What You Need to Know About Chronic Migraines

In most contexts, saying you have a migraine is often taken lightly. To most people who don’t suffer from the symptoms, a migraine is comparable to a simple headache, treated quickly by an over-the-counter painkiller. However, migraines can be excruciating, hindering your ability to do even the simplest everyday tasks. Almost 14.7% of the world’s population suffer from migraines, affecting both kids and adults.

There are two types of migraines: episodic and chronic. Episodic migraines last for a few hours and occur every few weeks or months. Chronic migraines are worse, lasting much longer and cropping up more often. The average chronic migraine symptoms linger for at least 15 days each month, lasting about three months. They have several possible triggers, ranging from simple physical activities to certain behaviors:

• Substance use and abuse (coffee, wine, etc.)
• Food additives such as MSG
• Hormonal medications such as birth control
• Medications
• Sensory stimuli (loud music, flashing lights, strong smells)
• Insomnia and sleep changes
• Mood disorders such as anxiety
• Intense physical activities
• Obesity

What are the symptoms?

The symptoms of chronic migraine are very incapacitating, have a significant impact on all aspects of your life, affecting both work and personal relationships. There are four stages of a migraine headache, and each stage has different symptoms.

Stage 1: Prodrome

First, the prodrome occurs one to two days before the migraine itself. These are the warning signals of an oncoming episode. These are very subtle and sometimes unnoticeable or attributed to other conditions. Symptoms include:

• Quick and sudden mood changes
• Constipation
• Sudden food cravings

Stage 2: Aura

An aura is a group of more noticeable symptoms before the oncoming migraine. These symptoms are often reversible, meaning they can be treated individually before it fully develops into a migraine. Examples include:

• Blind spots
• Seeing dots, flashing lights, and wavy lines
• Tinnitus
• Sudden temporary vision loss
• Speech difficulties
• Numbness in some parts of the body
• Pins and needles sensations in the limbs

Stage 3: Attack

The attack phase is when the aura fully develops into a migraine. The length and intensity vary per person, but there are several shared symptoms:

• Severe headache in one or both sides of the head
• Nausea
• Vomiting
• Throbbing pain
• Sensitivity to bright lights and loud sounds
• Sensitivity to certain smells and food
• Double vision
• Physical weakness
• Numbness
• Seizures

Stage 4: Post-drome

The post-drome is the “hangover” after the attack, leaving you feeling drained and tired for a whole day, maybe even more. While you may feel better, you still have to be careful because certain things can bring on the pain again for a moment:

• Coughing
• Sudden movement
• Straining the muscles
• Head-shaking

How do you treat chronic migraines?

Though there are several studies on migraines, the results are often inconclusive, with treatments often resorting to lifestyle management to avoid triggers and preventive therapies to reduce the attacks.

Making changes to your lifestyle can prevent the risk of developing migraines, mainly since they can be triggered by caffeine and alcohol intake. A doctor may recommend a preventive treatment plan such as cognitive behavioral therapy to manage stress, a regular exercise routine, and a diet plan.

Botox

Botulinum toxin type A, otherwise known as botox, is more popularly known for its aesthetic purposes, such as reducing wrinkles and adding lip fillers. However, Botox can also treat medical conditions such as muscle spasms, overactive bladders, and excessive sweating. It’s now also an FDA-approved approach to treating migraines. Botox has a high success rate for bringing relief to people who suffer from chronic migraines, cutting about half of the frequency.

A chronic migraine botox treatment is only recommended for people who suffer from migraines for at least 15 days, meaning it should only be for chronic migraines. It usually takes time to work, needing two to three sessions to maximize the effects. During this time, lifestyle changes are also recommended, as it can take up to 6 months to fully see the benefits of the treatment.

During treatment, the botox is injected around the pain fibers that act up during headaches, entering the nerve endings and eventually blocking the release of chemicals during pain transmission. It involves around 31 injections in the critical areas of the head and neck, such as the temples, forehead, and the upper bridge above the nose. This prevents the brain’s pain networks from being activated and triggering an attack.

Side effects of botox

According to the theoretical studies, botox injections for chronic migraines may involve a few side effects, especially to people who also suffer from muscle issues. However, based on the report of people who got botox treatments, the side effects are infrequent, and even if they show up, they usually go away after a few hours.

Possible side effects include temporary muscle weakness, a minor headache, neck pain stiffness at the injection sites.