A migraine is a neurological condition that causes intense, throbbing head pain, often on one side of the head
A migraine is not just a bad headache. It is a condition in which your nervous system misfires in a way that creates severe pain, usually in the front or side of your head. The pain typically throbs or pulses and can last anywhere from four hours to three days. Many people also experience nausea, sensitivity to light, or sensitivity to sound during a migraine.
Migraines happen when blood vessels in the brain constrict (tighten) and then dilate (widen), and when chemicals in the brain become imbalanced. Exactly why this happens is still not fully understood, but doctors know that migraines run in families and are more common in women than in men. A migraine is a medical condition, not a character flaw or something you can simply push through.
Key Takeaways
- Migraines cause throbbing pain, usually on one side of the head, and can last four hours to three days.
- Many migraines include warning signs called an aura—such as seeing flashing lights or zigzag lines—that appear 20 to 60 minutes before the pain starts.
- A doctor diagnoses migraines by asking about your symptoms and their pattern, not by blood tests or brain scans.
- Common migraine triggers include stress, hormonal changes, certain foods, sleep disruption, and weather changes, though triggers vary from person to person.
- Treatment options range from over-the-counter pain relievers taken early in an attack to prescription medications designed specifically for migraines.
The difference between migraines with aura and without aura
Some people experience a migraine aura—a set of warning signs that appear 20 to 60 minutes before the headache pain begins. An aura might be visual, such as seeing flashing lights, zigzag lines, or blind spots. It can also be sensory, such as tingling in your arm or face, or involve difficulty speaking. Not everyone with migraines has an aura, and not every migraine a person gets will include one.
Migraines without aura are more common overall. The pain simply begins without warning signs. Both types cause the same kind of throbbing pain and sensitivity to light and sound, and both respond to the same treatments. The main difference is that people with aura get a window of time to take medication before the worst pain arrives, which can sometimes prevent the migraine from becoming severe.
What happens during a migraine attack
A migraine typically unfolds in stages. It may begin with subtle changes hours or even a day before the headache—such as mood shifts, food cravings, or neck stiffness. Then comes the aura phase (if you have auras), followed by the headache phase, when the throbbing pain is at its worst. During this phase, many people cannot work, drive, or be around bright lights or loud noise.
After the headache pain fades, some people enter a recovery phase lasting hours to a full day. During this time, you might feel exhausted, foggy, or emotionally drained. Understanding these stages helps you recognize when a migraine is starting and take action early, which is when treatment works best.
Common migraine triggers
A trigger is something that sets off a migraine in a particular person. Triggers vary widely—what causes a migraine for one person may have no effect on another. Common triggers include stress and stress relief (the letdown after a stressful period), hormonal changes related to the menstrual cycle, skipped meals, dehydration, sleep disruption, and certain foods such as aged cheeses, cured meats, or foods with monosodium glutamate (MSG).
Environmental triggers include bright or flickering lights, strong smells, weather changes, and altitude changes. Some people find that caffeine withdrawal or too much caffeine triggers migraines. Keeping a migraine diary—writing down when migraines occur and what happened in the hours before—can help you and your doctor spot your personal patterns.
How doctors diagnose migraines
A doctor diagnoses migraines by listening to your description of the headaches and asking questions about when they happen, how long they last, what they feel like, and what happens during them. There is no blood test or brain scan that confirms a migraine. Instead, doctors use a set of criteria based on your symptoms. If your headaches match the pattern—throbbing pain on one side, lasting four hours to three days, with nausea or light sensitivity—your doctor will likely diagnose a migraine.
Your doctor may order imaging tests such as an MRI or CT scan if your migraines are new, have changed pattern, or are accompanied by neurological symptoms that seem unusual. These tests rule out other conditions, not to confirm a migraine. Bring a record of your headaches to your appointment—dates, times, pain level, and what made them better or worse—because this information is what doctors rely on most.
Migraine treatment options
Treatment falls into two categories: stopping a migraine once it has started, and preventing migraines from happening in the first place. For stopping an active migraine, over-the-counter pain relievers such as ibuprofen or naproxen work for some people, especially if taken early. Prescription medications called triptans are designed specifically for migraines and work by narrowing blood vessels and blocking pain pathways in the brain. Triptans come as pills, nasal sprays, or injections.
If you have frequent migraines—more than four per month—your doctor may recommend preventive medication taken daily. These include certain blood pressure medications, antidepressants, or anti-seizure drugs. Newer medications called CGRP inhibitors block a protein involved in migraine pain and have shown promise for people whose migraines do not respond to other treatments. Your doctor will work with you to find the medication that reduces your migraine frequency and severity with the fewest side effects for you.
When to see a doctor about headaches
See a doctor if headaches are new, occur more than twice a month, are getting worse over time, or follow a pattern that is different from your usual headaches. Also seek care if a headache is accompanied by fever, stiff neck, confusion, vision changes, difficulty speaking, numbness, or weakness—these can signal a different condition that needs immediate attention.
If you already have a migraine diagnosis but your migraines are becoming more frequent, more severe, or not responding to your current treatment, contact your doctor. Migraines can change over time, and your treatment plan may need adjustment. Keeping track of your migraines helps your doctor understand what is working and what is not.
Frequently Asked Questions
Can migraines cause permanent brain damage?
No. Migraines do not cause permanent damage to the brain, even when they are frequent or severe. However, very frequent migraines can affect your quality of life, work, and relationships, which is why treatment and prevention are important.
Are migraines hereditary?
Yes. If one or both of your parents have migraines, your risk is higher. However, having a family history does not mean you will definitely develop migraines. Genetics is one factor among many.
Can stress cause migraines?
Stress is a common trigger for many people, but so is the relief that comes after stress ends. Some people find their migraines happen on the first day of vacation or the weekend, when stress drops suddenly. Identifying whether stress itself or stress relief triggers your migraines can help you manage them.
Is a migraine the same as a tension headache?
No. A tension headache usually causes a dull, pressing sensation across the whole head and lasts 30 minutes to several hours. A migraine causes throbbing pain, usually on one side, lasts much longer, and often includes nausea or light sensitivity. They are different conditions and respond to different treatments.
Can children get migraines?
Yes. Children can have migraines, though they may describe the pain differently or the headache may be shorter than in adults. If your child has frequent headaches, talk to their doctor about whether migraines might be the cause.