The Stages of a Migraine

If you get migraines, you know that the pain you feel shifts throughout the attack. You may have even noticed certain warning signs that your next migraine attack is imminent. Better understanding those signs can help you manage your migraines — and so can proper treatment.

At Hawai’i Pain and Spine, on the Windward side of Oʻahu in Kailua, Hawai’i, Dr. Jonathan D. Carlson applies his specialty in migraines to help you find effective treatment, and more importantly, relief. With a robust selection of treatment options, he and our team can work with you to find what most effectively blocks your migraine pain. 

We’re also here to help you develop strategies for when migraines do strike, and that means understanding how they work. So let’s look at the four stages of a migraine. 

Prodrome

Prodrome means the early signs of a health condition, making it fitting for the first stage of a migraine. Most people notice their prodrome symptoms one or two days before the migraine attacks. 

Warning signs include:

• Mood changes
• Stiffness in the neck
• Yawning
• Increased thirst and urination
• Food cravings
• Trouble concentrating and sleeping

Not all people experience prodrome, and some people only experience prodrome with some of their migraines.

Aura

Roughly 30% of people who get migraines experience aura, or sensory disturbances that usually last an hour or less. 

Some examples of the sensory disturbances caused by aura include:

• Seeing shapes or bright spots
• Sight loss
• Numbness
• Tingling
• Hearing sounds

The aura usually precedes the actual migraine attack, but it can bleed into the headache or occur in tandem with the headache.

Headache

A migraine headache can last anywhere from a few hours to three full days. It’s usually marked by severe, throbbing or pulsing head pain and light and sound sensitivity. Some people also feel nauseous and may vomit as a result of their migraine attack. 

Postdrome

As if the migraine itself weren’t enough, many people also experience aftereffects, called postdrome, for up to a couple of days afterward. 

This is usually marked by:

• Fatigue
• Mood changes, from depressive symptoms to elation
• Trouble concentrating or confusion

By the time their postdrome symptoms recede, most people who suffer migraine attacks are left feeling exhausted. That’s why Dr. Carlson offers migraine treatment. 

Treating your migraines

Here at Hawai’i Pain & Spine, Dr. Carlson offers a variety of migraine treatment options, including:

• Medication for nausea
• Antiseizure medicine
• Beta-blockers
• Botox® injections
• Calcium channel blockers
• Ergotamine and caffeine
• Glucocorticoids
• Lisinopril (angiotensin-converting enzyme inhibitor)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Steroid trigger point injections
• Tricyclic antidepressants
• Triptans

Come visit us so he can help you identify the most effective treatment for your migraines. To find relief from the various stages of your migraine attacks, call our office to schedule your appointment today.