Migraines should be 'understood' more says Dr Goadsby
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Most of us have had a headache before and will continue to have them every now and then for the rest of our lives. These ‘normal’ headaches are usually the most common type of headache – the tension-type headache. Tension-type headaches are not the same as migraines, but why? Express.co.uk chatted to Hannah Braye, Nutritional Therapist at Bio-Kult to find out the difference between migraines and headaches.
There are more than 300 different types of headaches and they can be split into primary headaches and secondary headaches.
Tension headaches and migraines are both types of primary headaches, alongside cluster headaches.
Nearly 80 percent of the general population will have a tension-type headache at some point in their lives.
Migraines are less common but still affect around 15 percent (one in seven) of people, and can be incredibly debilitating.
While most people get these headaches mixed up, it’s very important to recognise the differences between the two so that the most appropriate treatment can be sought.
Here are the seven differences between migraines and tension types, so you can figure out which one you’re suffering from.
Pain severity
Whilst no headache is pleasant, in general, the pain experienced by migraine sufferers is much more severe than your average tension-type headache.
Hannah said: “Migraine sufferers will often be required to stop activities and lie down to rest in a dark room.
“In very severe cases emergency medical attention may even be sought for a migraine.
“The type of pain experienced also tends to differ, with migraines described as a throbbing or pulsating pain, whilst tension-headaches tend to be more of a constant, steady, dull ache in the head.”
Pain location
A further distinguishing feature between migraines and tension-type headaches is pain location.
Hannah explained: “Typically, migraines present with unilateral pain (on one side of the head), whereas with tension-headaches, the pain usually starts in the back of the head or forehead and spreads over the entire head.”
Other symptoms
Perhaps one of the biggest differences between migraines and other headaches is that migraine sufferers will often experience other symptoms in addition to head pain.
Hannah added: “For example, many migraine sufferers also experience nausea, vomiting, digestive issues and sensitivity to light, noise, movement and smell with attacks.”
Phases
Headache is actually only one stage of migraine – many sufferers also experience a prodrome up to 24 hours before an attack.
Hannah said: “A prodrome involves symptoms such as sensitivity, irritability, food cravings, or difficulty concentrating and these symptoms are a warning sign that a migraine is coming.”
Shortly before a migraine headache, around 10 to 30 percent of migraine sufferers will also experience an aura.
Hannah described an aura as “a range of neurological symptoms that can include visual disturbances, numbness, tingling or weakness, disturbed speech and memory changes.”
She said: “The phenomenon is unique to migraine and will not be experienced by those experiencing other types of headache.
After the migraine headache comes the postdrome phase, where sufferers often report feeling wiped out, fatigued or depressed.
Hannah said: “Those who suffer from tension-type headaches do not typically experience such different phases.”
Pathogenesis
Tension-type headaches and migraines have different pathogenesis, which is the manner of development.
Migraines involve the activation of the trigeminal nerve (a major pain pathway in the brain).
Hannah said: “This is thought to lead to the release of vasodilators, which induce pain responses and an inflammatory cascade of events.
“Tension-headaches on the other hand are usually caused by a tightening in the muscles of the face, neck or scalp, resulting in pinching of the nerve or its blood supply that results in the sensation of pain or pressure.”
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Triggers
The triggers or things that cause the two types of headaches are different.
Hannah said: “Tension-type headaches are often a result of stress, poor posture, dehydration or drug reactions.
“Whilst stress and medications can also trigger migraines in some, sufferers tend to have a more broad range of triggers, which will vary from individual to individual.
“For example, certain smells, changes in temperature, sleep deprivation, skipping meals, certain foods, alcohol or caffeine.”
The exact cause of migraines is unknown, but possible triggers include hormonal, emotional, physical, dietary, environmental and medicinal factors, according to the NHS.
Hannah added: “It is thought that magnesium deficiency could be a contributing factor to both migraines and headaches, and for women, hormonal fluctuations may also play a role in both types of headache. “
Involvement of the Gut
Recent research into migraine has revealed the health of the gut may play a key role in migraine development and that live bacteria supplements may be of benefit in the condition.
Gut hyper-permeability, also known as the leaky gut, caused by low levels of beneficial bacteria in the gut is a driver for inflammation throughout the body.
Hannah said: “It is now thought that inflammatory molecules originating from the gut can sensitise pain receptors on the trigeminal nerve, triggering the inflammatory cascade that results in migraine.
“In a recent clinical study, the 14 strains of live bacteria in Bio-Kult Migréa, taken daily, were found to significantly reduce migraine severity and frequency in as little as eight to 10 weeks.
“We are only just discovering the important role of the gut microbiota for many aspects of health, so there is the possibility that the gut could play a part in other types of headache.
“However, for now, the best evidence for this is in migraine. “
Bio-Kult Migréa is a multi-action live bacteria supplement, containing 14 different strains, plus magnesium and vitamin B6, both of which contribute to the normal functioning of the nervous system, and the reduction of tiredness and fatigue (£19.94 from www.bio-kult.com), Vitamin B6 also contributes to the regulation of hormonal activity.
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