Anyone who suffers, or knows someone who suffers from migraine headaches, knows that they are painful to have and to treat.

According to the Migraine Research Foundation, about 30 million Americans suffer from migraine headaches.

However, migraines are difficult to diagnose and treat because each person has their own pattern and triggers.

Glenn Weiss, medical director at Student Health Services, said, “People who aren’t doctors sometimes often hear the word ‘migraine’ and don’t know what it means. They think it is any severe headache, but what it really is is a headache that is caused in a certain way.

Not all migraines are severe and not all severe headaches are migraines.

“First of all, [a migraine] is a vascular headache. The blood supply flows to different parts of the brain; something triggers it to start like lack of sleep, stress or diet and the artery gets tight, so temporarily a part of the brain gets less blood. This often causes an aura where your left hand goes numb or you feel nauseous, but not all people have the aura,” he continued.

“The neurologic symptom when the brain is malfunctioning because of not enough blood is to send a chemical signal to the arteries to open. Then they become too open and stretch the nerves around the artery which causes pain.”  

When a person is suffering from a headache, the first response is to take some type of pain reliever. Weiss explained there are three types of medicine used to treat headaches.

Pain relievers like Ibuprofen or Tylenol with codeine are not really anti-migraine medicines but sometimes they work on less severe headaches, he explained. There are also preventative medicines and medicines used at the onset of a migraine.

“There are various medicines we can use to treat migraines, but it is hard to predict who will respond well. Different patients require different medicines. You can pick right on the first try for some, but it is usually a trial and error process and takes time,” Weiss said.  

Josh Johnson, pharmacist at CVS, said, “A lot of the medicines were not initially designed for migraines, but as these medicines have been used on people, we find that they are good at helping in the treatment of the migraines too.”

“The triptans have been specifically developed to treat migraines,” he said.

Many people who suffer from migraines take both preventative medicine and medicine at the onset of the headache.

“With migraines you commonly have an aura before the headache. That’s when the patient would usually start treatment. Ideally, the first dosing will resolve the symptoms, but there are times when the patient will have to repeat the medication,” he said.

Weiss explained triptans are used most commonly, but can be risky in older adults because they constrict the blood vessels in your head as well as your heart. If a person has any blockages, these may stop headaches but start a new problem.  

There are also natural remedies that can treat migraines. Weiss feels that sleep is probably the best, while Johnson explained headache sticks and patches, like HeadOn are used but have little proof as to how well they work.

When it comes to diagnosing a migraine, doctors are taught to tell headaches apart, but it takes a lot of interpretation. They should ask how long it lasts, where it is and how it feels to get an idea, but for each different kind there can be an overlap and that makes it hard to tell, Weiss explained.