Prodrome: This is the “preheadache” phase when you may start to see some warning signs like neck stiffness, mood changes, and frequent yawning. The prodrome phase can happen about 24 to 48 hours before the headache starts. Approximately 30% of people who get migraine experience these preheadache symptoms.
Aura: Up to 20% of people with migraine will experience sensory changes known as an aura. Most commonly, an aura changes how you see things, so you might notice sparkles, dots, flashing lights, wavy lines, or blind spots in your vision. Aside from affecting your eyes, an aura can make you feel numb, tingly, and cause ringing in your ears. These symptoms usually disappear just before the pain in the head begins. Headaches that occur with auras are known as “migraine with aura,” and headaches that don’t are known as “migraine without aura.”
Attack: This is when the actual migraine head pain hits—and you may also have nausea, vomiting, and sensitivity to light or sound, as we mentioned above.
Postdrome: After an attack ends, some people get a “migraine hangover,” meaning they feel depleted, fatigued, and just out of it for a day or so. Postdrome is more common than prodrome, with roughly 80% of people who deal with migraine getting to this stage.
The entire sequence can last anywhere from eight hours to three days, depending on how many stages you experience, the severity of the migraine, and whether you treat your migraine symptoms.
What are the best migraine treatments for relief?
Migraine treatment is very individualized, so you’ll want to speak with your doctor about how to find the best option for you and your symptoms. In some cases, your doctor may refer you to a neurologist, who better understands the intricacies of brain disorders.
“When patients have headaches that are not being well controlled, we take into account their medical history, what other medical problems they may have, and what the possible side effects of each medication are,” Anne Csere, D.O., an assistant professor in the department of neurology, pain, and headache medicine at the University of South Florida, tells SELF. For example, certain migraine treatments are not recommended for people who plan to become pregnant or who have a history of heart disease, she explains. Price is also an important factor because some medications are expensive and not covered by insurance.
Here’s a breakdown of the most common treatment options for migraine relief:
Abortive medications
Abortive medications are designed to stop migraine once it has started, and these can include both prescription and over-the-counter drugs. “The important thing with these medications is to take them soon after the headache starts,” says Dr. Csere. “These medications work best early in the migraine’s phase.”
Abortive medications include OTC pain relievers you probably already have on hand, like ibuprofen, naproxen sodium, and acetaminophen. Your doctor might recommend taking one of these medications with caffeine if you aren’t sensitive to it because it causes your blood vessels to contract, which can help relieve some of your pain. (This also makes the medications more effective.)