What Are Migraine Symptoms?: Migraine Tips, Causes, and Treatment

• Migraines are a severe form of headache that causes debilitating pain on one side of your head.
• There isn’t a specific cause for migraines, though genetics tends to play a role.
• There isn’t a cure for migraines, but there are medications and treatments that can help manage symptoms or prevent how often migraines occur.

Migraines are characterized by a severe headache and other symptoms that make it difficult to go about your daily routine. About one billion people experience a migraine each year, making it a common medical condition. For those who are familiar with the common symptoms of a migraine, continue reading to learn what an accurate diagnosis from a headache specialist may look like, ways to relieve symptoms, and migraine signs to look out for.

A migraine is a severe type of headache that causes throbbing or pulsing pain, usually on one side of the head. Migraines are often accompanied by symptoms such as nausea, vomiting, and sensitivity to light. Prodromal or pre-headache symptoms like neck cracking or stiffness, fatigue, or irritability occur before a migraine and serve as early warning signs of an impending headache.

Migraine attacks can last for a few hours or even days, which can make it difficult to go about your daily routine. According to the American Migraine Foundation, migraines can occur acutely (in short bursts) or someone can have chronic migraines, which is when the condition trigger headaches 15 or more days a month.

Types of Migraines

There are several different types of migraines. The two most common types are:

1. Migraines with aura: also called a classic migraine.
2. Migraines without aura: also called a common migraine.

An aura refers to sensory, cognitive, and visual symptoms that typically precede a migraine attack. Examples of aura symptoms can include seeing flashes of light or dots, difficulty speaking, vision loss, or tingling/​numbness. 

Other types of migraines include:

• Silent migraine
• Abdominal migraine (migraines in children)
• Menstrual migraine
• Vestibular migraine
• Retinal migraine, or ocular migraine
• Hemiplegic migraine
• Status migrainous

Migraine vs. Headache

While migraines and headaches may sound similar, migraines tend to be more painful and debilitating than an average headache.

Headache pain tends to occur across the forehead or as pressure on either side, whereas migraines tend to have more severe, throbbing pain on one side of the head. Headaches may occur due to stress or other factors like dehydration. Headaches may also be a symptom of a different medical condition, such as a cold or the flu. Typically, addressing the underlying cause resolves, whereas migraine symptoms are often treated with medication or holistic remedies until the migraine subsides. 

As with other neurological disorders, a migraine unfolds in stages, with each stage presenting unique symptoms. However, each person’s migraine experience varies, and not all individuals experience every stage during an attack.

Phase 1: Prodrome

The prodrome phase usually starts about 24–48 hours before the migraine occurs. Prodrome symptoms include:

• Fatigue
• Unexplained mood changes
• Nausea
• Trouble sleeping
• Difficulty concentrating
• Fluid retention
• Frequent urination
• Sudden food cravings
• Constipation
• Increased hunger/​thirst 
• Neck stiffness or cracking

Phase 2: Aura

People with migraine experience aura. A migraine aura phase can occur between 10 minutes and an hour before a migraine headache. During this phase, people may experience vision, cognitive, or other sensory symptoms. Some do not experience an aura phase, while others may experience an aura and headache phase at the same time.

Aura symptoms include:

• Vision changes, disturbances, or phenomena, such as flashes of light or bright spots/​shapes
• Vision loss or double vision
• Muscle weakness
• Numbness or tingling
• Trouble speaking
• Pins and needles feelings in one arm or leg

Phase 3: Attack

The migraine attack phase often begins with a headache that gradually worsens, resulting in severe head pain on one (or occasionally both) sides of the head. Migraine pain can travel from one side of the head to the other side of the head and worsen with movement or activity. Migraines typically last between 4 and 72 hours. Other migraine attack symptoms include:

• Increased sensitivity to light
• Sensitivity to odor or sounds
• Nausea
• Vomiting

Phase 4: Postdrome

After the migraine attack, it’s possible to feel fatigued or drained for up to a day. This is sometimes referred to as a migraine hangover and may have a significant impact on energy levels and mental health. During this phase, you may experience the following: 

• Dizziness
• Stiff neck
• Sensitivity to light and sound
• Trouble concentrating
• Brain fog

Note: Not all people with migraines experience postdrome symptoms or the same postdrome symptoms.

While a specific cause of migraines has not been found, studies show that genetic risk factors likely play a role. Those who experience migraines often have a family history of the condition.

Migraines can happen in both children and adults, and are more likely to affect adult women.

Migraine Triggers

Triggers are identifiable factors, such as events or circumstances, that can initiate the onset of symptoms. Common migraine triggers include:

• Stress
• Hormonal changes
• Weather changes
• Physical overexertion (too much physical activity)
• Head injury
• Exposure to harsh lights, sounds, or odors
• Missing a meal
• Some medications
• Certain food/​substance sensitivities (processed foods, etc.)

Triggers and their effects differ among people. Consulting with a healthcare professional may help you identify triggers and find ways to cope at the migraine’s onset. It can also help to keep a journal where you record your activities and symptoms right before or after a migraine hits, to determine what may have triggered it.

Many migraines often go undiagnosed and untreated, as they are mistaken for bad headaches. To specifically diagnose migraine headaches, you’ll meet with a neurologist (a specialist in brain chemicals and nervous system conditions). This healthcare provider will make a diagnosis based on your medical history, family history, symptoms, and a physical and neurological exam.

