Chronic Migraine

Some people think migraines and headaches are the same but no. Those who experience migraine symptoms cannot do anything just find a quiet place until is over. The treatment helps to decrease the severity and frequency they happen.

What is Chronic Migraine?

This is a disease in which an individual experiences long-lasting migraines and headaches. The symptoms usually change during the day with chronic migraines. As a result, it becomes hard to tell when a migraine ends or another starts.

What is The Difference Between Migraines and Headaches?

It is important to consider that a migraine is not just a severe headache. However, the International Classification of Headache Disorder classifies chronic migraine and headaches being the same but they are not.

If you experience a headache, it is often not severe and cannot disrupt your daily activities or routine. In most cases, people experience tension-type headaches (TTH) and the main symptom is pain that impacts your head or face but not the brain.

However, migraines negatively affect directly the brain. That’s why it is considered so severe. The migraine symptoms can make it difficult to perform daily activities and tasks. In other words, it may become insupportable to do daily activities once you experience a migraine.

How Common is Chronic Migraine?

Approximately 12%-15% of people in the entire world suffer from this condition. That makes it a common condition. However, chronic migraines are less common and affect about 1%-2.2% of the population worldwide. Furthermore, females and people assigned to female at birth (AFAB) are more likely to experience chronic migraines than males or people assigned to male at birth (AMAB).

Mostly, migraines begin in puberty and become decrease with aging.


The symptoms of chronic migraines are very similar to those of migraines. The only difference between them is that chronic migraines last longer and can appear more often. Healthcare providers usually diagnose this condition when you have at least 15 days of migraine and headache episodes monthly for at least 3 months.

Migraine Symptoms

Migraines can occur in different forms that are not the same as headaches as mentioned. The symptoms that people experience also are different because they depend on the severity of the condition, underlying diseases, use of medicines or recreational drugs, and others. Check below the four stages of migraines:

  • Prodrome – This is a stage that happens before a migraine and people usually feel certain differences that mean the migraine is forthcoming.
  • Aura – Symptom that occurs when a migraine disrupts some brain areas.
  • Headache – This is the pain stage of a migraine.
  • Postdrome – In this stage, a person feels the effects of a migraine. Some people call this stage a “migraine hangover”.

If you experience a chronic migraine, the symptoms should meet the following criteria. For example:

Migraine without Aura

In such cases, the migraine duration is between 3-4 hours. Check below some criteria:

  • Pain on the left or right side of the head
  • Pulsing pain or pounding feel
  • Moderate or severe pain
  • Usually, the pain worsens even with mild activities (such as walking or using stairs)

This phase usually provokes nausea, vomiting, and light and sound sensitivity.

Migraine with Aura

This migraine type occurs when you have at least 3 of the following criteria. For example:

  • The aura symptom spreads over five minutes or longer.
  • A succession or two or more aura.
  • Once aura begins it last between 5 minutes and 1 hour.
  • You have at least one aura with positive symptoms (meaning the symptoms add a negative effect).
  • You experience a headache that happens at the same time or within 60 minutes after an aura.

In such cases, a person can experience the following symptoms. Check below some examples:

  • Vision changes (such as flashing lights, haze, and others)
  • Tingling or numbness
  • Speech problems
  • Weakness or paralysis of one side of the body or face
  • Loss of coordination
  • Vertigo
  • Tinnitus
  • Digestive problems (including constipation or diarrhea)

In case you experience any of the symptoms listed above, do not hesitate to contact your doctor.


Researchers suggest that migraine can be genetic, especially if you have a close relative with this condition. Moreover, they suspect that certain processes can contribute to or cause migraines. For example:

  • Brain chemistry changes (such as serotonin changing levels)
  • Temporary changes (including those that make it hard for brain cells to send electrical signals)
  • Blood flow changes (for example widening or narrowing of the blood vessels that carry blood in the brain)
  • Malfunctions in pain centers in the areas of the brain
  • Some changes in how your body processes feels and pain

Risk Factors

The following factors may increase the risk of developing chronic migraine or worsen it. Examples include:

  • Mental disorders (such as anxiety and depression)
  • Chronic conditions (such as fibromyalgia)
  • Sleep disorders (including sleep apnea)
  • Head injuries (such as concussions)
  • Obesity

Migraine Transformation

In some cases, migraines can transform into chronic migraines, and these processes are not fully studied. One factor that contributes to this transformation is misuse of medicines. In other words, if you are using certain medicines more than is allowed, it may lead to chronic migraine.


