What Causes Migraines And How Long Do They Last

A migraine is a strong headache usually on one side of the head that often accompanies other symptoms such as nausea and sensitivity to light and sound. When you have a migraine, you may feel like every light is glaring, and all you want is to rest in a dark room or close your eyes to at least cool the throbbing head.

If you experience a migraine, you may want to know how long it lasts and ways to relieve the pain. This post explains that and more, including what causes or triggers migraines, their symptoms, and how to prevent them.

Migraine causes and triggers

What causes migraines are still unclear, but they are thought to occur due to inflammation of the blood vessels around the brain, causing increased blood flow into the brain. Also, changes in the brain activity and balance of chemicals seem to have a role.

The triggers vary from one individual to the other, but the most common triggers include:

Environmental factors

Some people experience migraines when they stay in environments with secondhand smoke, strong smells, humidity, temperature changes, bright lights, or loud noises.

Medications

Drugs that can trigger headaches include sleeping pills, hormone replacement therapy (HRT), and certain birth control pills.

Hormonal changes

Change in hormones that occurs during menstruation may trigger migraines.

Emotional triggers

Anxiety, depression, stress, and even excitement can trigger migraines.

Dietary factors

Some foods can trigger migraines. These include:

• Foods containing monosodium glutamate (MSG)

• Onions

• Chocolate

• Dairy foods, particularly some cheese

• Drinks or foods containing tyramine, e.g., red wine, chicken livers, aged cheese, smoked fish, and certain bean

• Fermented and  pickled foods 

• Other foods such as avocados, citrus, bananas, meats with nitrates such as hot dogs, bacon, cured meats, and  nuts such as peanuts

Genetic factors

A family history of the condition is also a common risk factor. 

How do you know if you're having a migraine? 

Migraine symptoms and even the severity of those symptoms may differ from one person to another. However, the following are the most common symptoms of a migraine:

• Throbbing headache

• Sensitivity to smells, light, and noise 

• Lack of energy

• Nausea 

• Vomiting 

You should visit your doctor if you experience these symptoms for a migraine diagnosis because a different condition could also cause them.

How long do migraines last?

Migraines have different triggers and frequencies. Some people experience migraine for a short time, and others may suffer for a few days. Typically, a migraine headache lasts for 4 to 72 hours¹ but can last longer if left untreated.

Some people may experience status migrainosus (SM), a long-lasting migraine that can cause symptoms for 72 hours, even when treated. 

Migraine stages

Migraines progress through four stages, with each leading to the other. However, you may not experience each stage with every migraine attack. Understanding these stages can help manage the condition. 

Recognizing the earliest symptoms of a migraine stage will help you take measures that may prevent the symptoms from worsening and the migraine from progressing.

Below are the four migraine stages and the most common symptoms for each:

1. Prodrome

This is the first stage of a migraine attack. Here, you may realize slight symptoms that are not related to headaches. These symptoms are usually a warning for an upcoming migraine attack several hours or days later. The symptoms include:

• Anxiety 

• Neck stiffness

• Fatigue

• Increased urination

• Increases thirst

• Food cravings

• Constipation

• Mood changes

2. Aura

Some people won't experience the aura phase with every migraine attack. But if it happens, this phase lasts for about 20–60 minutes and often occurs shortly before the main attack. Auras are caused by a wave of electrical nerve activity that spreads over the brain. While the electrical wave spreads, the nerves respond abnormally, thus leading to reversible neurological symptoms. 

Auras often happen before the headache in adults but simultaneously with the headache in children. However, some people can experience the symptoms without a headache. 

Auras include a wide range of sensory or neurological disturbances such as:

• Weakness

• Memory changes

• Fear and confused feelings

• Numbness or feeling as if pins and needles are piercing you

• Speech and hearing interruptions

• Dizziness and poor balance

• Visual disturbances whereby a person sees sparkles or 'stars,' dark spots, zigzag lines, and colored spots

3. Headache

The headache phase of a migraine attack involves mild to severe head pain. It often occurs on one side of the head, especially at the beginning of an attack, but the throbbing pain may sometimes be on both sides and all over your head. This stage of a migraine lasts for 4 to 72 hours and often leads to severe symptoms that can prevent you from performing your daily tasks. 

