“I get really bad sinus headaches when the weather changes,” the caller began, “and the over the counter medicines I’ve tried aren’t of much help. Is there anything you can suggest?”

“I’m sure I can,” I replied, “but first I’ll need to ask you a few questions. Where are the headaches located?”

“I’ll occasionally get one on the left side, but in most cases the pain is just behind my right eye.”

“How long do the headaches last?”

“Anywhere from one to three days, and I can’t function while I have them. I just have to go to bed and wait for the pain to go away.”

“Does anyone else in your family suffer from headaches like this?”

“Oh, my mother and my sister get sick headaches just before or during their periods, but they don’t complain of sinus trouble. Why do you ask?”

The preceding conversation is typical of many I have had over the years. The headaches are not “sinus” in character. They are a special type of headache called migraine. Most people are unaware of the fact that migraine headaches commonly occur in or around an eye and are often triggered by falls in barometric pressure.

Once believed to be rare migraine is now recognized as one of the most common headache types. Unfortunately, a great many migraine sufferers do not know what is causing their headaches or how to prevent and manage them. National surveys suggest that even when a physician is consulted the diagnosis of migraine is frequently overlooked. The Headache Wellness Center in Greensboro, North Carolina recently reported that 20 percent of individuals meeting their criteria for migraine had never had their headaches identified as such by their physicians. Sixty percent of the individuals had learned the diagnosis only after consulting at least three physicians.

Many people think that migraine is a synonym for a bad headache. Migraine, however, is more than just a headache. Migraine encompasses a wide spectrum of symptoms. Some migraine sufferers may experience intense throbbing pain but others may have no pain whatsoever. At times a migraine may be preceded by visual changes or weakness but in other instances it may appear without any warning. Occasionally the diagnosis is obvious but quite often it must be deduced by weighing all of the available evidence.

Classic migraine is defined as a severe throbbing headache on one side of the head. It is typically preceded by an aura, or warning signal. Auras are most commonly visual in nature. Wavy lines, spots, or color changes may appear. In some cases temporary blindness may occur. Some people may note a strange sensation or loss of feeling in a hand or arm while others may temporarily lose the use of a hand or arm. Some people even experience an aura as part of a dream, later awaking with a headache. The aura usually lasts for 15 to 20 minutes. It is rarely present for more than an hour. In most cases a headache follows the aura, but at times the aura occurs without the subsequent development of a headache. While they are typically self-limiting, migraines have led to strokes in rare instances. Migraine headaches typically last 12 to 48 hours and rarely remain for longer than three days.

Common migraine is less dramatic in its presentation. The headache may be either mild or severe, but it is not preceded by an aura. The pain may be more dominant on one side or the other, but it does not have the distinctive unilateral nature seen in classic migraine.

Nausea and vomiting commonly occur. Some individuals with migraine experience cycles of nausea and vomiting but do not develop the usual headache. This can be a particularly challenging problem as it is commonly assumed to be a “stomach virus” and the true nature of the problem ignored. The periodic nature of the problem and its association with factors that are known to trigger migraine are clues to its true cause.

Migraines make up the majority of headaches in children. Other recurring symptoms including abdominal pain may be a variation of migraine. Cycles of nausea and vomiting are particularly suspect. Instituting measures known to prevent migraine headaches can often clear these mysterious complaints.

It is far better to prevent a migraine than to attempt to treat it once it is present. Prevention begins with recognizing the things that can trigger the events and avoiding them to the degree it is possible to do so.

Fatigue can trigger a migraine so it is important to get regular and adequate rest. Prior to the advent of artificial lighting the average person slept for nine hours each night. Many people today believe that 6 or 7 hours sleep is enough, but they are sleep deprived and predisposed not only to migraine but other illnesses as well. Interestingly, oversleeping is also a trigger so it is best to get up at approximately the same time each day. Weekend or “holiday” migraine is a headache triggered by taking advantage of the opportunity to sleep in.

Bright or flickering lights can cause the problem. A fluorescent light that is going bad, a computer screen that flickers or sunlight bouncing off of waves are all potential triggers. Missing a meal can also make a person more susceptible.

Changes in altitude can result in migraine as can changes in barometric pressure. People who are prone to migraine need to be cautious when traveling to mountainous areas. If a low pressure system is moving in one should be alert to the possibility of a migraine occurring as well.

