The 4 Migraine Phases: Understand This to Help Prevent & Treat Your Migraines

Photo: NY Times

The 4 Migraine Phases: Understand This to Help Prevent & Treat Your Migraines

Migraine is a neurological disorder, a disease that in most instances occurs because people with migraines have a highly sensitive nervous system, according to the book, Managing Migraine.

People who have migraines are born with a nervous system that processes information differently than those who do not have migraines. The brain of a migraineur reacts to light and sound at a lower threshold than the brain of someone without a migraine. Also, once the brain of a migraineur is activated, it responds to that signal for a longer period of time. This means that the migraine-prone brain is more responsive to surrounding activities and tends to process the stimulation in the brain longer than in people without migraine. This heightened sensitivity and “low-threshold” for stimulus and triggers often causes a migraine cycle, which can be difficult to stop once it starts. It is important to understand the four phases of a migraine attack in order to learn how your brain and body are responding to the world around you, and this understanding can also help you recognize, prevent, manage, and treat your migraines more effectively.

Photo: NY Times
Photo: NY Times


1. Prodrome (Pre-Headache Phase)

When it happens: Several hours to up to two days in advance.
Frequency: About 60% of those with migraines will experience this phase.
Possible symptoms: Loss of appetite, muscle pain (especially in the head, neck, shoulders), anxiety, unexplained energy or feelings of euphoria, irritability, difficulty concentrating, food cravings, sensitivity to light, smells or noise, fatigue with frequent yawning.
What to do: Pay close attention to how your body is feeling and notate it on a migraine calendar. Recognizing these symptoms and the patterns your body exhibits before a migraine attack can help you effectively treat the migraine – and provide a window of opportunity to reverse the process before it turns into a full-migraine. During this phase, I often try taking an epsom salt bath to help with muscle tension and detoxification, stretching, massage, fresh organic juicing, or other non-invasive and non-toxic approaches to address the underlying cause of the prodrome symptoms.

2. Aura Phase (Pre-migraine Phase)

When it happens: About an hour before to right when the headache strikes.
Frequency: About 20% of those with migraines experience this phase, but not necessarily with each migraine.
Possible symptoms: Changes in vision, such as flickering, shimmering or flashing lights, tunnel vision, difficulty focusing, spots of vision loss or zigzag lines that cross your line of sight; skin sensations, such as numbness in your extremities or feelings of tingling or “pins and needles” in the face or hands; trouble speaking, writing or understanding words; muscle weakness
What to do: Immediately respond to the underlying cause of symptoms, seek acupuncture or homeopathic remedy, or take the medication you’ve been prescribed for your migraine. Make sure you have your migraine tool kit handy and avoid any triggers.

3. Attack Phase (Headache Phase)

When it happens: This is when the actual headache strikes; it can last for hours up to several days.
Frequency: 100% if the migraine is untreated.
Possible symptoms: Mild headache gradually develops into severe headache, throbbing or pulsing pain, often on one side but sometimes both sides of the head; sensitivity to light, sounds and sometimes smells; nausea and vomiting; blurred vision; light-headedness and/or fainting
What to do: Immediately respond to the underlying cause of symptoms, seek acupuncture or homeopathic remedy, or take the medication you’ve been prescribed for your migraine. Make sure you have your migraine tool kit handy and avoid any triggers. Rest in a cool, dark, quiet setting.

4. Postdrome (Post-headache Phase)

When it happens: After the attack phase has subsided, the symptoms of a migraine often persist for 24-48 hours.
Frequency: Most people who experience the attack phase will experience some form of postdromal phase.
Possible symptoms: Extreme fatigue, sluggishness, confusion, irritability, head pain if you move too quickly or bend over, migraine may return, low appetite, liver toxicity, memory lapses.
What to do: If you’ve been taking acute pain relievers, start to cut back so you avoid a rebound headache. Light detoxification is helpful at this phase – such as epsom salt bath, fresh vegetable juice, acupuncture, etc.  Continue to rest and avoid stress or other common triggers.

I can’t stress enough how important it is to understand these phases of the migraine attack. If you are new in your journey of healing, I recommend keeping track of your migraine cycle, medications, diet, sleep, stress, etc on a monthly calendar. A migraine calendar will help you recognize the symptoms you experience during the various migraine phases as well as help your doctor understand more about your migraines. You will have better options for treatment and your body’s ability to respond and recover will be better if you learn to recognize and respond to prodrome symptoms, for example. The goal is to recognize the symptoms and stop the migraine right then, before it turns into a full-blown attack. If you’d like help with this, please contact me and I will guide you through the process

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