Dr Fabregat explains that a migraine is much more than pain: it is a condition involving a dysfunction of several structures at different levels of the brain. These can cause a number of symptoms: before, during and after each episode.
As well as a headache, there may be photophobia, phonophobia, nausea, fatigue, difficulty concentrating, mood changes, appetite disturbances and excessive yawning. In some people, a migraine begins with an aura phase, with visual, sensory or language disturbances and, more rarely, motor symptoms.
One of the most common nervous system disorders
Around half of all adults have experienced a headache in the past year. It is the sixth most prevalent disorder and the one that causes the most disability among people aged 18 to 50, measured in days of healthy life lost.
The term “headache” encompasses more than 150 different types of head pain. Primary headaches, such as migraine or a tension-type headache, are disorders in themselves; with secondary headaches being the result of other problems, such as infections, metabolic disturbances or other diseases — and these can be serious in a small percentage of cases.
Identifying triggers to tailor treatment
Despite it being so common, some people still believe that a “headache is psychological”. But scientifically this has been disproved: it is a genuine neurological disorder, with a physiopathological basis and specific treatments.
The first step in controlling it is to identify the triggering factors. These can range from lack of sleep or stress to fasting, certain foods or even excessive screen time. Adopting healthy lifestyle habits, maintaining a regular sleep routine, following a balanced diet, exercising and staying well hydrated can significantly reduce the frequency of episodes.
When pain appears, self-medication should be avoided. It is healthcare professionals who should establish a personal treatment plan. This often combines medication with complementary techniques such as stress management or physiotherapy.
Advances and new treatments
In recent years, innovative options have been developed for better pain control and improved quality of life. Notable among these are treatments with botulinum toxin and medications that act on a protein involved in pain (CGRP). Anaesthetic nerve blocks can also be performed in some cases. These are small injections of anaesthetic into the nerves surrounding the head (pericranial nerves) to relieve pain locally.
These options are offered in specialised headache units, where each patient receives an individual assessment and personalised follow-up.
A section for an in-depth understanding of the condition
Delving deeper into what headache really is, how it affects daily life and the myths to be dispelled, the videopodcast Let's Talk About Health contains a particularly interesting section: “Let’s Talk About Headaches”, featuring Dr Neus Fabregat, from the Neurology Department at Hospital Clínic, and Patrícia Ripoll, a migraine patient.
INFORMATION DOCUMENTED BY:
Dr Neus Fabregat, Neurology Department, Hospital Clínic Barcelona.
