Migraine is so much more than just a headache. It is often a full-blown attack on the senses. Many people experience sensory hypersensitivity to light, sound, noise, touch and motion before, during and after a migraine attack, and they can sometimes signal that an attack is coming. In addition, while sensory sensitivities are migraine symptoms, coming into contact with visual, auditory, movement and/or olfactory stimuli can also trigger migraine attacks, so it can be circular.
Sensitivity to Light/Photophobia
Photophobia is painful sensitivity to light. It is extremely common and is reported in almost all forms of migraine. According the National Headache Foundation, 80-90% of people with migraine experience photophobia during migraine attacks. Migraine is the most common neurologic disorder causing photophobia, and is one of the major diagnostic criteria for migraine according to the International Classification of Headache Disorders. Photophobia is also common for those with cluster and tension headaches and is often associated with traumatic brain injuries.
Sensitivity to light can be a warning an attack is coming, and during a migraine attack many people need to retreat to a dark room. During an attack the light sensitivity can be so severe that even small lights or low light can cause intense or worsening pain.
Some things to try to manage photophobia include:
- Wear a hat or sunglasses/dark glasses when outside or are in places with very bright lights
- Bring a small desk lamp to the workplace, and if possible use that instead of harsh overhead lighting
- Create a space at home that allows you to control the light—use blackout or dark curtains and or/blinds and soft, low light options
- Try green light therapy
- Adjust the brightness settings on your electronic devices
- Wear blue blocking glasses when watching television or having screen time
- Limit screen time
- Go to a dark room during an attack
Sensitivity to Smell/Osmophobia
Osmophobia is intense sensitivity to smell. Like photophobia, it is highly common for those with migraine. It can occur during the prodrome phase of a migraine attack as well as the rest of the attack—even during the interictal period. Unfortunately, many scents can quickly and painfully make a migraine attack worse. Some of the most common scents to consider include:
- Cigarette smoke
- Nail polish
- Cleaning fumes
- Food/cooking smells
- Essential oils
- Off-gassing from products such as carpet, furniture or fabrics
Those who experience osmophobia can try to manage their symptoms/triggers by:
- Taking breaks while at work, or if you are stuck indoors try going outside to get fresh air as often as possible
- Opening a window if possible and ensuring proper circulation and ventilation in enclosed environments
- Talking to family, friends, co-workers and roommates about bothersome scents and asking them not to use scented products
- Only using fragrance-free products in your home and for personal care
- Wearing a high quality mask such as VogMask
Sensitivity to Movement
Many people with migraine experience motion sensitivity and may find that movement of any kind intensifies their head pain. For some people it can be so severe that just bending forwards and putting their head down can cause debilitating pain. This symptom is especially common for those with vestibular migraine who frequently experience dizziness, vertigo and disequilibrium, but can be found in any type of migraine. Motion sensitivity makes traveling of any kind difficult and can be very debilitating. Those with intense sensitivity may need to limit any movement during attacks, or have specific vestibular therapies and treatments. Some things to try include:
Some other things to try include:
- Not exercising at all during an attack, even at a low level
- Lying down in a dark quiet room and not moving during the worst part of an attack
- Sitting in the front seat while in cars
- Picking a spot in the horizon and focusing on it while in cars or on boats
- Getting fresh air by opening a window or sitting in the open air part of a boat
- Practicing meditation and deep breathing
- Sucking on ginger candies
Read more about vertigo and dizziness here.
Sensitivity to Noise/Phonophobia
Phonophobia is the intense sensitivity to sound. It is yet another very common migraine symptom—with about 70-80% of people with migraine experiencing it during an attack. Sounds such as loud cars and motorcycles, fireworks, chewing, clocks ticking, children crying, etc. may cause a reaction ranging from heightened irritability to intensified pain.
Some ways to manage phonophobia include:
- Lying down in a quiet room
- Using a white noise machine
- Wearing noise canceling headphones
Sensitivity to Touch/Allodynia
People with migraine can also experience painful sensitivity to touch, known as allodynia. This type of neuropathic pain can cause things that normally don’t hurt to become extremely painful. Those who experience this symptom may find that something as simple as taking a shower or combing one’s hair causes intense pain.
Managing allodynia is difficult but some soothing options include:
- Taking a warm bath with Epsom salt
- Wearing loose-fitting, comfortable clothing
- Using heat and/or ice packs
- Resting in a comfortable, calm spot
- Taking anti-inflammatory medications such as naproxen
- Applying topical ointments such as lidocaine
- Not wearing your hair in a pigtail or bun during an attack
Sensory hypersensitivity makes it feel as though interacting with the world is a constant attack on the senses. The best thing to do to manage these symptoms is to control the environment as much as possible, which is often easier said than done, especially when outside of the home. Many people learn tips and ideas to help manage from others who live with migraine, so we encourage you to share your experiences in our social media groups such as Migraine Meanderings. People who experience extreme hypersensitivity should also discuss it with their doctor, who may be able to offer specific treatment options and support for managing this challenging set of symptoms.