Migraine Headaches: What Causes Them and How to Treat Them

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026

Source currency note: this article is based on clinical information from the source pages, last reviewed July 08, 2025.

TL;DR

A migraine is a headache that can cause intense throbbing pain or a pulsing feeling, usually on one side of the head, often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Attacks can last 4 to 72 hours untreated and may progress through four stages — prodrome (subtle warnings 1-2 days before), aura (visual or sensory symptoms in about one in three people), attack, and postdrome (a "hangover" feeling for up to a day). Migraine is common — affecting 1 in 5 women, 1 in 16 men, and 1 in 11 children — and is a genetic neurologic disease, with about a 50% chance of passing to a child if a parent has it. Common triggers include hormonal changes, alcohol and caffeine, stress, sensory stimuli, sleep changes, weather changes, and certain foods or additives. Treatment splits into two tracks: acute medicines (pain relievers, triptans, gepants, lasmiditan, dihydroergotamine, antinausea medicines) taken at symptom onset, and preventive medicines (beta blockers, antidepressants, antiseizure drugs, Botox, CGRP antibodies, daily oral gepants, neuromodulation devices) for frequent attacks. Some migraine medicines are not safe during pregnancy.

Quick Answer: What You Need to Know About Migraines

Who is this for? Anyone who gets throbbing, one-sided headaches with nausea or light sensitivity — especially when attacks interfere with daily life.

What it is: A headache with intense throbbing or pulsing pain, usually on one side of the head, often with nausea, vomiting, and extreme sensitivity to light and sound.

Who gets it: It affects 1 in 5 women, 1 in 16 men, and 1 in 11 children — women are three times more likely than men, largely due to hormonal differences.

The four stages: Prodrome (warnings 1-2 days before), aura (visual or sensory symptoms in about 1 in 3 people, up to 60 minutes), attack (4 to 72 hours untreated), and postdrome (washed out for up to a day).

Common triggers: Hormonal changes, alcohol and caffeine, stress, bright lights and loud sounds, sleep changes, physical strain, weather changes, certain medicines, aged/processed foods, and food additives such as aspartame and MSG.

How it's diagnosed: Clinically — based on your medical history, symptoms, and a physical and neurological exam. No lab test or imaging can confirm or rule out migraine; MRI or CT scans are used only to exclude other causes.

Acute treatment: Pain relievers, triptans, gepants (ubrogepant, rimegepant, zavegepant), lasmiditan, dihydroergotamine, and antinausea medicines — taken as soon as symptoms begin.

Preventive treatment: Beta blockers, antidepressants, antiseizure medicines, Botox injections every 12 weeks, CGRP antibody injections monthly or quarterly, daily oral gepants, and neuromodulation devices — for frequent or disabling attacks.

Lifestyle support: A quiet dark room, cool compress, hydration, consistent sleep and meal routines, a headache diary, regular exercise, and stress management (the SEEDS method) all help.

What Is a Migraine?

A migraine is a headache that can cause intense throbbing pain or a pulsing feeling, usually on one side of the head. It often happens with nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with a migraine. An aura can include visual changes, such as flashes of light or blind spots. The aura also can cause tingling on one side of the face or in an arm or leg and trouble speaking.

It helps to understand that migraine is not "just a headache" — it is a genetic neurologic disease. It is very common, affecting one in five women, one in 16 men, and even one in 11 children, and it is the second leading cause of disability worldwide. Because it is hereditary, if a parent has migraine, there is about a 50 percent chance that a child may develop it too.

Medicines can help prevent some migraines and make them less painful, and combining medicines with self-help remedies and lifestyle changes also might help.

What Are the Stages and Symptoms of a Migraine?

Migraines can affect children and teenagers as well as adults. A migraine can progress through four stages that have different symptoms: prodrome, aura, attack, and postdrome. Not everyone who has migraines goes through all stages.

