Migraines can be absolutely hellish, as anyone who has ever had one knows. The misperceptions so many people have about migraines can just make the whole experience worse.
To debunk some of the more annoying or even harmful myths surrounding this all-too-common but still misunderstood health issue, we talked to a couple of doctors who specialize in treating migraines along with someone who actually has them. Here are totally false myths about migraines that people should quit believing.
Myth #1: A migraine is just a headache.
Charles R., 27, started getting migraines when he entered law school a few years ago. “It’s annoying when people think it’s just a regular headache,” he tells SELF.
This is probably the most pervasive myth about migraines, and it couldn’t be further from the truth. “Migraines are so much more than just having head pain,” Lauren Green, D.O., R.D., a board-certified neurologist at the USC Headache and Neuralgia Center and assistant clinical professor of neurology at the Keck School of Medicine of USC, tells SELF.
They’re actually a “chronic neurologic disease,” Lauren R. Natbony, M.D., assistant professor of neurology at the Center for Headache and Facial Pain at the Icahn School of Medicine at Mount Sinai, tells SELF. Although the cause still isn’t 100 percent clear, researchers are starting to think some sort of genetic mutation leads to neurological abnormalities that trigger migraines, according to the National Institute of Neurological Disorders and Stroke (NINDS).
An excruciating pulsing headache on one or both sides of the head is only one part of the package. Migraines can also cause issues like nausea and vomiting, sensitivity to light, sound, and touch, blurry vision, and even fainting, according to the Mayo Clinic. These other symptoms can be as debilitating as the headache itself, MaryAnn Mays, M.D., director of the Neurology Residency Program at Cleveland Clinic, tells SELF.
Myth #2: A migraine is simply a temporary nuisance.
Actually, migraines can announce their presence long before any pain strikes and stick around for the after-party, too.
- The prodrome stage occurs about one to two days before the onset of any migraine pain, according to the Mayo Clinic. It includes symptoms like constipation, mood changes, food cravings, increased thirst and urination, yawning more than usual, and neck stiffness.
- The aura stage begins before the head pain (and can continue into it), usually lasting for 20 to 60 minutes. “The term aura denotes neurologic symptoms that can include alterations in vision, speech, sensation, and motor function,” Dr. Natbony says. For example, someone may see flashing light or zigzag lines or feel pins and needles sensations in an arm or leg, Dr. Green says.
- The “migraine attack” can last four to 72 hours if left untreated. This is when people can experience the main symptoms you might think of when it comes to migraines: a ton of pain, sensitivity to light, nausea, vomiting, and lightheadedness.
- The post-drome stage can last for around a day after the attack. Also known as a “migraine hangover,” this can leave people feeling moody, exhausted, dizzy, confused, still sensitive to sensory input like light, or even elated, the Mayo Clinic explains.
None of the above sounds like a minor inconvenience, you know?
Myth #3: If you don’t get an aura, it’s not a migraine.
Actually, only about one-third of people with migraines experience aura, according to NINDS. And, since people don’t always experience all migraine stages, “most people who have migraine with aura also have migraine without aura,” Dr. Natbony says.
Myth #4: Over-the-counter drugs should be enough to treat anyone’s migraines.
If someone has mild to moderate migraines, OTC pain relievers may be enough, according to the Mayo Clinic. Charles, for example, is usually able to manage his symptoms with OTC drugs containing a mix of pain relievers and caffeine, along with resting in a quiet, dark room for a few hours. But for many people, these types of drugs won’t do the trick.
That’s why there are various prescription drugs that are stronger in order to treat migraine pain, like triptans, which narrow blood vessels and obstruct pain pathways in the brain, and ergots, which decrease the pain messages your nerves can send, the NINDS explains. There are also preventive drugs, including erenumab-aooe, a buzzy treatment the Food and Drug Administration (FDA) approved in May 2018 that blocks the activity of a molecule that is implicated in migraine attacks.
It’s important to talk to your doctor if you’re trying to treat frequent head pain by taking over-the-counter drugs a couple of times a week. That puts you at an increased risk for a medication-overuse headache, Dr. Mays says. This is when the medicine starts causing head pain instead of treating it, leading you to take more of the same painkillers. It’s a nasty cycle that you definitely want to avoid.
Myth #5: People use migraines as an excuse to get out of work, school, or other obligations.
No, people with migraines aren’t just playing hooky. “[Migraines] can be very disabling,” Dr. Green says. “It’s very hard to just push through a migraine and continue on with your day.” Many people need to lie down in a dark, quiet room for hours to limit sensory input, or simply because the pain and other symptoms are so bad that they can’t do anything else.
This is certainly the case for Charles. He usually gets his migraines in the evening, which sometimes forces him to cancel hanging out with friends. In the past, friends have thought he was using migraines as an excuse to bail on their plans, he says, but no—migraines can cause some serious suffering, and it’s only natural that you may not be able to live your usual life when dealing with one.
Myth #6: Men don’t get migraines.
It’s true that migraines are about three times more common in women, according to the NINDS. (This appears to be due in part to the way estrogen changes can trigger migraines.) But there are still plenty of men who have the condition as well. Thanks to this misperception, though, they can be less likely to seek treatment. Dr. Green says she hears something like, “I’m a guy, I can't have migraines—it must just be a tension headache,” from her reluctant male patients all the time. That brings us to our next myth, actually…
Myth #7: It’s not a migraine, it’s just a tension headache.
Some people with migraines experience neck stiffness or pain radiating into their head and mistake it for a tension headache, Dr. Natbony says. Tension headaches are actually the most common type of head pain, according to the Mayo Clinic, so that’s a good guess. But neck pain can happen with migraines, too, and it’s important to know exactly what you’re dealing with so you can get appropriate treatment.
Neck issues can happen with both migraines and tension headaches thanks to your trigeminal nerve, which transmits information about pain in your head and neck to your brain, according to the NINDS. So, how can you tell the difference?
As opposed to the migraine symptoms described above, tension headaches typically cause a mild to moderate dull ache, feeling of tightness across your forehead or the sides and back of your head, and sensitivity in your scalp, neck, and shoulders, according to the Mayo Clinic.
Migraines tend to require more intensive treatment than tension headaches, which you can often treat with pain relievers like nonsteroidal anti-inflammatory drugs, according to the NINDS. If you’re not sure which you’re dealing with, see a doctor.
Myth #8: It’s not a migraine, it’s just a sinus headache.
Sinus headaches and migraines are often confused for one another, even among patients and doctors themselves. They can both cause similar head pain, along with other who-asked-for-this symptoms like sinus pressure and a runny or stuffy nose, Dr. Natbony explains. (The reason why is pretty fascinating: Your trigeminal nerve is linked to a bundle of nerves known as the sphenopalatine ganglion that influences processes like breathing, so head pain can cause nose-related issues, too.)
While both conditions can prompt similar symptoms, true sinus headaches occur when you get an infection that inflames your sinus cavities, Dr. Natbony explains. Fortunately, there are some ways to tell the difference between sinus headaches and migraines, like spewing out yellow or green mucus (you probably have a sinus infection, bud) or dealing with nausea (migraines are more likely to be your issue).
Another big one is if sinus infection drugs only help your nasal issues but not the pain—that’s a clear sign you might need to tackle migraines, not sinus problems. If you’re dealing with persistent head pain and sinus issues, don’t just curse your brain and nasal passages. See your doctor for the correct diagnosis and treatment that target all your symptoms, not just some of them.