The intense, throbbing pain of migraine is the result of chemical and hormonal reactions in the brain. Find out how the pain starts — and how to make it stop.
By Erica Patino Medically Reviewed by Jason Paul Chua, MD, PhD
Reviewed: December 30, 2022
During a migraine attack, pain sensations spread through the trigeminal nerve, which extends from the brain and branches throughout the face.
Even though migraine is a prevalent condition that, according to the National Institute of Neurological Disorders and Stroke, affects more than 10% of individuals globally, it wasn't fully known until recently.
In the past, medical professionals thought that variations in brain blood flow were the cause of migraine symptoms. But today, according to John Hopkins Medicine, scientists have determined that a combination of chemical substances and hormones, such as serotonin and estrogen, are to blame for the pain and other symptoms of a migraine attack. This unpleasant mixture is stirred up by the following.
The Anatomy Of Migraine
A migraine is not only a headache. It is a neurological condition with a cerebral origin. The Association of Migraine Disorders asserts that those who suffer from migraines have oversensitive nerve systems that overreact to particular stimuli, such as stress, hormonal changes, lack of sleep, dehydration, or particular foods or beverages.
Despite the fact that each person's triggers are unique, they all result in the same series of actions: According to Medhat Mikhael, MD, a pain management specialist and the medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California, the trigeminal nerve, which originates in the brain and branches out throughout the face, first becomes inflamed and dilated. As a result, pain perceptions propagate from the face to the brain.
According to Dr. Mikhael, it frequently results in a throbbing pain that is typically located on one side of the head, where the trigeminal artery widens.
However, the head pain might be so severe that it sets off additional migraine symptoms, such nausea. Mikhael explains that the majority of migraine sufferers would claim, "I didn't throw up, but I felt so terrible in my stomach, I thought I was going to,"
Photophobia, often known as light sensitivity, is another typical migraine symptom. Light can exacerbate pain during a migraine attack by stimulating nerve cells in the space between the eyes and in some parts of the brain. According to a study published in the European Journal of Neuroscience in 2021, phonophobia, or sensitivity to sound, may be brought on by nerve stimulation in the brain stem.
Aura, which might include momentary vision loss or visual disruptions like zigzag lines or flashing lights, can occur in a small percentage of migraine sufferers just before the pain becomes severe. According to the Mayo Clinic, this is caused by a chemical or electrical wave that travels across the brain in speech centers or regions that receive sensory inputs or regulate movement.
Neurological problems can affect certain persons and cause tingling in the arms or face or, less frequently, trouble speaking. Aura does not harm the brain, according to the Mayo Clinic, despite the fact that any of these symptoms can be unsettling.
How To Stop And Prevent Painful Migraine Attacks
Try to stop a migraine attack as soon as you start to feel it coming on. The best approach, according to Gina Dumkrieger, PhD, senior research fellow and assistant professor of neurology at Mayo Clinic in Tempe, Arizona, is to treat migraines as soon as they begin, she adds.
An over-the-counter pain reliever like aspirin, acetaminophen, or a nonsteroidal anti-inflammatory drug (NSAID) like naproxen or ibuprofen may be able to stop, or at least lessen, a migraine episode. Use these with caution, though, since the American Migraine Foundation warns that taking them too frequently (more than 15 days per month) can backfire and result in migraines from prescription abuse.
Talk to your doctor about getting a prescription for a migraine treatment, such as a triptan or a calcitonin gene-related peptide (CGRP) inhibitor, if over-the-counter medications don't relieve your symptoms. Triptans block the routes that carry pain signals from the body to the brain by restricting the trigeminal artery, but because they also constrict other arteries, they might have undesirable side effects including flushing of the face or tightness in the chest, according to Mikhael. The CGRP protein, which is involved in pain transmission during a migraine attack, is inhibited by CGRP inhibitors, which normally have no side effects.
Consult a neurologist, pain expert, or headache specialist who can accurately identify your condition and begin the necessary preventive treatment if you experience two incapacitating migraines per month or four days with a migraine headache per month, advises Mikhael. Prescription preventive drugs such beta-blockers, calcium channel blockers, anti-seizure drugs, botulinum toxin injections, and CGRP inhibitors can be helpful for some people.
You may be able to prevent some of your migraine attacks and lessen their discomfort with the appropriate medical care.
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