Stage 1: Prodrome (1-2 days before)

One or two days before a migraine, you might notice subtle changes that warn of an upcoming attack:

Prodrome Warning Sign	What It Looks Like
Constipation	Changes in bowel habits
Mood changes	From depression to elation
Food cravings	Specific hunger that feels unusual
Neck stiffness	Tension in the neck muscles
Increased urination	More frequent need to urinate
Fluid retention	Mild swelling or bloating
Frequent yawning	Unusual tiredness signals

Stage 2: Aura (up to 60 minutes)

An aura might occur before or during migraines in about one in three people. Auras are reversible symptoms of the nervous system. They are usually visual but also can include other disturbances. Each symptom usually begins gradually and builds up over several minutes, up to 60 minutes.

Aura Symptom	Description
Visual changes	Seeing shapes, bright spots, or flashes of light
Vision loss	Temporary blind spots or loss of vision
Pins and needles	A feeling of tingling in an arm or leg
Weakness or numbness	In the face or on one side of the body
Trouble speaking	Difficulty forming words

Stage 3: The attack (4 to 72 hours)

A migraine usually lasts 4 to 72 hours if it is not treated. How often migraines occur varies from person to person — they might occur rarely or strike several times a month. During a migraine, you might have pain that is usually on one side of your head, although it can occur on both sides; pain that throbs or pulses; sensitivity to light, sound, and sometimes smell and touch; and nausea and vomiting.

Stage 4: Postdrome

After a migraine attack, you might feel drained, confused, and worn out for up to a day. Some people report feeling elated instead. Sudden head movement might briefly bring on the pain again.

When Should You See a Doctor?

Migraines are often not diagnosed or treated. If you regularly have symptoms of migraines, keep a record of your attacks and how you treated them. Then make an appointment with your health care professional to discuss your headaches. If you have a history of headaches, see your provider if the pattern changes or your headaches suddenly feel different.

See your health care professional right away or go to the emergency room if you have any of the following symptoms — they could be caused by a more serious medical issue:

Red-Flag Symptom	Why It Matters
An abrupt, very bad headache like a thunderclap	Can signal a serious vascular event
Headache with fever, stiff neck, confusion, seizures, double vision, or numbness/weakness anywhere in the body	These symptoms could be a sign of a stroke
Headache after a head injury	May indicate trauma-related bleeding or swelling
A chronic headache that worsens after coughing, exertion, straining, or sudden movement	Can indicate pressure changes inside the skull
New headache pain after age 50	New headaches in later life warrant evaluation

What Causes Migraines?

Though migraine causes aren't fully understood, genetics and environmental factors appear to play a role.

Changes in the brainstem and its interactions with the trigeminal nerve — a major pain pathway — might be involved. Imbalances in brain chemicals also might be involved, including serotonin, which helps regulate pain in your nervous system. Other chemical messengers play a role in migraine pain, including calcitonin gene-related peptide, also known as CGRP.

What triggers a migraine?

There are a number of things that can bring on a migraine. Knowing your own triggers is one of the most practical things you can do.

Trigger	How It Works
Hormonal changes	Fluctuations in estrogen seem to trigger headaches in many people — before or during menstrual periods, or during pregnancy and menopause. Hormonal medicines, such as oral contraceptives, also can worsen migraines. Some people, however, find their migraines occur less often when taking hormonal contraceptives.
Alcohol and caffeine	Alcohol, especially wine, and too much caffeine, such as in coffee, can trigger a migraine.
Stress	Stress at work or home can cause migraines.
Sensory stimuli	Bright or flashing lights can induce migraines, as can loud sounds. Strong smells can trigger migraines in some people — including perfume, paint thinner, and secondhand smoke.
Sleep changes	Missing sleep or getting too much sleep can trigger migraines in some people.
Physical strain	Intense physical exertion, including sexual activity, might provoke migraines.
Weather changes	A change of weather or barometric pressure can prompt a migraine.
Medicines	Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
Foods	Aged cheeses and salty and processed foods might trigger migraines. Skipping meals also can bring on a migraine.
Food additives	These include the sweetener aspartame and the preservative monosodium glutamate (MSG). These additives are found in many foods.

