This is National Migraine and Headache Awareness Month. Let’s observe it by taking a closer look at migraine, which is more than a headache. Migraine is a disabling neurological condition that has different symptoms and treatment approaches compared to other types of headaches, such as tension and cluster headaches.

Migraine causes pulsing pain that often starts on one side of your head. It typically gets worse with physical activity and makes you extremely sensitive to light, sound or smell. A migraine can last for hours or even days. Research shows it’s the sixth most disabling disorder in the world.

There are many different types of migraine. The most common are migraine with aura, or complicated migraine, and migraine without aura, or common migraine.

About 25 to 30 percent of people with migraine experience auras just before the headache pain begins. An aura is a group of sensory disturbances that may include flashes of light, zigzag lines or other vision changes. They may also include ringing in the ears, tingling on one side of the body and an inability to speak clearly. Auras serve as a warning sign that a migraine is imminent.

However, most migraine sufferers experience common migraine, without aura. Common migraines typically start slower that complicated migraines, last longer and interfere more with everyday activities. The pain is often only on one side of the head.

Migraine typically occurs in four stages: prodrome, aura, headache and postdrome. Each stage has its own symptoms.

The prodrome, or warning stage, is the calm before the storm. You may notice changes in your body and mood anywhere from a few hours to a few days before the migraine actually begins. Prodrome symptoms include difficulty concentrating, irritability and/or depression, nausea, vomiting, constipation, sensitivity to light or sound, food cravings, increased urination and muscle stiffness.

Aura symptoms were discussed above.

Symptoms of the headache stage include neck pain and stiffness; depression, giddiness and/or anxiety; sensitivity to light, sound or smell; nasal congestion; insomnia; nausea and vomiting; loss of appetite; feeling very warm or cold; diarrhea; dizziness; and blurred vision.

During this stage, you may feel a dull ache that develops into a pulsing pain that has been described as feeling like an icepick being jabbed into your head. The pain may shift from one side of your head to the other, or it can affect the front of your head, the back of your head or your entire head. The headache stage lasts anywhere from four to 72 hours.

The postdrome, also known as the migraine hangover, can last from a few hours to a day after the migraine is over. There are lingering symptoms that may include an inability to concentrate, depressed mood, fatigue, lack of comprehension and euphoric mood. About 80 percent of people with migraine experience this stage.

Researchers don’t know the cause of migraine, but they have identified certain risk factors. These include genetics. Up to 80 percent of people who have migraine have a parent, sibling or child with the disorder. Gender is another risk factor. Women are two to three times more likely to develop migraine than men. You are also at a higher risk if you live a high-stress lifestyle. Smoking also increases your risk.

Stress is a trigger for migraine. Other factors that may trigger migraine include hormonal changes; pickled, processed or canned foods; alcoholic or caffeinated beverages; certain medications; infections such as a cold or the flu; loud sounds, bright lights and strong smells such as paint fumes or heavy perfumes.

Your doctor can generally diagnose migraine based on the symptoms you report. The physician may order blood tests or an imaging exam, such as a CT or MRI, to rule out other disorders.

There is no cure for migraine. However, it can usually be managed with medication, and in some cases it can be improved. There are two main approaches that include medications: abortive and preventive.

Abortive treatment is designed to stop your migraine and ease your pain. Medications used in this approach includes over-the-counter pain relievers and prescription medications such as triptans, which reverse the changes in your brain that contribute to migraine.

Other abortive medications include ergot alkaloids, which narrow the blood vessels in the brain; and calcitonin gene-related peptide (CGRP) antagonists, which bind to CGRP and keep it from working. An influx of CGRP is believed to contribute to the development of migraine. CGRP antagonists can also be used to prevent migraine.

Preventive treatments are designed to reduce the frequency, severity and duration of migraine. They include medications such as beta blockers, calcium channel blockers, certain antidepressants and anti-seizure medications, and BOTOX injections. Wearable devices that stimulate your vagus and trigeminal nerves can also prevent migraine or give relief if the headache has started.

If you suffer from chronic migraine, don’t give up. See your doctor about abortive and preventive treatment approaches. Maybe you will find some relief from your misery.

Patti DiPanfilo

The ancient Chinese therapy of acupuncture has gained considerable steam in the United States during the past 20 years or so. Today, more than three million Americans receive the treatment each year, and the number just continues to grow.

If you’ve had acupuncture, let us know what you think about it. If you’re just considering it, here are a few particulars to help you make a more informed decision.

In Chinese medicine, health depends on the balance of the extremes (yin and yang) of the life force, or energy, known as chi. This life force flows through pathways in the body called meridians. The Chinese believe illness results when there’s an imbalance of chi.

The acupuncture treatment involves inserting very thin needles through your skin at specific points on your body that correspond to the meridians. By accessing the meridians, the treatment brings the chi back into balance and helps you feel better. Many in the medical community, however, remain skeptical of its benefits.

Western medicine has long known about acupuncture. An article that ran in The New York Times in 1854 is the first known to report on it in the United States. More than 160 years later, many health care practitioners are still wary of its value. However, during the century plus since that first article was written, a lot of research has been conducted and more has become known about this alternative therapy’s effectiveness.

For example, a 2012 meta-analysis, which is a study of existing research, compared acupuncture to standard medical treatment for musculoskeletal pain, chronic headaches and osteoarthritis. The researchers found a statistically significant benefit to acupuncture when compared to standard treatment.

One reason for this, scientists speculate, is acupuncture needles create tiny injuries where they are inserted. These injuries cause the body’s immune system to react by sending anti-inflammatory proteins and other healing substances to the injury site. By revving up the immune system, it is primed to manage bigger problems.

Another possibility the researchers suggest is the increased blood flow and immune system substances now present at the injury site could help remove accumulated cellular byproducts that may be leading to certain painful conditions.

A popular way acupuncture is being used in this country is as a complementary treatment along with standard medical care. Western health care practitioners see acupuncture points as places where muscles, connective tissue and nerves can be stimulated. One theory is that the treatment incites neurotransmitters to release the body’s own pain-killing chemicals.

A 2017 meta-analysis of 29 clinical trials seemed to back this approach to using acupuncture. It looked at nearly 18,000 patients with chronic neck, low back, knee or headache pain.

The study found that adding acupuncture to standard medical care, such as anti-inflammatory medications, significantly reduced the number of headaches and migraines. It also reduced the severity of neck and low back pain, and the pain and disability associated with osteoarthritis.

Acupuncture has been shown to be effective in treating pain, but it also treats other types of disorders. It’s been used to help with conditions related to cancer treatment, such as nausea and vomiting, and severe dry mouth. One study showed it is even effective at treating anxiety and depression.

The World Health Organization reports that acupuncture is effective for treating 28 conditions, but there’s evidence to suggest it may have therapeutic value for many more. If you’re thinking about trying acupuncture, consider this: it is a less costly treatment option than many standard therapies, and it has very few side effects.