You know your migraine pain is complicated, and so are the signs and symptoms that let you know you’re experiencing more than just a headache. Some early warning signs begin days before a migraine hits, and other commonplace symptoms like nausea occur along with the migraine pain.
As frustrating as migraines are, they are also unique to the individual. Each person experiences them differently. The key to understanding yours, says neurologist Robert Cowan, MD, a clinical professor at the Stanford University School of Medicine, is to “pay attention to your environment and see what triggers the headaches.”
Here are common alerts to look for:
1. Yawning. A day or two before your migraine hits, you might find yourself yawning more frequently than usual. For many people, this is a bothersome early warning sign, but it also gives you time to initiate your migraine treatment plan. Other early warning signs (called prodromes) that could accompany this yawning are fluid retention, food cravings, fatigue, thirst, feeling muddle-headed, and personality changes, says Dr. Cowan.
2. Aura. These vision effects, which include seeing spots or stars, blurred vision, or tunnel vision, begin 30 minutes to an hour before the migraine pain and then go away completely just before the headache hits. For women, there’s another important reason to be aware of aura — premenopausal women who experience aura before migraine are at increased risk for stroke. “We advise women to not smoke or take birth control pills or do anything that would increase their heart disease risk,” Cowan says.
3. Nausea. Some signs and symptoms vary among people who experience migraines. Nausea is a symptom that some people may experience with migraine. There are other health conditions that may cause nausea with migraine like flu or meningitis. Nausea will typically keep you from wanting to eat; some people also experience vomiting, and others may have diarrhea or other digestive upsets.
4. Pain on one side of your head. Tension headaches and other headache types tend to cause your head to ache all over, or at least evenly on both sides. As with nausea, greater pain on one side of your head is a telling sign that you have a migraine and not another type of headache. Migraine pain generally gets worse with physical activity. People with migraines may also describe the pain as intense, throbbing, or debilitating, making it hard to carry out daily activities.
5. Sensitivity to light or sound. People who have migraines often complain that their headache pain is accompanied by acute sensitivity to noise or light. A smaller number of people also complain of highly sensitive skin. For some people, light, sound, and certain smells can also be migraine triggers. Cowan explains that people who have migraines seem to have an overactive brain stem, the area of the brain that determines whether stimuli in the environment are painful.
6. “Pins and needles.” Changing sensations, like the feeling of tingling in your hands or feet or numbness in arms, legs, or parts of your face, are all associated with migraine. They may occur as part of an aura event or during the migraine pain. These types of physical sensations are often alarming and can increase the anxiety and stress of migraine pain.
7. Blurry vision. Blurred or shimmering visual sensations can occur as part of the aura stage of a migraine or with the migraine pain itself. A small proportion of migraine sufferers experience the symptoms of aura, such as blurry vision and other neurological changes, but do not also have headache pain. These changes in vision are thought to be due to changing blood flow in your brain.
Once you are aware of these key warning signs, you’ll be better able to figure out when to seek migraine treatment and hopefully limit the degree of pain.