Migraine
More than just a headache — causes, triggers and effective management
Migraine is a complex neurological condition that affects around 10 million people in the UK. It is characterised by recurrent episodes of moderate to severe headache, often accompanied by nausea, vomiting, and sensitivity to light and sound. Despite being extremely common, migraine remains widely misunderstood and underdiagnosed.
What is a migraine?
A migraine is much more than a bad headache. It is a neurological event involving changes in brain chemistry and blood flow. Attacks typically cause a throbbing or pulsating headache, usually on one side of the head, which can last from 4 to 72 hours. Many people also experience an 'aura' — visual disturbances such as flashing lights or zigzag patterns — that precede the headache.
Triggers and patterns
Migraine triggers vary widely between individuals. Common triggers include stress, hormonal changes (particularly in women around menstruation), disrupted sleep, dehydration, skipping meals, bright or flickering lights, strong smells, certain foods and drinks, and changes in weather. Keeping a headache diary can help identify personal triggers so they can be avoided or managed.
How are migraines treated?
Treatment falls into two categories: acute treatment to relieve symptoms during an attack, and preventive treatment to reduce the frequency and severity of attacks. Acute treatments include over-the-counter pain relievers and prescription medications called triptans, which are specifically designed for migraine. Preventive medications are taken daily and include beta-blockers, anticonvulsants and antidepressants. Newer injectable treatments targeting a protein called CGRP are also available for severe, frequent migraines.
Medication overuse headache
An important consideration in migraine management is medication overuse headache (MOH) — also known as rebound headache. This occurs when pain-relieving medications are taken too frequently (more than 10 days per month), causing the brain to become more sensitive to pain. If you find yourself reaching for pain relief very frequently, speak to your GP or specialist, as gradually withdrawing the overused medication can significantly improve the situation.
Managing migraine in daily life
While migraine cannot currently be cured, it can be well managed. Maintaining regular sleep, eating at regular times, staying hydrated, and managing stress can all reduce attack frequency. Acupuncture has also been shown to help some people. If migraines are frequent and significantly affecting your life, specialist referral to a headache clinic may be appropriate. The Migraine Trust provides excellent support and resources. All content in this article has been prepared following careful evaluation of current neurology guidelines to ensure it reflects best practice.