Headache & Migraine Pain by International Pain Foundation

HEADACHE & MIGRAINE PAIN

Migraine headaches tend to first appear between the ages of 10 and 45. Sometimes, they begin later in life. Migraines may run in families. Migraines occur more often in women than men. Some women, but not all, may have fewer migraines when they are pregnant

A migraine headache is caused by abnormal brain activity. Many things can trigger this activity. However, the exact chain of events remains unclear. Most medical experts believe the attack begins in the brain and involves nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.

It can be a disabling syndrome that influences every aspect of a person’s life. Sufferers expect that they will be incapacitated by these sickening headaches monthly, weekly or even daily and struggle to work their lives around this excruciating chronic illness.

According to the National Headache Foundation, migraines are more than just a “bad headache.”

Migraine pain and associated symptoms affect 28 million Americans, equivalent to 13% of the population; one in every four U.S. households has a migraine sufferer. In a U.S. population study, the prevalence of migraine is estimated to be 12% (17% in women and 6% in men).

Migraine afflicts both men and women, although women experience migraine more often than men, at a ratio of 3:1. Peak prevalence for migraine is between the ages of 30 to 39 for both genders. Many people are unaware that certain pain conditions are more prevalent in women than in men, such as migraine headache, chronic pelvic pain, fibromyalgia, temporomandibular joint disorder and irritable bowel syndrome, to name a few.

Women with migraine are at an increased chance of widespread chronic pain, and the chance increases as a function of headache frequency. Migraine frequency also correlates with depression. One study of 53 women with episodic migraines and 37 women with chronic migraines found that:

Widespread chronic pain is more likely among women with chronic migraine than in episodic migraine

Women with chronic migraine were more likely to have symptoms of moderate or severe depression relative to women who do not suffer from migraines

Both episodic and chronic migraine sufferers experience impaired quality of life compared to women who do not suffer from migraines

Depressive symptoms influenced the quality of life of women with chronic migraine

Headaches, including migraine, appear to be more common in patients with temporomandibular joint disorders (TMDs) as compared to controls. Clinical and epidemiological studies have demonstrated that people with headache and those with TMDs often share similar signs and symptoms – and evidence suggests that TMDs and headache disorders such as migraine are comorbid.

A recent study found that nearly two-thirds of all patients with chronic daily headaches also had TMD.

This is not intended to be a comprehensive summary of the available information on this topic. Please consult with your health care professional for additional information.

Facts

A recent study found that nearly two-thirds of all patients with chronic daily headaches also had TMD.

A separate study found that 81.7% of people who suffered from chronic headaches turned to Complementary Alternative Medicine (CAM), because they wanted to “be active against the disease,” “leave nothing undone,” or because conventional therapies had failed.

Approximately 90% of migraineurs have moderate or severe pain, three-quarters have a reduced ability to function during their headache attacks, and one-third require bed rest during their attacks.

Approximately one third (24-42%) of migraine patients have attacks almost exclusively related to sleep or awakening (sleep migraine). Sleep disturbances are commonly reported by migraines. However, it is not really known whether migraine attacks are the major cause of thereported sleep disturbances, whether coexistentsleep disturbances trigger migraine attacks during the night or if there are parallel (but non-causal) mechanisms linking migraine and sleep problems.

In addition, women with migraine appear more likely to experience painful TMDs when compared to women with no headache.

In one study, one-year migraine prevalence was 53% and lifetime prevalence was 67% in women between the ages of 17 and 45 years with chronic pelvic pain, a rate approximately 3 times the 18% one-year prevalence in the general U.S. female population and more than double the 23% peak prevalence among similarly aged women.

One study found the association between painful TMDs and headache to be highest in chronic migraine, followed by episodic migraine and episodic tension-type headache.

The National Headache Foundation estimates that industry loses $31 billion per year due to absenteeism and medical expenses caused by headache; migraine sufferers alone lose more than 157 million workdays each year.

While obesity is not associated with the prevalence of migraine attacks, an association has been found with the frequency of attacks.

References

• National Institutes of Health. Medline Plus. “Migraine.” http://www.nlm.nih.gov/medlineplus/ency/article/000709.htm.
• National Headache Foundation. “Migraine Facts.” http://www.headaches.org/press/NHF_Press_Kits/Press_Kits_-_Migraine_Facts.
• Lipton R, Bigal M, Diamond M, Freitag F, Reed M, Stewart W. “Migraine prevalence, disease burden, and the need for preventive therapy.” Neurology. 2007 Jan; 68:343-9.
• International Association for the Study of Pain. “Global year against pain in women fact sheet: endometriosis and its association with other painful conditions.” 2007.
• Stuginski-Barbosa J, Dach F, Bigal M, Speciali JG. “Chronic pain and depression in the quality of life of women with migraine – a controlled study.” Headache. 2012 Mar;52(3):400-8.
• Bender SD. “Orofacial pain and headache: a review and look at the commonalities.” Curr Pain Headache Rep. 2014 Mar; 18(3):400.
• Bigal M, Liberman J, Lipton R. “Obesity and migraine: A population study.” Neurology. 2006 Feb; 66:54.
• Karp B, Sinaii N, Nieman L, Silberstein S, Stratton P. “Migraine in women with chronic pelvic pain with and without endometriosis.” Fertil Steril. 2011 Mar; 95(3):895-9.
• Gaul C, Schmidt T, Czaja E, Eismann R, Zierz S. “Attitude towards complementary and alternative medicine in chronic pain syndromes: a questionnaire-based comparison between primary headache and back pain.” BMC Complementary and Alternative Medicine. 2011,11:89.
• Engstrom M, Hagan K, Bjork M, Gravdahl G, Sand T. “Sleep-related and non-sleep related migraine: interictal sleep quality, arousals and pain thresholds.” J of Headache and Pain. 2013. 14:6

Provided by International Pain Foundation