Migraine: Symptoms, Causes, Treatments
What Is A Migraine?
A migraine is a neurological condition characterised by recurrent, moderate to severe headaches, often accompanied by other symptoms. It affects millions of people worldwide, with chronic sufferers frequently reporting a significant decline in their quality of life.
“Traditional pharmacological treatments often prove ineffective or lead to unwanted side effects, highlighting the need for alternative therapies. Transcranial Magnetic Stimulation (TMS), particularly single-pulse TMS (sTMS) and repetitive TMS (rTMS), has been extensively researched as a non-invasive option for acute and preventive migraine management.” (Bhola et al., 2022)
Symptoms of Migraine
Some of the most common symptoms of Migraine include:
- Nausea,
- Vomiting,
- Sensitivity to light and sound.
What are the treatment options for migraines?
Treatments aim to prevent migraines, relieve symptoms, or improve quality of life. Options should be discussed with a healthcare professional to ensure suitability.
Medications
- Acute:
- Over-the-counter pain relievers (e.g., paracetamol, ibuprofen, aspirin).
- Triptans (e.g., sumatriptan) for moderate/severe migraines.
- Anti-nausea drugs (e.g., metoclopramide).
- Preventive:
- Beta-blockers (e.g., propranolol).
- Antidepressants (e.g., amitriptyline).
- Anticonvulsants (e.g., topiramate).
- CGRP inhibitors (e.g., erenumab).
Therapies
- Repetitive Transcranial Magnetic Stimulation (rTMS): A non-invasive treatment using magnetic pulses to stimulate brain areas, potentially reducing migraine pain or frequency. Offered by specialists for chronic migraines, particularly when other treatments are ineffective. Suitability and side effects (e.g., temporary headache, scalp discomfort) should be discussed with a doctor.
- Cognitive Behavioural Therapy (CBT): For stress or psychological triggers.
- Physiotherapy: For neck tension or posture issues.
Lifestyle Changes
- Regular sleep and meal schedules.
- Adequate hydration.
- Stress management (e.g., mindfulness, yoga).
- Avoiding identified triggers (e.g., foods, caffeine).
- Tailored physical activity.
Alternative Treatments
- Acupuncture: May reduce migraine frequency for some.
- Hypnotherapy: May help with stress or pain, with limited evidence.
- Supplements: Magnesium, riboflavin, or coenzyme Q10, under medical supervision.
- Biofeedback: To control physiological responses like muscle tension.
All treatments require professional guidance to ensure safety and efficacy.
Why Choose TMS for Migraines?
TMS offers a cutting-edge, non-invasive approach to managing migraines. By targeting brain regions involved in migraine mechanisms, TMS may provide both immediate relief and long-term prevention.
- Non-Invasive and Drug-Free: TMS avoids the side effects associated with medications.
- Preventive and Acute Relief: TMS offers solutions for both reducing attack frequency and managing acute episodes.
- Improved Quality of Life: Helps manage associated symptoms like mood changes and anxiety.
What TMS May Improve
Migraines where TMS may be helpful:
(Please note, this information is investigational and not a substitute for professional medical advice.)
Single-pulse TMS (sTMS):
- Key finding: Alleviates pain intensity during migraine episodes.
- Clinical evidence: 46% of patients reported significant relief, compared to 22% in a placebo group (Bhola et al., 2022).
- Implication: Suitable for immediate, drug-free relief.
- Repetitive TMS (rTMS):
- Key finding: A 50% reduction in migraine days over 12 weeks of treatment (Lipton et al., 2010).
- Clinical evidence: Shows potential for long-term migraine management and prevention.
- Implication: Helps reduce attack frequency and improve overall quality of life.
Reported Benefits of TMS for Migraines
Studies have highlighted several benefits for migraine sufferers using TMS:
- Pain Reduction:
Decreased severity and frequency of migraine attacks. - Improved Functioning:
Better sleep and reduced migraine-associated anxiety.
Enhanced mood and overall well-being.
Considerations and Cautions
- Limited Evidence: Research is promising but still evolving, especially for long-term outcomes.
- Individualised Approach: Treatment should be tailored to each patient’s condition and history.
- Commitment: TMS often requires multiple sessions over weeks for optimal results.
- Side Effects: Mild side effects may occur, including headache, scalp discomfort, or temporary auditory changes.
Important Note
Outcomes vary, and the decision to pursue TMS should follow a comprehensive consultation with a healthcare professional, such as a neurologist or pain specialist. They can assess your condition, explain risks and benefits, and develop an individualised treatment plan.