Different environmental factors can provoke a migraine including foods, substances, smells, sounds, and others. Check below the most common of them:

  • Stress and anxiety
  • Hormonal changes (such as menstruation)
  • Hunger and dehydration
  • Barometric pressure changes
  • Sleeping not enough or too much
  • Several fragrances or odors
  • Food or food additives (including cheeses, red wines, chocolate, preserved meats, and others)
  • Caffeine
  • Special sounds (such as low-frequency or high-frequency sounds)
  • Misuse of headache medicines


While migraine complications are uncommon they are possible. Examples include:

  • Status migrainous (severe migraine that lasts 3 days at least)
  • Strokes
  • Aura-related seizures
  • Myocardial infarctions (very rare)


First, healthcare professionals usually perform a neurological examination. They can also ask you some questions about symptoms, medical history, daily life, routine, and activities. In addition, if doctors are not sure about the diagnosis, they may also order you to do some tests. For example:

  • Magnetic resonance imaging (MRI) scans
  • CT scans
  • Blood tests


Generally, the treatments for migraines and chronic migraines are similar. The primary treatment option is medicines. Therefore, drugs are used in two forms such as to prevent migraines and to “rescue” you.

Preventive Medicines

The following medicines are very effective for chronic migraines. They help to lessen the severity and how often they happen. For example:

  • Angiotensin II receptor blockers (ARBs) – Candesartan
  • Antiseizure medicines – Valproic acid or Topiramate
  • Antidepressants – Amitriptyline, Nortriptyline, or Venlafaxine
  • Beta-blockers – Atenolol, Metoprolol, or Propranolol
  • Botulinum toxin injections
  • Calcium channel blockers (CCBs) – Verapamil or Flunarizine
  • Monoclonal antibody-based injections – Erenumab, Fremanezumab, or Galcanezumab

Rescue Medications

These medications should not be used as a long-term treatment because they can provoke chronic migraines.

Over-the-counter (OTC) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

  • Aspirin
  • Acetaminophen (also known as Paracetamol)
  • Ibuprofen
  • Naproxen

Triptan Medicines

These are prescription medications used in the migraine treatment. For example:

  • Almotriptan
  • Eletriptan
  • Frovatriptan
  • Naratriptan
  • Rizatriptan
  • Sumatriptan
  • Zolmitriptan

Overuse of these medications can also lead to chronic migraines.

Doctors may direct you to administer Ergotamine, a medication that narrows the blood vessels in the brain, which impacts the pain signal processing.

Medical Procedures

The following medical procedures can help in chronic migraine treatment. Examples include:

  • Alternative treatment options – Acupuncture is a procedure that usually helps to improve migraines.
  • Transcranial magnetic stimulation (TMS) – This procedure uses a magnetic field that influences the electrical activity of the brain.
  • Nerve Stimulation – The most common nerves for this procedure are the vagus nerve, occipital nerve, and supraorbital nerves.

In case someone experiences migraines due to stress and anxiety, psychotherapy can help them. There are different forms of psychotherapy and to choose the best for you, it is advised to consult a healthcare professional.

Frequently Asked Questions

Can chronic migraine be cured?

There is no way to cure this condition but the proper treatment can improve the symptoms and decrease the migraine and headache episodes.

What are foods that trigger migraines?

It is advised to avoid the following foods if you experience migraines. For example:

  • Cheese
  • Chocolate
  • Coffee
  • Coke
  • Citrus fruits
  • Red wine

For more details talk with your doctor.

What are the best painkillers for migraine?

Physicians usually prescribe the following medications to treat migraines. Examples include Sumatriptan and Rizatriptan. It is not allowed to use these medications more than is prescribed by your doctor because it may lead to chronic migraines. Ask your healthcare professional if you have any additional questions.

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