When is a headache more than just a headache

According to the American Migraine Foundation, migraine affects 40 million Americans, and for more than 90% of those affected, migraine interferes with education, career or social activities. And while all migraines are headaches, not all headaches are migraines. A headache is a symptom, whereas migraine is a neurological disease that often includes moderate to severe head pain along with other neurological disturbances.

Dr. Bradley Torphy and Dr. Alexander Feoktistov serve as Co-Medical Directors of Ascension Illinois' Comprehensive Headache and Migraine Unit. Together they lead a multidisciplinary team dedicated to the diagnosis and treatment of complex headache disorders, including chronic and treatment-resistant migraine.

"It's much more than a headache. Oftentimes, people with a migraine have light sensitivity, sound sensitivity, nausea, and just a slew of symptoms that are beyond the headache," said Dr. Torphy.

"Despite affecting nearly 40 million Americans, migraine remains one of the most underrecognized and misunderstood neurological disorders," said Dr. Feoktistov. "Many people still think of migraine as simply a bad headache, but it is actually a complex neurological disease that can affect vision, balance, concentration, mood and overall quality of life. The headache itself is often only one component of a much broader condition."

Often, inpatient services are not needed for people with migraine. And according to both doctors, Chicagoland should feel very fortunate that there is a specialized unit right here in the area. According to Dr. Torphy, the inpatient unit is utilized by people who have an unrelenting migraine or headache. So if somebody has a migraine or a headache that's not going away, usually a primary care physician is able to prescribe a steroid. But when someone's tried one or two outpatient regimens to try to stop this cycle of headache and they're not successful, then they should consider inpatient treatment. The majority of this inpatient service involves giving a patient specialized intravenous (IV) medication.

"When treating an acute migraine attack, both the choice of medication and the timing of treatment are critical," Dr. Feoktistov explained. "Migraine-specific therapies are generally much more effective than traditional pain medications because they target the biological mechanisms that drive migraine. Patients also tend to have the best outcomes when treatment is started early, before the attack becomes fully established."

Dr. Torphy explained that chronic migraine prevalence comes from a genetic predisposition, but that a number of things can trigger them - especially changes in weather, stress and the menstrual cycle for female patients. And as adults, migraine affects about three times as many women as men.

"One of the important preventive strategies for migraine is maintaining consistency in daily routines," said Dr. Feoktistov. "Irregular sleep schedules, skipped meals, dehydration, and unmanaged stress are among the most common triggers we see. While we cannot control every factor, such as weather changes or fluctuations in barometric pressure, establishing healthy and predictable habits can significantly reduce migraine frequency in many patients."

If you are worried about the possibility that your headaches are migraines, and that you may need specialized medical attention, there are a few simple questions you can ask yourself:

• Do you ever experience a disabling headache? This is the headache that's severe enough to slow down your natural pace in life.
• Do you ever experience sensitivity to light? This would manifest as a general preference to be in a darker environment if you have a choice.
• Do you ever experience nausea as it relates to your headache or migraine? Not necessarily to the point of vomiting, but in some patients this could present as a decrease in appetite, or feeling a little bit queasy.

"Migraine is dramatically underdiagnosed and overlooked. They're more common than a lot of patients or providers realize, and it can be a highly disabling condition," Dr. Torphy said. "Listen to your body and intuition if you're worried about the headaches you're experiencing."

If you are worried about the severity of your headaches, it is always a good start to check in with your primary care provider. And if you have continued issues, Ascension Illinois houses a specialized 43-bed unit designed to foster a soothing, quiet and welcoming environment. The unit features relaxation and therapy spaces, a biofeedback suite and an incredible view of Lake Michigan in Chicago's Lakeview neighborhood.

"Dedicated inpatient headache programs are exceptionally rare in the United States," Dr. Feoktistov said. "For patients with severe, disabling, or treatment-resistant migraine, access to a specialized multidisciplinary headache unit can provide treatment options that simply are not available in most hospitals. And one of the few specialized inpatient headache units in the country is located right here in Chicago."