Hormonal changes can trigger migraines. Many women experience menstrual migraines and those using oral contraceptives or estrogen preparations may be more susceptible to the phenomenon.

Diet plays a major role in migraine. Food additives, preservatives and artificial sweeteners can all trigger migraine. Sodium nitrite, monosodium glutamate (MSG) and aspartame are the most notorious. Chinese restaurant headache is migraine triggered by MSG. Certain foods can bring on a migraine when eaten. These include items that contain tyramine including aged cheeses, fermented sausages, cured meats, sour cream, red wine and ales. Phenylethalamine, which is found in chocolate, can also be the culprit.

Food allergies can be the cause of migraine. The most common offenders are wheat, oranges, tea & coffee, dairy, corn and eggs. In one study 85 % of the participants became headache free when they avoided the offending foods. Food allergy tests are available. It is also possible to develop a test diet by eliminating foods that have typically been eaten more than twice a week. If the frequency of headaches drops on the test diet one food at a time can be reintroduced. Those that trigger headaches should be avoided.

Excessive stress can also trigger migraines. Effective stress management can decrease migraine risk. Migraine trigger factors are additive. For example, at times it may be possible to eat a chocolate bar without consequence. If, however, a major project is due, rain is in the forecast, and lunch was missed eating the chocolate bar may set off a major migraine.

The second phase of migraine prevention is proper nutritional supplementation. Adequate levels of essential fatty acids are essential in migraine management. Platelets are blood components that are designed to stop bleeding by plugging leaks in our blood vessels. When platelets clump together abnormally migraine can result. The body requires essential fatty acids to prevent the platelet membranes from becoming sticky. Fish oils containing EPA and DHA are beneficial as are plant oils containing omega-3 fatty acids. Essential fatty acid supplementation has been shown to decrease migraine frequency by up to 86 percent.

Vitamin and mineral deficiencies play a significant role in migraine. Magnesium, calcium, B vitamins, vitamin D, and trace minerals have all shown benefit in decreasing migraine severity and frequency. Hypoglycemia, a drop in blood sugar levels, can also trigger migraine. Chromium can moderate blood sugar levels and should be considered in individuals who have a predisposition to hypoglycemia. People who have a family history of diabetes are in this category. Chromium polynicotinate is the preferred form of supplementation.

Migraines are more likely to occur if the body is too acidic. Green plants are very beneficial in reducing the acidity of the body. Litmus or pH paper is available to monitor the body’s acid-alkaline balance. Saliva should be checked each morning upon arising. If the pH is less than 7 a green plant supplement should be taken. Barley green, wheat grass, and other green plant supplements may be taken in whatever amount is necessary to normalize pH levels.

Accumulated toxins can also produce migraine headaches. I have seen many people eliminate their migraines by going through an herbal detoxification program such as the Nature’s Pure Body system.

Other supplements may be of benefit in preventing migraine. It was recently observed migraine headaches ceased in an individual taking glucosamine sulfate for osteoarthritis. Based upon this experience ten people with migraines that had failed to respond to traditional preventive and therapeutic modalities were given glucosamine. After they had been taking the supplement for 4 – 6 weeks a significant reduction in headache intensity and frequency was reported. It is suspected that glucosamine provides the body with a greater ability to produce mucopolysaccarides that have an anti-inflammatory effect.

A widely reported herbal preventative for migraine is feverfew. About one in four people with migraine report improvement when taking 85 mg. of feverfew daily. This is substantially less than the number reporting improvement with other measures, but it is worth trying if migraines persist after addressing the major issues.

Migraines are difficult to treat successfully. Pain relievers are often ineffective. Several techniques are helpful in relieving or controlling the pain, however. Nearly all migraines are characterized by the presence of tender points on the temples, above the eyes and on the back of the head near the neck. Applying pressure to these sites, going to a dark, quiet place, and applying a cold compress to the forehead or back of the neck was effective in relieving the intensity of migraine pain 85 % of the time.

It is now possible to prevent the overwhelming majority of migraine headaches. Because other headache types respond favorably to many of the same modalities a precise diagnosis is unnecessary. Any headache sufferer can benefit by taking the steps outlined above. As toxins and allergens are eliminated and proper supplements are added other conditions can be expected to improve as well.