Who Is at Risk for Migraines?

Several risk factors make you more prone to having migraines:

Risk Factor	What to Know
Family history	Having a family member with migraines means you have a higher chance of developing them yourself
Age	Migraines can begin at any age, though the first often occurs when you're a teenager. Migraines tend to peak during your 30s and then gradually become less frequent.
Sex	Women are three times more likely than men to have migraines
Hormonal changes	Migraines might begin just before or shortly after your first menstrual period. They also might change during pregnancy or menopause. Migraines generally improve after menopause.

Can Migraine Cause Complications?

A complication for some people with migraines is medication overuse headaches. Taking painkillers too often can trigger these headaches. Medication overuse headaches may occur if you take aspirin or ibuprofen for more than 14 days a month, or medicines known as triptans for more than nine days a month. The risk seems to be highest with medicines that combine aspirin, acetaminophen, and caffeine.

Medication overuse headaches can lead to a painful cycle. If medicines stop relieving pain and begin to cause headaches, you might then try taking more pain medicine to find relief. This is a key reason why frequent migraines are better managed with a preventive treatment plan.

How Are Migraines Diagnosed?

Migraine is a clinical diagnosis — the diagnosis is based on the symptoms reported by the patient. There is no lab test or imaging study that can rule in or rule out migraine. Based on screening diagnostic criteria, if you have the symptoms of headache associated with sensitivity to light, a decrease in function, and nausea, you likely have migraine.

Migraines can be diagnosed by a specialist trained in treating headaches, known as a neurologist. The diagnosis is based on your medical history, symptoms, and a physical and neurological exam. One common question is why migraine doesn't show up on an MRI: migraine is a disease of abnormal function within the setting of normal brain structure, and an MRI solely shows structure.

If your condition is complex or suddenly becomes serious, tests to rule out other causes of your pain might include:

Imaging Test	What It Does
MRI scan	Uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. Helps diagnose tumors, strokes, bleeding in the brain, infections, and other brain and nervous system conditions.
CT scan	Uses a series of X-rays to create detailed cross-sectional images of the brain. Helps diagnose tumors, infections, brain damage, bleeding in the brain, and other medical conditions that can cause headaches.

How Are Migraines Treated?

Migraine treatment is aimed at stopping symptoms and preventing future attacks. Many medicines have been designed to treat migraines, and they fall into two broad categories:

Category	When It's Taken	Goal
Pain-relieving (acute or abortive) medicines	During migraine attacks	Stop symptoms; work best when taken as soon as symptoms begin
Preventive medicines	Regularly, often daily	Reduce how often migraines occur, how painful they are, and how long they last

Your treatment choices depend on how often you have headaches and how painful they are, whether you have nausea and vomiting, whether your headaches are disabling, and whether you have other medical conditions.

Acute (pain-relieving) medicines

These work best when taken as soon as symptoms begin.

