Tracking headaches and migraines to determine if they may be something more serious.

Ever hear of someone having a really intense headache? It can come as a sharp pain when some people skip a meal or their morning coffee. Some people can push through, take some Tylenol, and go about their day. But some headaches can shut people down completely. The pain throbs and pulsates. Some may experience nausea, light sensitivity, or sound sensitivity. The latter are symptoms of a migraine, which affects more than 15% of the population. To determine the difference between a headache and a migraine, track the severity of the pain, know the triggers, and monitor how effective treatment is in subsiding the pain.

Headache Red Flags

Some pain isn’t safe to ignore. You don’t want to miss signs of infection, stroke, brain bleeds from trauma, or amass in the brain. According to a 2022 study published in the Journal of Headache and Pain, more than half of migraine patients are female. Most commonly, patients are between ages 30-39 and can identify a close relative who shares the diagnosis. Joanna Smith, PA-C, provides treatment for migraine patients in the Jefferson City SSM Health Spine and Pain Management Center. She says you should seek treatment if you’ve experienced the following:

• A sudden severe headache that you consider the worst headache of your life
• Any headache that doesn’t respond to treatment
• Any new onset headaches if you’re over the age of 50
• Any headaches for patients with cancer
• Any headaches that are associated with symptoms like a fever or a stiff neck or any neurological symptoms

If you have mild, infrequent headaches and over-the-counter medications take the pain away, this is a good sign. Monitor your dosage and how often you have these headaches. The magic number to track headache severity is 4 out of 10 for pain. When the Tylenol and Aleve don’t seem to work, it’s time to talk about other medications.

Are you having four or more headaches a month? You’re in migraine territory. Prescription medications like Triptan can help relieve the pain. If an aura precedes the migraine and you’re counting four migraines a month, talk to your healthcare provider about prevention medications like antidepressants, beta-blockers, calcium channel blockers, anti-convulsants, and calcitonin gene-related peptide (CGRP) receptor antagonists.

Pain Prevention

Are you dehydrated, tired, or hungry? If you feel a headache or migraine coming, do your best to identify the trigger. “It’s very important to take frequent breaks,” Joanna says. “Depending on what your job is, take your lunchtime, don’t work through it. Don’t sit at your desk for hours on end. Get up every hour or so, even if it’s just a short walk around the office. Make sure when you’re not at the office you do some kind of exercise that you enjoy.”

Some common triggers include prolonged screen time, sleeping too little or too much, stress, and nitrates found in aged cheeses, hotdogs, and wine. Know your triggers to find a remedy, like nitrate-free spirits or using blue-light glasses during screen time.

If stress is a trigger, try to increase your self care with relaxation techniques such as meditating, praying, yoga, walking, or spending time in nature. On your journey to finding a treatment that works for you, it’s important to remember the disorder does not define you.

Figuring out the best treatment for each patient is Joanna’s favorite part of her job at SSM Health.

“A lot of times, we see people with chronic pain who have had pain affect their quality of life for months or years,” Joanna says. “To finally see them get some relief with an injection or medication, it’s very rewarding.”

The Do’s and Don’ts of Headaches and Migraines

It helps to consider common triggers to cope with headaches or migraine attacks. These do’s and don’ts may help navigate tension, cluster, or severe headaches:

Do…
+ Rest in a quiet, dark room with a cool cloth on your forehead.
+ Try to sleep as often as possible.
+ Take any medication your healthcare provider has recommended.

Don’t…
– Drive, especially if your vision is affected.
– Avoid intense physical activity.
– Look at a screen for too long.