for example, by flashing lights, loud noises or strong odours)
•Daily use of pain medications - If you use medicine meant to relieve headache pain too often, that can cause a rebound headache.

How are migraines treated?

Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved.
There are two main treatment approaches that use medications: abortive and preventive.

Abortive medications are most effective when you use them at the first sign of a migraine. They are taken while the pain is mild and act by stopping the headache process. These include over-the-counter medications found to be effective for some people with mild to moderate migraines.

Preventive medications may be prescribed when migraines are severe, occur more than four times a month and are significantly interfering with your normal activities. Preventive medications reduce the frequency and severity of the headaches.

If you have been suffering from migraines or chronic headaches and trying to treat your symptoms with medication to no avail, consult your doctor for more information on this novel treatment.

The opinions expressed in this publication are those of the authors. They do not purport to reflect the opinions or views of his employer.