Migraine: Symptoms, Triggers, Treatment & Care

Our plan covers migraine symptoms, triggers, treatment, prevention, and when to seek care.

Migraine is a recurring disorder of the brain and nerves, not just severe head pain^2,3. An attack may cause pain, nausea, vomiting, fatigue, and changes in the senses^1,3. Symptoms may last for hours or days and make daily tasks hard^3,4.

Care often includes treatment during attacks and steps to prevent future attacks^2,5. Tracking your symptoms may also help you and your clinician find useful patterns^3,7.

Migraine is a long-term brain disorder that causes repeated attacks^2,4. Head pain is common, but an attack can affect much more than your head^3,6.

The pain is often moderate or severe and may feel like throbbing or pulsing^1,2. It often affects one side of the head^1,2. However, pain can occur on both sides or move between sides⁶.

Routine activity may make migraine pain worse^2,6. Light, noise, or strong smells may also increase discomfort^1,6. Many people have nausea, vomiting, or reduced ability to function during attacks^1,2.

Migraine differs from person to person^3,6. One person may have severe pain and vomiting. Another may have vision changes or nausea without head pain^1,3.

Doctors often group attacks as migraine with aura or migraine without aura⁶. Aura means short-term changes in vision or other nerve functions^2,7. Migraine without aura is the more common type.

A migraine attack may pass through several phases^1,6. Each phase can cause different symptoms⁶. However, not every attack includes every phase^1,6.

Migraine symptoms may occur during prodrome, aura, headache, and postdrome phases^1,6. The order and strength of these symptoms can vary^3,6.

Prodrome is the early phase of an attack³. It may start hours or days before the main symptoms³.

Possible prodrome signs include these common changes:

These signs do not occur with every attack^1,6. A diary may help you spot patterns in your migraine attacks⁶.

Aura is a group of short-term, reversible nerve symptoms^2,7. It can occur before head pain or during the headache phase^1,7.

Aura often builds over several minutes and lasts no longer than one hour. It may cause flashing lights, bright spots, shapes, or other vision changes^1,7.

Some people see zigzag lines during aura¹. Others may have a brief loss of vision. Aura can occur before or during a migraine, and some migraine episodes have no headache^1,3.

Migraine pain often starts slowly and grows stronger^1,3. It may feel throbbing, pulsing, pounding, or dull^1,6.

The headache phase may last from four to 72 hours⁶. Symptoms lasting for hours or days can interfere with daily life^3,4.

Other migraine symptoms may occur with head pain:

Postdrome is the phase that follows the headache¹. It may cause exhaustion, dizziness, nausea, or mood changes^3,6.

This phase can last up to two days^3,6. Some attacks end without a clear postdrome phase^1,6.

Some attacks cause migraine symptoms without head pain^1,3. These attacks may involve vision changes, nausea, vomiting, or bowel changes³.

A clinician can review such symptoms and consider other possible causes^3,7. This review is helpful when the pattern is new or unclear.

A trigger is an event or exposure linked with the start of an attack. Common migraine triggers vary from one person to another^1,3.

Several triggers may work together during one attack¹. Finding one possible trigger does not mean it causes every attack.

Stress and anxiety are often linked with migraine attacks^1,4. Attacks may also follow too much sleep, too little sleep, or sleep changes^1,3.

Skipped meals and hunger can contribute to attacks^1,3. Dehydration is another reported trigger⁹.

Hormone changes may affect migraine patterns^3,7. These changes can occur during menstrual cycles, pregnancy, or perimenopause^3,7.

Physical strain and overexertion may also trigger attacks^1,3. Too much physical activity can trigger migraine attacks in some people^3,4.

Weather changes may trigger an attack for some people^1,3. Changes in the wider environment may also play a role¹.

Reported sensory triggers include these exposures:

Too much caffeine may trigger migraine⁹. Caffeine withdrawal may also trigger an attack in some people¹.

Alcohol is another reported trigger^1,3. Red wine is a common example.

Tobacco may contribute to attacks^1,3. Certain medicines can also affect migraine patterns^1,7.

Frequent use of acute medicine may cause medication-overuse headache. This condition is linked with acute treatment on at least ten days each month.

Some people report attacks after eating certain foods or ingredients¹. Examples include chocolate, aged cheese, processed meat, and fermented foods¹.

These foods do not trigger attacks in everyone¹. A food may only contribute when other triggers are also present¹.

Track food patterns before making broad changes to your diet. A diary can show links between meals, drinks, and later symptoms³.

You can use paper, a calendar, or an app for tracking. Bring the diary to medical visits so your clinician can review it.

A useful headache diary may include these details:

Acute treatment aims to stop or ease symptoms during an attack^5,10. Medicines that relieve migraine symptoms can be more effective when taken sooner^1,5.

Resting in a dark, quiet room may help during an attack¹. Closing your eyes may also reduce unwanted light¹.

These simple steps can support your treatment plan:

Acetaminophen, aspirin, and nonsteroidal anti-inflammatory drugs may treat mild or moderate attacks^4,10. Nonsteroidal anti-inflammatory drugs are often called NSAIDs².