In some cases, your neurologist may also want to do blood tests, an MRI scan, or a CT scan. These will be requested to ensure there isn’t another underlying cause for your headaches or symptoms.

During these tests, your doctor will note the frequency and severity of your migraines to quantify how intense they are.

Migraine Frequency

Migraines can occur at varying times, so they are often categorized into three different levels: episodic migraine, high-frequency episodic migraine, and chronic migraine. 

1. Episodic migraine: Episodic migraines occur every once in a while, and can range from happening once a year to multiple times a week. Typically, a person with migraines experiences them 2–4 times per month on average. 
2. High-frequency episodic migraine: High-frequency episodic migraines occur between 9–14 times in a month, for a minimum of 3 months. 
3. Chronic migraine: Chronic migraines happen over 15 times a month, and at least 8 of those migraines include symptoms such as moderate to severe pain, sensitivity to light and/​or sound, nausea, pulsing or throbbing pain, or pain that increases when you move. 

Migraine Severity 

In addition to migraine frequency, doctors also take into consideration the severity of the migraines. Those who experience consistent and severely painful migraines can have difficulty participating in their daily lives, so determining migraine severity can help the doctor figure out the correct treatment plan for you. The most common way to determine this is using the Migraine Disability Assessment Scale (MIDAS) score. 

To get your MIDAS score, you’re asked questions about activities or daily routines you participate in when experiencing migraines. This can include tasks at home, work, and social or family obligations. You’ll also be asked to rate the pain level from your migraines over the last 3 months on a scale of 1–10. Once you’ve answered the questions, you’ll be given one of the following scores:

• Grade 1: Little to no disability

• Grade 2: Mild disability

• Grade 3: Moderate disability

• Grade 4: Serious disability

Symptom management, trigger avoidance, and preventative treatment, such as limiting stress, are the bedrocks of migraine management. Medications are often the main source of acute treatment, though you’ll want to monitor how often and how much you’re relying on medications, as too much can result in medication-overuse headaches.

Typically, migraine medications fall into two general categories: 

• pain-relieving medications 
• preventive medications

Pain-Relieving Medications

Pain-relieving medications focus on treating head pain and migraine pain. They are often used to block pain signals and reduce inflammation to help with migraine pain. Examples include:

• Over-the-counter pain relievers, like ibuprofen and or aspirin
• Triptans, like Imitrex or Maxalt
• Gepants, like Nurtec ODT
• Ditans, like Reyvow
• Antiemetics, like Gimoti

Preventive Medications

Preventive treatment typically consists of medications that are administered to help lessen the likelihood of a migraine occurring. Examples include:

• Beta-blockers, like Inderal
• Antidepressants, like Amitriptyline
• Anti-seizure drugs, like Topamax
• Calcium channel blockers, like Verapamil

Holistic, Home Remedy Migraine Treatments

While pain and preventive medications can help reduce the number and intensity of migraines, the experience can still be difficult to manage in the moment when a migraine attack occurs. Some ways you can help ease your migraine pain when it first occurs are:

• Resting in a dark, quiet room: Because harsh lights and sounds can trigger or worsen migraines, finding a dark and quiet space to lie down can help make the experience less severe.
• Applying a compress to your head: Using a warm or cold compress on your head can help soothe migraine headaches.
• Staying hydrated: While it is difficult to think about in the moment, keeping water close by to stay hydrated can help ease head pain.
• Removing the migraine triggers: if a trigger like alcohol or caffeine is the culprit, you should stop using it to avoid worsening your migraine. 

The National Center for Complementary and Integrative Health also discusses relaxation techniques and therapies that may help reduce the symptoms of a migraine. These include practices like acupuncture, massage for head and neck pain, and hypnotherapy.

Trying to determine if head pain is a migraine or ​“just a headache” can cause migraines to go undiagnosed or untreated. When left untreated, migraines and their symptoms can worsen.

Some signs you should see a doctor may include:

• Your headaches become more severe
• You have frequent, severe headaches that disrupt your daily life
• If your symptoms worsen after starting treatment
• If you develop new symptoms

You should contact 911 immediately if you or a loved one experiences any of the following severe symptoms:

• Severe headache pain that lasts for more than 72 hours
• A headache that is the worst you’ve ever experienced (sometimes referred to as a thunderclap headache)
• Loss of vision or consciousness
• Frequent vomiting

Questions To Ask My Doctor

Some questions you can ask your doctor about migraines include:

• How can I best prevent migraines from occurring?
• What type of migraine do I have?
• Do I have chronic migraines?
• Can we determine any potential triggers I have?
• What treatments are available?
• How will migraines impact my life, and what changes can I make to help?

• https://www.ninds.nih.gov/health-information/disorders/migraine

• https://americanmigrainefoundation.org/migraine-signs-symptoms/

• https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches#diagnosis-and-tests

• https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201

• https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/migraine-headaches

• https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine

• https://migrainetrust.org/understand-migraine/stages-of-a-migraine-attack/ 
• https://www.nccih.nih.gov/health/providers/digest/headaches-and-complementary-health-approaches 
• https://americanmigrainefoundation.org/resource-library/reality-chronic-migraine/ 
• https://pmc.ncbi.nlm.nih.gov/articles/PMC9959615/ 
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8904749/