It has been a little while but I hope this post finds you managing your migraines successfully. If not, it could be because you are suffering more than one kind of migraine or headache. There are several, and many present symptoms that are often lumped in together and called a migraine, but have different effective treatments.
My migraines have been slowly improving since the many attacks I outlined in my previous post. They are not totally under control, but the gaps between are getting wider. It proves that the measures I am taking are working to an extent.
But they still come!
By now you will know that I have been an advocate of knowing yourself and your body well. Keeping diaries and analyzing trigger, time and lifestyle patterns have helped me pin-point that my migraines aren’t all the same and stem from different things. I’ve suspected this for years, but it became so obvious that I decided to write this post so you too could benefit from my insights.
- Have you ever taken abortive medicine convinced it would do no good and your migraine disappeared?
- Have you gone to sleep and when you woke up your migraine is almost gone?
- Have you forced yourself through some form of physical activity to find that your migraine as eased?
Doesn’t make any sense does it? When nine times out of ten you’re stuck with your migraine for three days straight no matter what you do.
Why does it work sometimes and no others?
Could it be that they are different kinds of headache/migraine that stem from different root causes?
All migraines are not the same.
By studying my own, I now know that I have several kinds, some leading to a full-blown migraine and others I can stave off before they become severe.
This is what I found.
Full-on hormone triggered migraine usually comes while I sleep meaning no measures can be taken. It creeps up from behind and clobbers me before I know it’s there. I wake up in the morning feeling like I’ve been hit around the head with a bat, barely able to open my eyes, unable to eat and wanting to be sick with the slightest movement. The only measures worth taking are to remain in bed, in a darkened room, with a cold compress, and wait it out. For me, this lasts on average 2-3 days.
Thankfully, I don’t get these all the time any more. These are my worst kind and the ones I can do nothing about.
But here’s the thing; I get those in between that don’t follow the pattern.
Here’s what I discovered.
I also have headaches that come on suddenly and in waves. They are intense and painful but subside again fairly quickly (usually within an hour).
These are Cluster Headaches
They occur more in men, are extremely painful and affect the side of the head and around the eye. No wonder they are confused with migraine.
Causes are unclear but thought to stem from brain activity in the hypothalamus area. There appears to be a genetic link and they run in families.
With mine, I can very often pin-point the pain to a place on the side of my head no bigger than a fingertip. This makes it much more painful as it is concentrated onto a small area.
They begin suddenly without warning and are severe. Some people describe them as a sharp burning or piercing sensation on the side of the head. Pain is typically felt around the eye, temple and sometimes in the face. Bouts can last from 4 to 12 weeks, followed by long headache free periods. They normally recur on the same side of the head each time.
Sufferers of Cluster headache normally have at least one of the symptoms below:
- A red and watering eye
- Drooping or swelling of the eyelid
- Smaller pupil in one eye
- Sweaty face
- A blocked or runny nostril
- A red ear
Anything familiar with you?
Attacks are extreme, usually only last between 15 minutes and 3 hours, but occur several times in a day. They happen in patterns over several days, lasting weeks or months at a time. Often a period of remission will follow before another attack. They also follow a pattern of times of the day or even seasons such as spring and autumn.
Documented triggers are:
- Warm temperatures
- Strong smells such as paint or petrol
So what can you do if this is you?
As always, see a professional. But don’t be palmed off. The symptoms are very similar to migraine but they are different. It might not be constant pain over a 72-hour period like a migraine, but comes in pulses over days, weeks, or months. Not to be taken lightly, insist on seeing a headache specialist – not just a neurologist. Believe me, this is imperative.
So what is the treatment?
Just like migraine, over the counter painkillers are rarely affective. In this instance they are just too slow. Remember these types of headaches come on fast and ferocious.
There are three main treatments you can take as soon as an attack starts:
- Sumatriptan injections administered yourself up to twice a day.
- Sumitriptan or Zolmitriptan nasal spray if you prefer not to have injections
- Oxygen therapy – breathing pure oxygen through a mask
Is there anything you can take to prevent an attack?
The main medicine is Verapamil tablets taken several times a day. These can cause heart problems so you must be regularly monitored on them.
Corticosteroids, Lithium and Occipital Nerve Blocks (Injections of local anaesthetic to the back of the head) There is a new treatment known as External Vagal Nerve Stimulation – to stimulate a nerve in the neck.
