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Guide Headache & Migraine Pain
Migraine Is Not “Just a Headache”: Triggers, the Diary That Helps, and When to Ask for More
About one in eight Americans gets migraines, women three times as often as men. Understanding the phases and triggers is the first step towards fewer bad days.
This article is general health information written by our editors from the sources listed below. It has not yet been medically reviewed — see our medical review policy. It is not advice for your situation.
The light from the kitchen window is suddenly unbearable. The smell of coffee turns your stomach. Within an hour the pulse behind one eye has become a hammer, and the only option is a dark room and a closed door. People who have never had a migraine often picture a bad headache; people who have know it is a whole-body event that can write off a day.
What migraine is
MedlinePlus describes migraines as a recurring type of headache causing moderate to severe pain that throbs or pulses, often on one side of the head, with other symptoms such as nausea, weakness and sensitivity to light and sound. About 12 per cent of Americans get them. Anyone can be affected, but women are three times more likely than men, most people with migraine have family members who have it, and conditions such as depression, anxiety, sleep disorders and epilepsy make it more likely.
Attacks often move through phases. A “prodrome” can begin up to a day before, with early signs such as food cravings or mood changes; some people have an aura — flashing lights or zigzag lines — before the pain; then the headache itself; then a period of fatigue and fogginess afterwards. Not everyone has every phase every time.
Triggers — and why they are personal
Researchers believe migraine has a genetic cause, with attacks set off by triggers that vary from person to person. MedlinePlus lists stress, anxiety, hormonal changes, bright or flashing lights, loud noises, strong smells, some medicines, too much or too little sleep, sudden weather changes, overexertion, tobacco, caffeine or caffeine withdrawal, skipped meals and medication overuse. Some people find certain foods or ingredients contribute, especially combined with other triggers. Finding your own pattern is detective work, which is where the diary comes in.
The diary
For a month or two, note the date and time each attack starts and ends, what you ate and drank, how you slept, where you were in your cycle, stress, weather and what medicine you took. Patterns that are invisible day to day often jump out on paper, and a diary turns a vague “I get a lot of headaches” into something a clinician can act on.
A trap worth knowing about
Taking medicine for migraine too often can cause more frequent headaches — medication-overuse headache. If you are reaching for pain relief on more than ten to fifteen days a month, that in itself is a reason to talk to a clinician about prevention rather than just treating attacks.
When to ask about a specialist
Consider it if attacks are frequent, if their pattern is changing, if pain medicine is needed on many days a month, or if treatment from your primary care clinician has not helped. SEVA Healthcare lists the following for headache and migraine pain on its official page: occipital nerve block, stellate ganglion block, Botox and trigger point injections, and ketamine infusion therapy. Botox for chronic migraine is an established preventive treatment; the others are used for particular headache types. A doctor decides what, if anything, fits after an evaluation.
Seek urgent care for
A sudden, severe “worst ever” headache; headache with fever and a stiff neck; headache with confusion, weakness, trouble speaking or loss of vision; or a headache after a head injury. These are not migraine symptoms to wait out.
Questions to discuss with your clinician
- Which type of headache do I have — and could I have more than one type?
- Am I having enough attacks to consider a preventive treatment?
- Could my current medicines be adding to the problem?
- If a nerve block or Botox is suggested, what does it involve and how long does the effect usually last?
Our Headache & Migraine Pain page has the full list of warning signs and a link to SEVA Healthcare’s official page.
Frequently asked questions
What should a migraine diary include?
For a month or two, note the date and time each attack starts and ends, what you ate and drank, how you slept, where you were in your cycle, stress, weather and what medicine you took. Patterns that are invisible day to day often show up on paper, giving a clinician something to act on.
Can taking pain medicine too often make migraines worse?
Yes. Taking medicine for migraine too often can cause more frequent headaches, known as medication-overuse headache. Reaching for pain relief on more than ten to fifteen days a month is a reason to talk to a clinician about prevention.
When is it worth asking about a specialist?
Consider it if attacks are frequent, if their pattern is changing, if pain medicine is needed on many days a month, or if treatment from your primary care clinician has not helped. A doctor decides what, if anything, fits after an evaluation.
Which headache symptoms need urgent care?
Seek urgent care for a sudden, severe "worst ever" headache; headache with fever and a stiff neck; headache with confusion, weakness, trouble speaking or loss of vision; or a headache after a head injury. These are not migraine symptoms to wait out.
Sources
- Migraine — MedlinePlus (NIH), 2026-10-16
- Headache & Migraine Pain — SEVA Healthcare (official service page), 2026-10-16
This article is sponsored content by SEVA Healthcare and is for general information only — it is not medical or legal advice. Treatment options depend on an individual evaluation, and results vary from person to person. In an emergency, call 911. Spotted an error? See our corrections policy.
