How to tell a headache from a migraine

What triggers migraine?
Many believe that some foods can trigger a migraine, but research has produced conflicting results. One study of 500 people with dietary migraine showed that the major culprits were cheese, chocolate, citrus fruits and alcohol. Another, in which 90 patients were given elimination diets and then challenged with either ‘good’ or ‘bad’ foods, resulted in the same number of attacks in both groups. Only alcohol, and especially red wine, was clearly shown to bring on an attack in some sufferers.

Keeping a detailed daily diary that covers about six migraines and includes what you eat, your activities and emotions and external factors like weather conditions and environmental pollution, can help to identify underlying patterns.

How is it treated?
The treatment of migraine depends on the frequency and the severity of the attacks. Many sufferers use over-the-counter painkillers containing aspirin, paracetamol or ibuprofen, sometimes with an added anti-sickness ingredient. It is important to take any medication as soon as you start to experience symptoms because migraine can interfere with the ability of the gut to absorb. Soluble painkillers may enter the blood stream more quickly.

If over- the- counter remedies do not work, your GP can prescribe a stronger drug such as ergotamine or one of the triptans. These come in various forms, including tablets, suppositories, injections and nasal sprays: one form may work when another does not. For very frequent and debilitating attacks, your doctor may prescribe preventative medication such as beta-blockers or tricyclic antidepressants, though these may not stop the migraines altogether.

Healthy alternatives
Some people have found complementary therapies beneficial. Biofeedback, which uses relaxation to raise skin temperature, has been shown in clinical trials to be helpful, as has acupuncture. The herb feverfew has come out well in at least three trials, though some researchers are not convinced of its effectiveness. Feverfew can be grown at home or bought dried in capsule form. It should not be taken during pregnancy.

For further information visit the websites of the Migraine Trust and the Migraine Action Association