The Migraine Awareness Month has just concluded. Owing to lack of awareness around migraine--a headache that can cause severe throbbing pain or a pulsating sensation, usually on one side of the head---people afflicted with the disorder often suffer in silence. Very few know that migraine ranks in the top 10 leading causes of years lived with disability, worldwide. The HEALTH PIONEER brings a detailed report on this commonly prevalent illness and medications available to manage it.
I feel my head pounding when I try to move or when a door slams. It gets muc worse when curtains are pulled aside. Bright, white lights make it worse, leaving me feeling tizzy.”
“It’s like I am being hit in the head with a hammer before I am totally incapacitated in bed. Sometimes, it is for days that I am unable to carry out even my daily routine.”
These are just a few testimonies shared by the patients suffering with migraine. Astonishingly, around 1 billion people worldwide have migraine. This makes it the third most common illness in the world, allergies and cold flu being the first two respectively.
In India, over 200 million people have migraine, which remains undiagnosed in many cases. Among the age group of 15-49, migraine is the number one cause of YLD (Years Lost due to Disability). Unfortunately, there is still a lack of awareness around this condition.
Untreated, a migraine attack may last for 4-72 hours, and tension headaches may potentially last for a week, impacting more women than men.
Migraines present as severe and debilitating headaches – usually on one side of the head – that cause a painful throbbing and pulsating feeling and is often accompanied by nausea, dizziness, vomiting and sensitivity to light and sounds.
Chronic migraine is defined as a headache occurring on 15 or more days per month for more than three months, which, on at least 8 days per month, has the features of migraine headache.
Episodic migraine is defined as having headaches on fewer than 15 days a month.
According to a recent study, in India, migraine patients have poor awareness of their headache triggers and do not recognise it unless asked specifically.
The doctors suggest Yoga and meditation that can help the body to recover from stressful events such as migraine episodes. In fact, a study published in 2018 found that Yoga paired with Ayurveda, a holistic form of medicine, reduces migraine symptoms and pain intensity and improves quality of life.
Owing to the lack of awareness around the condition, about 40 per cent of the patients in India end up consulting with a general physician or other doctors for issues related to eyes, digestion, or ENT related problems. According to a study conducted by the World Health Organisation (WHO) less than 50 per cent of people suffering from migraine consult a physician and it is very often confused with sinus, cervical headache, hunger headache and even a hangover.
Therefore, 50 per cent of patients self-medicate as they go to chemists for painkillers.
Reaching out to a specialist, that is a Neurologist, can be truly beneficial for patients suffering from migraine. A neurologist can help dive deeper into the intricacies of the condition and find solutions towards managing it.
Underdiagnosis and insufficient treatment is due to gaps in knowledge. Understanding triggers help as they could be related to stress, hormonal changes, weather changes, sleep cycle, bright lights, etc. There is low awareness regarding the distinction between migraines and home remedies to alleviate symptoms temporarily. With chronic migraine, only 1 in 20 patients find the correct diagnosis and guided treatment. Some chronic and mild conditions have similar symptoms and so, patients are diagnosed with these instead of migraine, which can further delay their treatment therapies.
dr Debashish Chowdhury
Head of Neurology Department,
GB Pant Hospital, Delhi
A wide range of migraine treatment is available aimed at stopping symptoms, cutting down intensity and attacks and preventing future episodes. Many medications have been designed to treat migraine, its frequency and intensity. Medications used to combat migraines can be pain-relieving medications and injections such as nerve blocks. Then, there are certain devices that are based on neuro-modulation therapies that can be taken monthly or quarterly basis, preventive therapies, and Botox injections which are approved by the USFDA. These all are safe and result-oriented, but should be taken only after consulting a doctor. But best medicines are lifestyle modifications such as avoiding triggers that cause migraine. Then there are evidences that meditations and some stretching exercises too helps in subsiding the illness.
Asst. Prof. Dr Divyani Garg
Neurology Department, Safdarjung Hospital, Delhi
Owing to its chronic nature, migraine is one of the non-curable diseases like diabetes or epilepsy, but it is preventable and controllable. Migraines can have a negative impact on not just the patient, but also their families, co-workers and the society, which is why it is important to diagnose and treat patients in a timely manner. By identifying and avoiding the triggers, or in some cases by using preventive therapy, patients can partially prevent and/or control the disease. Preventive therapy can be highly beneficial for the patients if followed with adherence. As for any other disease, treatment adherence and a healthy lifestyle are two key aspects in order to prevent the disease and live a healthier life.
Dr RK Dhamija,
Director, Institute of Human Behaviour and Allied Sciences (IHBAS) Delhi
People commonly use medication to treat their symptoms. However, other methods such as Yoga may be an effective way to reduce the frequency and severity of migraine. However, someone who experiences migraine should avoid Yoga classes that are vigorous or involve heat, as well as poses that stress the neck.
Ishwar V Basavaraddi
Director, Morarji Desai National Institute of Yoga,
Union Ministry of Ayush, Delhi