CHRONIC MIGRAINE

Chronic migraine is a type of migraine characterized by frequent headaches occurring more than 15 days per month over a period longer than three months. It usually involves intense, often pulsating pain, accompanied by symptoms such as nausea, vomiting, light sensitivity (photophobia), and sound sensitivity (phonophobia). This condition can severely impact quality of life.

Genetic factors
Genetic predisposition plays a major role in the development of chronic migraine. Individuals with a family history of migraines are more likely to develop chronic migraines.

Environmental factors and triggers

• Stress and anxiety: Emotional or physical stress is a common trigger and can worsen symptoms.
• Diet: Certain foods, such as chocolate, aged cheese, caffeine, or foods high in MSG, can trigger migraines.
• Hormonal changes: Fluctuations during menstruation, pregnancy, or menopause can increase migraine frequency and intensity.
• Irregular sleep patterns: Poor-quality sleep, lack of sleep, or irregular schedules are significant triggers.
• Exposure to stimuli: Bright lights, loud noises, strong odors, or weather changes can provoke or intensify migraines.

Medication overuse
Excessive use of migraine medication can paradoxically cause chronic migraine, often referred to as rebound headaches.

Underlying health conditions
Sleep disorders, depression, anxiety, or even neck and posture problems can contribute to chronic migraine.

Identify and avoid triggers
Keeping a migraine diary can help recognize personal triggers, such as certain foods, stress, or environmental factors.

Manage stress
Relaxation techniques such as meditation, yoga, deep breathing, and CBT can reduce frequency and intensity of migraines.

Maintain regular sleep habits
Good-quality sleep is essential. Going to bed and waking up at the same time daily, while limiting screen use before bedtime, helps prevent migraines.

Engage in regular physical activity
Exercise like walking, swimming, or yoga improves circulation and reduces muscle tension, lowering migraine risk.

Follow a balanced diet
Eating regular, healthy meals and avoiding trigger foods helps. Staying hydrated is also essential since dehydration is a common trigger.

Avoid overuse of pain medication
Excessive reliance on pain relievers can lead to chronic migraine. Always follow medical guidance for safe use.

Preventive medications
Prescribed to reduce the frequency and severity of attacks:

• Antidepressants: Certain SSRIs can help prevent migraines.
• Anticonvulsants: Medications like topiramate or valproate, also used for epilepsy, may be effective.
• Beta-blockers: Often prescribed for hypertension, they may reduce migraine frequency by regulating stress and circulation.
• Botulinum toxin (Botox®): FDA and Health Canada–approved for chronic migraine prevention, Botox® can reduce the frequency of attacks by blocking pain-related nerve signals.

Rescue medications
Used to treat acute migraine attacks: triptans, NSAIDs, and combination medications to relieve pain and associated symptoms.

Cognitive Behavioral Therapy (CBT)
CBT helps patients manage stress and psychological factors that can trigger or worsen migraines, while also teaching coping strategies.

Acupuncture and physical therapies
Acupuncture and therapeutic massage may help reduce migraine pain and improve overall well-being.