The point to note about cluster headaches is that they are often confused with migraine, and yet when accurately diagnosed, they are treated with different medications. They are severe, debilitating and can recur for several months at a time.
So what about the ones I get that feel like I’m being stabbed in the head with a letter-opener? They occur very similarly to a cluster headache, but are they the same?
These are quick jabs or jolts of severe pain around one eye/temple or side of the head. They can happen any time, and even a few times a day. They also seem to come and go just like a cluster headache.
Oh yeah, and you’ll love this part … You are more likely to suffer Icepick headaches if you already get migraines or Cluster headaches. Life just gets better and better, doesn’t it? Oh, and the age you are most likely to get them: 45-50. Yippee! Check, check and check!
Causes, are still unclear. They do know they are not brought on by disease or injury. It is suspected that you get them because something is wrong with the way your brain sends pain signals to your body.
- Sudden movements
- Bright light
Again, it is recommended that you keep a diary of whenever an attack occurs. Stressful day, bright sun, vigorous exercise etc. Then, when you have enough information, take it to your doctor. Insist this is not a migraine, or cluster headache.
Treatment, is the hardest of all. Despite being excruciating, they come and go so quickly, very often it’s impossible to get something down.
- Indomethacin (Indocin) is a non-steroidal anti –inflammatory drug that can be used for prevention.
Icepick headaches aren’t serious in most cases (although they feel it). Get other causes ruled out though, just in case.
So I get all of the above – a nice mixed bag. And it is my guess that I bet you do too.
So what is it that causes the most misery to the most people, and is entirely treatable?
The Tension Headache
- Constant pain affecting one or both sides of the head
- Tightening of the neck and or back muscles
- Pressure behind the eyes
These headaches can start reasonably mild, but build from duration of 30 minutes to several days. These too are often mistaken for migraine.
Absolutely anyone can get tension headaches and at any time of life. Teenagers and women seem to get them more often, suggesting a connection with stress relating to hormonal fluctuations.
Now just because this type of headache is the most common, doesn’t mean they can’t be severe. These can occur in a chronic form happening more than 15 days in a month.
So even though the cause is tension, you should still seek medical help. A headache specialist will quickly rule out other forms of headaches and conditions and then be able to treat you effectively.
- Poor posture
- Missing meals
- Lack of physical activity
- Bright sunlight
- Certain smells
Notice the similarities to migraine
- Applying hot flannel to neck
Keep a diary for cause patterns
I know I get this type of headache too.
For a long while, I couldn’t work out why I always got a migraine after I competed in a rodeo. I made sure I slept well, stuck rigidly to my diet, hydrated regularly. It seemed no matter what I did, I still got one the day after – sometimes lasting as long as 3 days. First of all I thought it must be the rush of adrenalin stopping the effectiveness of my prophylactic migraine meds (Amitriptyline & Propranolol)
Then it hit me.
What I did was very exerting. I used a lot of muscles – Particularly in my back.
I found that massage and rubbing Ibuprofen gel between my shoulder blades and up to my neck and scull helped, but they still came. Then I remembered my Paramax painkillers that I kept for those times when the pain was so bad all I wanted to do was sleep. They usually left me too drowsy for anything else.
It got me to wondering, what if I took them following a rodeo before bed as a preventative measure?
It worked quite well.
This weekend I had a two-day rodeo, which was normally a recipe for a huge episode lasting several days. This time I woke up with a manageable headache where I could still function. Two Paramax tablets taken before bed had staved it off. It must have relaxed me enough that my muscles didn’t cramp up.
I will try this again to test that it wasn’t a one off. Then I will talk it over with my doctor. Maybe he will recommend a better muscle relaxant. I’ll keep you posted.
So there you have it.
I am a chronic migraineur who also suffers cluster, icepick and tension headaches. All have similar symptoms, but are treated and prevented very differently.
This could make a hell of a difference to you. Many of you would have been misdiagnosed with one or more of these. You are probably using the wrong medication and wondering why nothing works.
Whatever your headache is, it makes your life miserable. Please drop me a line and tell me your story. I really hope something I’ve said resonates with you. Feel free to download any of the free stuff.
Until next time – keep soldiering on migraineurs!