Acetaminophen and nonsteroidal anti-inflammatory drugs are examples of medicines used for acute migraine care¹⁰. NSAIDs are first-line options for mild or moderate attacks unless a contraindication exists¹⁰.

A contraindication is a health issue that makes a medicine unsuitable. Treatment choices should account for contraindications, side effects, cost, and the needed form¹⁰.

Taking pain relievers too often can cause medication-overuse headaches⁶. Aspirin and ibuprofen may also cause ulcers or bleeding in the digestive tract.

Ask a clinician or pharmacist which option fits your health history. They can also explain how often you can safely use it.

Triptans are targeted medicines for moderate or severe attacks¹⁰. They come as pills, nasal products, dissolving tablets, and injections.

Triptans have vascular contraindications, which involve certain blood vessel conditions¹⁰. They may be unsafe for people at risk of heart attack or stroke.

Gepants are medicines that block calcitonin gene-related peptide, also called CGRP. CGRP is a protein involved in migraine care.

Gepants and ditans do not have the vascular limits linked with triptans¹⁰. This difference can affect medicine choice when vascular disease is a concern¹⁰.

Lasmiditan is a ditan for migraine with or without aura. It can cause sleepiness and dizziness. Do not drive or use machinery for at least eight hours after taking it.

Some gepants interact with strong CYP3A4 inhibitors, including some cancer drugs. A pharmacist can check your medicine list for possible interactions.

Dihydroergotamine is available as a nasal medicine. People with coronary disease or high blood pressure should avoid it. It should also be avoided with kidney or liver disease.

Anti-nausea medicines may be used with pain treatment. Nasal or injected options may help when vomiting makes pills hard to use.

Opioids and barbiturates are usually avoided because better options are available. These drugs can be addictive and are used only when other treatments fail.

Some migraine medicines are unsafe during pregnancy. If pregnant or trying to conceive, discuss every migraine medicine with a clinician first.

Migraine treatment and prevention may combine daily habits, medicines, and other forms of care^2,4. The goals include fewer attacks, less pain, and better daily function⁹.

A steady routine may help reduce attack risk^1,7. Choose changes that are realistic for your daily life.

A migraine prevention routine can include these steps:

Biofeedback uses a device to show body signals, such as heart rate or muscle tension¹. It teaches greater control over some of these body responses¹.

Preventive treatment may be considered when attacks are frequent or disabling⁹. It may also help when acute treatments fail or cannot be used⁹.

Long-lasting or severe attacks may lead to a prevention discussion. Frequent use of acute medicine is another reason to consider prevention⁹.

Personal preference can also support the choice to start preventive care⁹. A clinician can explain the likely benefits and risks of each option.

Several medicine groups have evidence for migraine prevention^2,9. The right choice depends on health needs, side effects, and other conditions^5,10.

A clinician may discuss these medicine groups:

Chronic migraine is a form that causes headache symptoms very often over time. A clinician must decide whether this diagnosis applies.

Neuromodulation uses stimulation devices as a treatment option for migraine^9,10. Evidence varies, but these devices may be considered for some people^9,10.

Check with your healthcare provider before taking supplements such as magnesium, riboflavin, or coenzyme Q10¹. Supplements can affect other parts of your health or care plan.

A healthcare professional can assess recurring headaches and discuss migraine-specific treatment. An exam can also help rule out another cause^1,10.

If a headache condition suddenly becomes serious, tests may help find another cause. MRI can show stroke, bleeding, tumors, infections, and other brain conditions. If a headache comes on suddenly and is extremely severe, or you have new neurological symptoms such as difficulty speaking, vision problems, confusion, or numbness, call emergency services or go to an emergency department right away; these signs may indicate a serious cause such as stroke or bleeding in the brain.

CT scans can also show bleeding, brain injury, tumors, or infections. A clinician may order imaging to rule out other causes of your symptoms^1,5.

If migraines interfere with daily life, talk with a healthcare provider^2,6. A clinician can review possible treatment and prevention choices.

Discuss care in these situations:

Migraine diagnosis is based mainly on health history and symptoms^2,5. The clinician also performs physical and nerve function exams^1,5.

Expect questions about when attacks start and how long they last³. The clinician may ask about pain, triggers, nausea, and vision changes³.

Standard migraine diagnosis does not require a lab or imaging test². Blood tests, MRI, CT, or other tests may help rule out another cause^1,5.

Bring your headache diary and current medicine list to the visit. The diary can help your clinician spot patterns and plan care^3,7.

Migraine may cause pain, nausea, vomiting, fatigue, and sensitivity to light or sound^1,3. Attacks can also occur without head pain^1,3.

Medicine to relieve migraine symptoms can be more effective when taken sooner^1,5. Steady sleep, regular meals, stress care, and trigger tracking may support prevention^1,7.

Keep a clear record of attacks and treatment results. Use that record to plan care with your clinician^3,7.

New or unclear symptoms need a professional assessment. A sudden serious change may require tests to rule out another cause.