Headache or Migraine? Talk to Your Doctor

When the pounding pain in your head is unbearable, daylight hurts your eyes, and nausea is overwhelming, you likely have a migraine. The condition is common, affecting about 15% of people, mostly in in their 20s to 40s. Yet the debilitating condition is misunderstood and sometimes ignored by sufferers as just a bad headache.

While the condition can cause people to be nonfunctional and take a sick day, fewer than 50% of sufferers see a doctor for diagnosis or treatment, according to the American Migraine Foundation. “I see a lot of patients who report having headaches or migraines,” says Washington Health Medical Group’s Thomas Collins-Pallett, MD, of Family Medicine – Mowry Family Practice, who is certified by the American Board of Family Medicine.

“There’s no need to suffer in silence. We have a lot of treatment options today,” he adds. “We still don’t understand what the path to a migraine is, but we have many ways to treat it.”

Dr. Collins-Pallett, who was recently recognized by Bay Area News Group as the Best in Fremont Doctor, first became interested in headaches after seeing so many patients who suffered and didn’t know if anything could be done. “People would check off headaches on the questionnaire we give them before their annual physical. Many were well informed about their triggers, but others weren’t sure.”

A Headache or a Migraine?

“Tension and stress, and dehydration, are the standard reasons people might get a routine headache,” he explains. “But the causes of migraines are varied, including hormonal shifts, sleep problems, changes in weather and atmospheric pressure, foods, smells, menstruation, and more.”

The difference between a migraine and a headache, he explains, is in the duration and severity. Migraines usually start with an aura, a series of sensory disturbances that include seeing sparks, bright spots, and zig-zags, and speaking difficulties. A few minutes to an hour following the aura, the pain starts, and can last from a few hours to up to three days. Not everyone, however, will get the aura, Dr. Collins-Pallett notes, and severity varies.

In addition to pulsating pain, migraine sufferers can have light sensitivity, nausea, and vomiting. Some people experience an occasional migraine, while others suffer three to five times a month.

“A lot has to do with tracking one’s triggers,” the doctor adds. “Many random foods can cause a migraine. I had one patient who said celery would set them off.” Perfumes, cleaning products, candles, and other smells are also common triggers, along with weather changes and hormones.

“Doctors used to think that dilating blood vessels caused migraines, but that theory has been debunked,” according to Dr. Collins-Pallett. “There are currently a lot of theories, but so much about migraines we just don’t understand.”

Medications are Effective

The good news, he adds, is that doctors have many treatment options, starting with taking a non-steroidal anti-inflammatory (NSAID) over-the-counter medicine like Aleve for an occasional routine headache.

For migraines, Dr. Collins-Pallett describes two categories of medications that either cure an episode or prevent it.

Triptans are taken orally or sprayed in the nose, and are most effective immediately after a symptom is noticed. The preventative medications are taken every day, and while they may not stop all migraines, they will cause them to happen less frequently, he explains. Medications include ergotamine and ergot alkaloids, and gepants, which reduce blood vessel dilation. “We’ve had a lot of success in helping people with medications,” he says. He recommends consulting with your doctor on what is right for you.

Dr. Collins-Pallett also recommends trying to reduce stress and tension, when possible. “We don’t have a lot of control over stress in our lives, but limiting stressful situations, exercising regularly, and practicing meditation and mindfulness can help.”

“If you’re dealing with migraines and headaches and you don’t feel like you’ve found good solutions, talk to your doctor.”

For more information on Dr. Collins-Pallett, visit https://www.washingtonhealth.com/find-your-physician/thomas-collins-pallett-md/