Read More
- Bhola, R., et al. (2022). Single-pulse Transcranial Magnetic Stimulation for Acute Migraine Relief: A Randomised Clinical Trial. Headache, 62(8), 978–986.
- Lipton, R. B., et al. (2010). Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial. The Lancet Neurology, 9(4), 373–380.
- Rossi, S., et al. (2015). Repetitive TMS over the visual cortex for migraine prevention.
- Grangeon, L., Lange, K. S., Waliszewska-Prosół, M., Onan, D., Marschollek, K., Wiels, W., Mikulenka, P., Farham, F., Gollion, C., & Ducros, A. (2023). Genetics of migraine: where are we now? The Journal of Headache and Pain, 24, Article 12. https://doi.org/10.1186/s10194-023-01547-8
Learn More
FAQ about Migraines
Migraines are a series of moderate to severe throbbing or pulsing headaches, usually on one side. Symptoms of migraine are different from person to person but are often accompanied by nausea, vomiting, seeing patterns and sensitivity to light and sound.
Medically, they are a neurological condition likely caused by abnormal brain activity affecting nerve signals, chemicals (e.g., serotonin), and blood vessels. They are different from a sudden “thunderclap” headache (which requires immediate medical attention). The exact cause isn’t fully understood, but research shows that genetic, environmental, and lifestyle factors (such as diet) contribute. A recent meta-analysis estimated that genes play a role in the trait’s variation by up to 42%.
Common reasons/causes/triggers include:
- Hormonal changes (e.g., menstrual cycles, pregnancy, menopause).
- Stress (emotional or physical).
- Dietary factors (e.g., caffeine, alcohol, aged cheeses, processed foods, skipped meals).
- Sleep disturbances (e.g., insufficient or irregular sleep).
- Environmental factors (e.g., bright lights, loud noises, strong smells, weather changes).
- Physical factors (e.g., overexertion, fatigue, dehydration).
- Certain medications (e.g., oral contraceptives).
A headache diary can help identify personal triggers.
Yes, migraines often have a hereditary component, particularly migraines with aura. If a parent or sibling has migraines, you may be more likely to experience them. However, environmental and lifestyle factors also play a significant role. Discussing family history with a doctor can aid in management planning.
Migraines are diagnosed through a medical history and clinical assessment by a healthcare professional, such as a GP or neurologist. No specific test exists (even genetic testing indicates a predisposition, not an eventuality), but diagnosis involves:
- Reviewing symptoms (e.g., pain type, frequency, duration, nausea, sensitivity to light/sound, aura).
- Assessing medical and family history, including triggers.
- Performing a physical and neurological exam to rule out other causes.
Imaging (e.g., MRI, CT) or blood tests may be used if headaches are severe, sudden, or atypical to exclude other conditions.
There is no cure for migraines, but they can be effectively managed with treatments and lifestyle changes to reduce frequency, severity, and impact. Some people experience fewer migraines over time, particularly with age or hormonal changes. A personalised plan with a healthcare professional can improve quality of life. There are many support groups available, including Migraine Australia.
A range of healthcare professionals can assist:
- General Practitioner (GP): For initial diagnosis, treatment, and referrals.
- Neurologist: For complex or severe migraines.
- Pain Specialist: For chronic migraines, including rTMS options.
- Psychologist/Counsellor: To manage stress or mental health factors.
- Physiotherapist: For physical triggers like neck tension.
- Pharmacist: For medication advice.
- Dietitian: For dietary trigger management.
A GP-coordinated, multidisciplinary approach is often most effective.
Consult a doctor if:
- Migraines occur frequently (e.g., >4–5 days/month) or worsen.
- Migraines significantly affect daily life, work, or relationships.
- Over-the-counter medications are ineffective or cause side effects.
- New symptoms appear (e.g., sudden severe headache, vision loss, weakness, confusion).
- Headaches follow head injury.
- You’re pregnant, planning pregnancy, or using medications like oral contraceptives.
Urgent medical attention is needed for sudden, severe, or atypical headaches.
- Migraine & Headache Australia (www.migraine.org.au): Resources and support for migraine management.
- Healthdirect Australia (www.healthdirect.gov.au): Trusted health information.
- Pain Australia (www.painaustralia.org.au): Chronic pain resources.
- Your GP or Neurologist: For personalised advice or specialist referrals.
- Support Groups: Via Migraine & Headache Australia for peer support.
- Lifeline (13 11 14) or Beyond Blue (1300 22 4636): For mental health support.
For rTMS details, consult a specialist clinic or doctor. Verify online information with a healthcare professional.