How Do You Know If Your Headache Is A Migraine?

In the past year or two I have been getting horrible headaches every month, and in some months two to four days in a stretch. My sinuses also act up. I have seen several doctors who tell me it is migraine or stress-related. I have medication for migraine, stress, and sinuses. None of that really works.

I tried watching what I eat, and I exercise. The pain usually begins at the base of the skull on the right hand side and work its way along the side of my right ear and also down to the right side (trapezius) shoulder. I use ice packs or heat packs hoping to get some relief. Most often my eyes become watery, sometimes I see what I call “twinkle little stars,” which is followed by nausea. Sometimes there are no stars, just nausea, and I will need to go to the bathroom.

I find sometimes the medication (because it is too much for my system) brings about abdominal cramps and I have to use the bathroom. The pain at the base of my skull feels like the joints are grinding — at other times my head feels as if it is a sponge being squeezed of every ounce of water in it. When I get these bad attacks of whatever, I have to lock my self away from light and noise especially. I’d appreciate any information you can give me.

Migraine is a commonly misdiagnosed type of headache, both by headache sufferers and the doctors they go to. I suppose this comes about because of the tendency of everyone to consider bad or very painful headaches to be migraines, especially if they occur in women, are related to their menstrual periods, and have run in the family. I often hear women tell me that they have migraines, and they got them from their mother who suffered all her life from them.

The confusion also arises from the fact that one can have mixed headaches, with some migrainous features, and some features of tension headaches, and that not all migraines follow the same pattern. In classical migraines, which acount for about a third of the total, there is an aura which precedes the headache. This generally includes visual, crenellated, scintillating visual images which move across the visual field. Within a few minutes, the headache begins, and this is usually one-sided, throbbing or pounding, very severe, accompanied by photophobia (light seems to increase the pain), and nausea or vomiting. Some people describe the pain as “like have a nail pounded into the back of my eye with a hammer.” If the sufferer is able to go to sleep, the headache is usually gone when she reawakens.

Pain at the base of the skull going down to the trapezius, shoulder muscle, even if one sided, is less likely to be migraine. The little stars the writer describes seem to occur with the headache, not before, which would not be consistent with a migraine aura. And the medication doesn’t really work, which is more typical of muscle tension headace than migraine.

I assume that she has been given sumatriptan (Imitrex). In my experience sumatriptan is highly effective in stopping a migraine headache, often within 10-15 minutes. The headache may recur later, requiring another injection, but the relief is usually very quick, and very complete. Because sumatriptan causes the arteries to constrict, it can only be used a limited number of times in a day or a week, and the major side effect one worries about is precipitating a heart attack in an older person susceptible to heart problems. Chest pain after the injection is fairly common, and doesn’t necessarily mean that the person is having a heart attack, but the medicine is not advised for people who have had, or are thought to be susceptible to, a heart attack.

A pill form Is now available but it appears to be less effective than the injection form of Imitrex. I would always advise a migraine sufferer to use the injection form of Imitrex if they can tolerate giving themselves the injection.

For people who can’t use sumatriptan, there are other treatments, which I have described in detail in some of my previous answers. Please surf through my archived answers for discussions about migraines.

The information provided on Health Search Online is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment.