Despite common depictions, migraines are often a lot more complicated than just being particularly painful headaches. In fact, migraines often move through various stages, each of which can have wildly different migraine symptoms. For example, symptoms in the beginning prodrome migraine phase are often different from migraine itself.
Sadly, there is a clear lack of information on migraine symptoms and pain management. And that makes diagnosing and treating migraines much harder for the 12% of the population who lives with them. That’s why today, I’m covering everything from the initial prodrome migraine phase all the way to the final, postdromal stage.
The Four Stages of Migraines
For most people who suffer from migraines, there are four distinct migraine stages. But nobody knows exactly how they work—all researchers know is that migraines are caused by nerves in your blood vessels sending pain signals to the brain. What exactly causes these signals to be sent is still unclear.
Since the causes of migraines are still so mysterious, most migraine research focuses on identifying migraines based on different migraine symptoms for each stage. First comes a precursor to the migraine itself, the prodrome migraine phase.
1. Prodrome Migraine Phase
The initial prodrome migraine phase is also sometimes called the pre-headache phase, since it is technically before the migraine itself. Depending on the person, prodromal migraine symptoms can begin between a few hours and a couple of days before the onset of a migraine.
While most people do not experience all the symptoms of the prodrome migraine phase, common symptoms include:
- Trouble focusing
- Difficulty reading or speaking
- Trouble sleeping
- Depression and irritability
For people who experience the prodromal migraine stage, it can be a helpful warning that a migraine is coming. As a result, some treatment plans account for these stages and recommend relaxation and/or medication to stop the migraine before it begins. However, because the prodrome migraine phase may not precede every migraine, this is not a fool-proof method.
2. Aura Phase
As mentioned above, migraines are caused by nerves sending pain signals. However, that is not the only nerve symptom of migraines. Aura is a experienced by up to a third of people with migraines, and it presents with many varied symptoms, although they are usually visual. Symptoms of aura include:
- Seeing shapes or bright spots that aren’t there
- Vision loss
- A “pins and needles” feeling in the extremities
- Trouble speaking
- Hearing things that aren’t there
Unlike the prodrome migraine phase, the aura stage can happen either before or during a migraine. But in general, individual symptoms will not last longer than an hour and will stop once the migraine has passed.
3. Headache Phase
The headache phase is what people usually think of when they think of migraines. It can last anywhere from a few hours to three days, and it is typically characterized by pain on both sides of the head. How much the headache phase varies from person to person, and it can even vary wildly in the same individual. For this reason, it can be hard to anticipate how bad a migraine will be.
And in some cases, the pain may even change during the same migraine. Pain can shift from one part of the head to another or start on one side and gradually develop in both sides of the head.
Of course, pain is not the only symptom during this migraine stage. Other symptoms during the headache migraine phase include:
- Nausea and vomiting
- Sensitivity to light, smell, and sound
- A burning sensation in the head
Unfortunately, there is no reliable way of determining how long this stage will last. An individual could have a migraine lasting one hour, then the next week have a migraine that lasts days. Working with your doctor to create an individualized treatment program is a big part of managing chronic migraine symptoms.
4. Postdrome Migraine Phase
Sadly, even when a migraine has passed, there may still be yet another migraine phase. Known as the postdromal phase, this occurs in four out of five people who experience migraines. Like the prodrome migraine phase, postdromal symptoms may not appear after every migraine. But when they do, they typically manifest as:
- Trouble concentrating
- Emotional highs and lows
- Difficulty understanding people and things around you
Even though the headache is over at this stage, some people report being sensitive to light and smells, which can trigger headaches for them. For this reason, it’s important for individuals with migraines to be particularly careful for the couple of days after a migraine.
Monitoring Your Own Migraines
Understanding the different phases of migraines can be a great tool in managing your own migraine symptoms. If you think you’re experiencing different migraine stages, try keeping a journal and recording any symptoms you feel in a given day. In this way, you can help identify patterns to your migraines, which in turn can help you and your healthcare provider find ways to manage your symptoms.
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