The symptoms of the headache phase can occur even when you don't experience auras. They include:

• Blurred vision

• Vomiting

• Irritability

• Nausea

• Dizziness and lightheadedness

• Increased sensitivity to noise and light

• Stiffness in the neck and shoulders

• Potential sensitivity to smell, movement, and touch 

• Throbbing pain in the head 

4. Post-drome

This is the final stage of a migraine attack and has symptoms that mirror the prodrome stage. The symptoms can last for 24 to 48 hours and include:

• Aching body

• Confusion

• Depression

• Difficulty concentrating

• Drained feeling

• Weakness

• Dizziness

• Elated feelings

How to prevent migraine attacks

Below are ways to avoid migraine attacks: 

Keep a migraine diary

Avoiding migraine triggers is the best way to prevent the condition. A migraine diary will help you identify potential triggers. Take note of the next time you experience a migraine attack, not when the condition starts, what you are doing at that time, its duration, and what gives you relief.

Check your eating habits

You can prevent migraines by avoiding foods and drinks that trigger the condition. Create a journal of the foods you eat to note when certain foods lead to a migraine. You can also avoid foods and drinks that trigger the condition, including chocolate, alcohol, caffeine, and aged cheese. 

Other than the foods you eat, eating habits matter too. Ensure consistency in your eating habits by eating at around the same time every day and avoiding skipping meals. You may be at higher risk of developing migraines if you fast or skip meals. 

Manage stress

Migraines can result from emotional factors such as stress and anxiety. Avoiding daily stress may be difficult, but keeping it under control can help prevent migraines. One way to avoid stress is to simplify your life.

Instead of finding ways to squeeze more activities into the day, you can prioritize some and leave others out or delegate what you can. 

You should also take a break whenever you feel overwhelmed. Other ways to manage stress include staying positive and finding time to do something you enjoy. 

Get a healthy amount of sleep 

Falling asleep may be difficult when you have a migraine. Sometimes, the condition makes you wake up at night. But poor night's sleep can trigger migraines. 

There are several ways to improve your sleep. First, establish regular sleep hours and go to bed and wake up at the same time every day. However, you should not try so hard to sleep. Otherwise, you will feel more awake. Another tip to sleeping well is minimizing distractions. For example, avoid using your phone or taking work materials to your bed. 

How to ease migraine pain

If you are experiencing migraines, there are several things you can do to ease the pain. These include:

Home remedies 

Several home remedies, such as changing your environment, can help ease migraine pain. When you experience a migraine, consider moving to a quiet room with less lighting. You can even draw the curtains to block sunlight. Try to limit your screen time since electronic devices such as TV, computer, and phones can exacerbate migraine symptoms. 

Other home remedies that can provide relief include increasing water intake if you are not feeling nauseous and some massage. Finally, identifying and avoiding migraine triggers will help prevent the condition and ease the pain if you are already experiencing the migraine. 

OTC medication

You can ease migraine pain by taking over-the-counter medications² such as naproxen (Aleve), aspirin (Bayer), and ibuprofen (Advil). These medications are helpful when the migraine symptoms are mild or infrequent.

Prescription medication

There are two treatment options for migraines:

Abortive treatment

Abortive treatment involves treating migraine headaches and symptoms as they occur. The drugs include over-the-counter medications such as naproxen, aspirin, ibuprofen, and acetaminophen. These can help treat migraine symptoms and ease the pain when it occurs.

However, they may not work for people with chronic or severe symptoms. If you're such a person, you should see your healthcare provider, who can prescribe stronger medications such as triptans, lasmiditan,  ergot alkaloids, and CGRP antagonists.

Preventive treatment

Preventive treatment involves taking medication to reduce the period you deal with migraine symptoms and lower the severity of attacks. The medications include beta-blockers, antidepressants, anticonvulsants, and calcium channel blockers.

When should you see a doctor?

Migraines usually last for 4 to 72 hours and can go away on their own or with simple home remedies. However, this condition can worsen if left unmanaged. The pain can move from one side of your head to the other and affect the front or back of the head or even the whole head.

Sometimes, your migraine may last for more than three days or won't go away. Status migrainosus is a debilitating migraine that takes more than 72 hours and usually fails to respond to normal treatment. This condition is more medically serious and often leads many people to the emergency department, where the doctor administers several drugs to break the pain cycle.

You should see a doctor if the migraine lasts three days or more. 

The lowdown

Migraines are severe headaches that usually bring along other symptoms. People experiencing migraines can identify specific things that trigger the condition and use the information to avoid migraines in the future. Migraine attacks often last for 4 to 72 hours.

You should seek medical attention, especially when you experience a severe migraine episode with a sudden or extreme headache alongside other symptoms such as seizures.