Medicine Type	Examples	Key Notes
Pain relievers	Aspirin, ibuprofen (Advil, Motrin IB); caffeine + aspirin + acetaminophen combinations (Excedrin Migraine)	Available over the counter or by prescription; combination medicines usually only help mild migraine pain. Taken too long, they can cause medication overuse headaches and possibly ulcers and gastrointestinal bleeding.
Triptans	Sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), naratriptan, almotriptan, eletriptan (Relpax), frovatriptan (Frova)	Prescription medicines that relieve many migraine symptoms by blocking pain pathways in the brain. Available as pills, shots, nasal sprays, nasal powders, and disintegrating tablets. Might not be safe if you're at risk of a stroke or heart attack.
Dihydroergotamine	Migranal, Trudhesa (nasal spray)	Most effective when taken shortly after symptom onset for migraines lasting longer than 24 hours. Side effects can include worsening nausea and vomiting. Avoid with coronary artery disease, high blood pressure, or kidney or liver disease.
Lasmiditan	Reyvow (oral)	Approved for migraines with or without aura; significantly improved headache pain in studies. Can make you sleepy and cause dizziness — don't drive or operate machinery for at least eight hours after taking it.
Oral CGRP antagonists (gepants)	Ubrogepant (Ubrelvy), rimegepant (Nurtec ODT)	More effective than placebo at relieving pain two hours after taking; also treat nausea and light/sound sensitivity. Side effects: dry mouth, nausea, excess sleepiness. Not to be taken with strong CYP3A4 inhibitor medicines such as some cancer treatments.
Intranasal zavegepant	Zavzpret (nasal spray)	Relieves migraine pain within two hours, lasting up to 48 hours; also improves nausea and light/sound sensitivity. Side effects: change in sense of taste, nasal discomfort, throat irritation.
Antinausea medicines	Chlorpromazine, metoclopramide (Gimoti, Reglan), prochlorperazine (Compro)	Usually taken with pain medicines when nausea and vomiting accompany migraines.
Opioid and barbiturate medicines	Various	Usually avoided due to better options; can be highly addictive; used only if no other treatments are effective.

Some migraine medicines are not safe to take during pregnancy. If you're pregnant or trying to get pregnant, don't use any of these medicines without first talking with your health care professional.

Preventive medicines

Your provider might recommend preventive medicines if you have long-lasting, very bad headaches that happen often and don't respond well to treatment. Preventive treatment might be a daily oral medication, a monthly injection, or an injection or infusion delivered once every three months.

Preventive Option	Examples	Key Notes
Blood pressure-lowering medicines	Beta blockers: propranolol (Inderal LA, InnoPran XL), metoprolol (Lopressor, Toprol-XL); calcium channel blocker: verapamil (Verelan)	Verapamil can be helpful in preventing migraines with aura.
Antidepressants	Tricyclics: amitriptyline, nortriptyline (most commonly used); venlafaxine (Effexor XR)	Tricyclics can cause dry mouth and sleepiness and may interact with other medicines; venlafaxine has fewer side effects and interactions.
Antiseizure medicines	Valproate, topiramate (Topamax, Qudexy XR)	Might help if you have less frequent migraines. Side effects include dizziness, weight changes, and nausea. Not recommended in pregnancy or when trying to conceive.
Botox injections	OnabotulinumtoxinA shots about every 12 weeks	Help prevent migraines in some adults, particularly chronic migraine.
CGRP monoclonal antibodies	Erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy), galcanezumab-gnlm (Emgality), eptinezumab-jjmr (Vyepti)	Block the CGRP chemical messenger. Given monthly or once every three months by injection. Most common side effect is a reaction at the injection site.
Atogepant	Qulipta (daily oral tablet)	A gepant that helps prevent migraines. Potential side effects: nausea, constipation, fatigue.
Rimegepant	Nurtec ODT	Unique in that it both prevents migraines and treats them after they begin.

Neuromodulation therapy

Devices that stimulate nerves, known as neuromodulation devices, can reduce the number of migraines you have or make them less painful. These devices are noninvasive and work by stimulating a peripheral or cranial nerve to change the brain's response to pain. Therapies include transcutaneous supraorbital nerve stimulation, external vagal nerve stimulation, and distal transcutaneous electrical stimulation. Combined occipital and trigeminal neurostimulation is another option.

Another therapy, single-pulse transcranial magnetic stimulation, treats the brain to relieve migraine pain — for this, you place the device on the back of your head.

What Lifestyle Changes and Home Remedies Help?

When symptoms of migraine start, try heading to a quiet, darkened room. Close your eyes and rest or take a nap. Place a cool cloth or ice pack wrapped in a towel on your forehead and drink lots of water.

