06/23/2026
“Migraines are not just a bad headache”
By Tracy L. Kahl D.O.
A migraine will make your head hurt, but there’s more to it than a typical headache. You can have more than head pain when you get one. A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities. Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.
Prodrome (1-2 days prior to the headache)
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, about 60% of people who have migraine notice symptoms like:
• Sensitivity to light, sound, or smell. Levels of light and sound that don't usually bother you may feel uncomfortable or even painful. Odors like those of cigarette smoke, car exhaust, perfume, and cleaning products may seem especially unpleasant.
• Fatigue
• Constipation.
• Mood changes, from depression to euphoria.
• Food cravings.
• Neck stiffness.
• Increased urination.
• Fluid retention.
• Frequent yawning.
Aura (30-60 minutes prior or at onset of headache)
Up to 25% of people who have migraines can experience an aura, it typically occurs 30-60 minutes before the onset of pain, but it can also occur during migraines. Examples of migraine auras include:
• Visual phenomena, such as seeing various shapes, wavy lines, bright spots or flashes of light.
• Vision loss.
• Pins and needles sensations in an arm or leg.
• Weakness or numbness in the face or one side of the body.
• Difficulty speaking.
• Smelling an odor that others are unable to notice
Attack or Headache Phase (Last 4hr up to 72 hr)
During a migraine, you might have:
• Pain usually on one side of your head, but often on both sides.
• Pain that throbs or pulses.
• Sensitivity to light, sound, and sometimes smell and touch.
• Nausea and vomiting.
Post-drome (can last up to 1-2 days following the migraine)
About 80% of people with migraine have postdrome. Symptoms include:
• Feeling tired, wiped out, or cranky
• Feeling unusually refreshed or happy
• Muscle pain or weakness
• Food cravings or lack of appetite
• Trouble concentrating
Migraine triggers
There are numerous migraine triggers, not all triggers effect migraine patients the same. But avoidance of your specific trigger can help decrease the frequency of migraine headaches dramatically.
• Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women. Hormonal medications, such as oral birth control pills, also can worsen migraines.
• Alcohol, especially wine or other aged liquors
• Caffeine excessive or fluctuating amounts, especially high concentration found in energy drinks
• Stress
• Sensory stimuli. Bright or flashing lights, loud sounds. Strong smells — such as perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
• Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people
• Physical strain. Intense physical exertion.
• Weather changes. A change of weather or barometric pressure can prompt a migraine.
• Foods. Aged cheeses and salty and processed foods might trigger migraines. Chocolate. Peanut butter. Skipped meals.
• Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.
• Dehydration.
• Medication-overuse. The medication you take for your headaches can start to cause headaches if over-used.
Treatment
There's no cure for migraine, but there are many ways to treat it. Migraine treatment is aimed at stopping symptoms and preventing future attacks. Make an appointment with your healthcare provider to come up with a treatment plan that will work for you if you think you may be suffering from migraines.
