“It literally feels like I was hit upside the head with a baseball bat,” says Anna Williams as she describes what a migraine attack feels like for her. We begin this new series with the hallmark of migraine symptoms—head pain. Arguably the most debilitating symptom for many, head pain presents in many forms. It can vary from person to person and even attack to attack, and it has the power to bring daily activities to a complete halt.
What does migraine head pain feel like?
Severe head pain is common during the attack stage of migraine. You may experience pain that is throbbing, pulsing, pounding and/or stabbing. It often begins on one side of the head or behind one eye, but pain that is radiating or on both sides is also common. Pain often intensifies with movement, and/or exposure to bright lights, loud sounds or scents. You will likely feel the need to lie down, and the pain may be so severe that it causes you to miss hours or even days of work or other activities.
Are there other types of head pain?
Other types of head pain can occur during an attack. Many people with migraine also experience allodynia, which is a type of nerve pain that causes extreme sensitivity to touch. This can make the head and scalp feel very tender and sore, or it can feel like burning or stinging. Allodynia is something we will be exploring in more depth in a future blog, because it is something that isn’t necessarily just limited to the head, and can have a huge impact by itself.
Specific headache disorders may present with different types of head pain. For example, the head pain that comes along with cluster headaches is typically described as severe burning or stabbing pain, usually behind one eye or on one side of the head. The pain that comes with trigeminal neuralgia is often described as an intense electrical shock that travels down the face. And tension headache pain generally has a slow onset of dull to moderate pain on both sides of the back of the head. With migraine you can experience any or all of these, and again, we’ll be taking a closer look specifically at facial pain later in this blog series.
- Note: It’s important to document how your pain feels during an attack. Keeping track of intensity, location, sensation and duration can help your doctor better understand your specific type of migraine and the level of disability you are experiencing, and find the best treatment options for you.
How long does head pain last?
Migraine head pain can start out dull and build slowly, or it can have a sudden onset. If left untreated, head pain can last 4-72 hours, although in some cases it can last for days, weeks or even months. Many people who live with migraine have some kind of chronic daily head pain that varies in severity but rarely, if ever, goes away.
When and how should you treat head pain?
Moderate to severe head pain should be treated. Abortive medications typically work best if taken early on in an attack. If you are having 4 or more headache days per month, or if your attacks are significantly interfering with your life, the American Headache Society recommends that you use a preventive medication alongside abortive options.
However, remember that medication is just one part of managing head pain. Check out our migraine treatment toolbox for other treatment options. You may also find some relief using the following:
- FDA-cleared medical devices for migraine
- Heat/ice packs
- Light filtering glasses
- Weighted blankets
- Green light lamps
- Chiropractic care
- Massage therapy
- Nerve blocks (e.g., occipital, trigeminal, supraorbital, auricular, sphenopalatine ganglion)
Read our article on managing acute pain for more information and ideas.
When should you talk to your doctor?
If you are regularly having head pain, even if it’s not intense, you should talk to your doctor. If your attacks are happening more frequently or the head pain is having a severe impact on your quality of life, it may be time to see a headache specialist. Check out other signs and remember the acronym, SNOOP, as a guide for when to seek medical attention:
- S: systemic symptoms (e.g. fever, weight loss)
- N: neurologic symptoms or abnormal signs (e.g. confusion, impaired consciousness)
- O: onset is sudden or abrupt
- O: onset after age of 50 of new and progressive headache
- P: pattern change (e.g. change in severity, frequency or features)
We want to know!
How would you describe your head pain to people who don’t have migraine? Is there anything that brings you relief or comfort from this often incapacitating migraine symptom?
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