Beyond the immediate response, five habits support long-term migraine control:

Home Remedy	How to Do It
Relaxation techniques	Breathing exercises and relaxation training teach you ways to deal with stressful situations, which might reduce the number of migraines you have.
Consistent sleep and eating routine	Don't sleep too much or too little. Set and follow a consistent daily sleep and wake schedule. Try to eat meals at the same time every day.
Hydration	Staying hydrated, particularly with water, might help.
Headache diary	Recording symptoms — visual disturbances, unusual sensations, when headaches occurred, how long they lasted, and what triggered them — helps you learn your triggers and what treatment works. It also helps your provider diagnose and track progress.
Regular exercise	Regular aerobic exercise reduces tension and can help prevent migraines. With your provider's agreement, choose aerobic activities you enjoy, such as walking, swimming, and cycling. Warm up slowly, because sudden intense exercise can cause headaches. Regular exercise also helps with weight management — obesity is thought to be a factor in migraines.

A simple way to remember the lifestyle pillars is the SEEDS method: Sleep (keep a consistent schedule, reduce screens at night), Exercise (start small — even five minutes once a week, then build), Eat (healthy, balanced meals at least three times a day, stay hydrated), Diary (track migraine days and symptoms, and bring it to appointments), and Stress management (therapy, mindfulness, biofeedback, and relaxation techniques).

Nontraditional therapies

Nontraditional therapies might help with chronic migraine pain:

Therapy	What the Evidence Suggests
Acupuncture	Clinical trials have found acupuncture may be helpful for headache pain; a practitioner inserts many thin, disposable needles into several areas of your skin at defined points.
Biofeedback	Appears effective in relieving migraine pain; uses special equipment to teach you how to monitor and control physical stress responses such as muscle tension.
Cognitive behavioral therapy	May benefit some people with migraines; teaches how behaviors and thoughts affect how you perceive pain.
Meditation and yoga	Meditation may relieve stress, a known trigger; regular yoga may reduce the number of migraines or how long they last.
Herbs, vitamins, and minerals	High-dose riboflavin (vitamin B-2) may reduce the number of migraines and how painful they are. Coenzyme Q10 might decrease frequency, but larger studies are needed. Magnesium supplements have been used with mixed results. Feverfew and butterbur might prevent migraines, though study results are mixed — butterbur is not recommended because of safety concerns.

If you are pregnant, talk with your health care professional before trying any of these treatments.

Preparing for Your Appointment

You'll probably first see your primary health care professional, who might then refer you to a doctor trained in evaluating and treating headaches, called a neurologist.

What you can do: Keep track of your symptoms with a headache diary — write a description of each incident of visual disturbances or unusual sensations, including when headaches occurred, how long they lasted, and what triggered them. Write down key personal information, including major stresses or recent life changes. Make a list of all medicines, vitamins, and supplements you take, including doses — it's particularly important to list all medicines you've used to treat your headaches. Write down your questions, and take a family member or friend along if possible.

Questions to Ask Your Provider	What Your Provider Will Ask You
What is likely triggering my migraines?	How often do your headaches occur?
Are there other possible causes for my migraine symptoms?	How bad are your symptoms?
What tests do I need?	What, if anything, seems to make your symptoms better?
Are my migraines likely short-term or long lasting?	What, if anything, appears to worsen your symptoms?
What is the best course of action?	Does anyone else in your family have migraines?
What are the alternatives to the primary approach you're suggesting?	—
What changes to my lifestyle or diet do you suggest I make?	—
I have other health conditions — how can I best manage them together?	—
Are there printed materials you can give me? What websites do you recommend?	—

Conclusion

Migraine is a common, genetic neurologic disease — not "just a headache" — but it is also highly treatable. The path to relief starts with a clinical diagnosis based on your symptoms and history, moves to acute medicines taken at the first sign of an attack, and, for frequent or disabling migraines, adds preventive treatment ranging from daily pills to monthly injections and neuromodulation devices. Between appointments, a headache diary, consistent sleep and eating routines, hydration, exercise, and stress management give you real control over your triggers. If your headache pattern changes, or a headache ever arrives like a thunderclap, comes with fever or neurological symptoms, or follows a head injury, treat it as an emergency. You don't have to simply endure migraines — with the right diagnosis and treatment plan, most people significantly reduce their attacks and get their lives back.

If migraines are disrupting your work, sleep, or family life, talk to your provider about a prevention plan.

Frequently Asked Questions

What is a migraine and how is it different from a regular headache?

A migraine is a headache that causes intense throbbing or pulsing pain, usually on one side of the head, often with nausea, vomiting, and extreme sensitivity to light and sound. Unlike a typical headache, migraines can last 4 to 72 hours, may include warning signs (aura), and are a genetic neurologic disease rather than a simple pain event.

Why do I keep getting migraines?

Migraine causes aren't fully understood, but genetics and environmental factors play a role — if a parent has migraine, a child has about a 50 percent chance of developing it. Changes in the brainstem's interaction with the trigeminal nerve and chemical imbalances involving serotonin and CGRP are also involved. Everyday triggers such as stress, hormonal changes, alcohol, caffeine, sleep changes, and certain foods bring on attacks.

What are the four stages of a migraine?

A migraine can progress through prodrome (subtle warnings 1-2 days before, such as food cravings and frequent yawning), aura (visual or sensory symptoms in about 1 in 3 people, building over up to 60 minutes), the attack itself (4 to 72 hours of throbbing pain with nausea and light/sound sensitivity), and postdrome (feeling drained and confused for up to a day). Not everyone experiences all four stages.

How is migraine diagnosed?

Migraine is a clinical diagnosis based on your medical history, symptoms, and a physical and neurological exam — no lab test or imaging study can confirm or rule it out. If your condition is complex or suddenly becomes serious, MRI or CT scans may be used to rule out other causes such as tumors, strokes, or bleeding.

What is the best treatment for migraines?

Treatment depends on attack frequency and severity. Acute medicines — pain relievers, triptans, gepants (ubrogepant, rimegepant, zavegepant), lasmiditan, dihydroergotamine, and antinausea medicines — stop attacks when taken early. For frequent migraines, preventive treatment includes beta blockers, antidepressants, antiseizure medicines, Botox every 12 weeks, CGRP antibody injections, daily oral gepants, and neuromodulation devices, combined with lifestyle changes.

Can lifestyle changes prevent migraines?

Lifestyle changes help manage triggers and reduce attacks. The most effective habits are consistent sleep and meal routines, hydration, a quiet dark room with a cool compress at symptom onset, a headache diary, regular aerobic exercise with a slow warm-up, and stress management through therapy, mindfulness, or biofeedback. Some people also benefit from acupuncture, biofeedback, cognitive behavioral therapy, yoga, or supplements such as high-dose riboflavin (vitamin B-2) or CoQ10.

Can painkillers make migraines worse?

Yes — taking painkillers too often can cause medication overuse headaches. This can happen with aspirin or ibuprofen used more than 14 days a month, or triptans used more than nine days a month, with the highest risk from combinations of aspirin, acetaminophen, and caffeine. It creates a painful cycle where medicines stop relieving pain and begin causing headaches, which is why preventive treatment matters for frequent migraines.

Are migraine medicines safe during pregnancy?

Some migraine medicines are not safe during pregnancy. If you're pregnant or trying to conceive, don't use any migraine medicine — including supplements and complementary therapies — without first talking with your health care professional.

Related Reading

Migraines that strike during a workout deserve their own look — see our guide to exercise headaches

If headaches are showing up on more days than not, read our guide to chronic daily headaches

References

Migraine — Symptoms & causes (Mayo Clinic)

Migraine — Diagnosis & treatment (Mayo Clinic)

Rinnit.com provides general health information for educational purposes. This content does not replace professional medical advice — always consult a qualified healthcare provider for diagnosis and treatment.

Health information, not medical advice. This article is for general education and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your own health, and seek emergency care for urgent symptoms.