You feel it building behind one eye. The light in the room turns sharp, the sound of your own family becomes too much, and you know the next few hours belong to a dark bedroom rather than to your day.
If that is familiar, you are not simply someone who gets headaches. You are very likely someone who gets migraines, and the difference matters because the two are treated in completely different ways.
How a migraine differs from an ordinary headache
A tension headache, the everyday kind, tends to feel like a tight band around the whole head. It is uncomfortable but it usually lets you carry on with your day.
A migraine is different in character. The pain is often on one side, throbbing rather than steady, and it is frequently made worse by movement, light and sound. Many people feel sick or actually vomit, and afterwards they feel drained for a day.
Some people get a warning phase called an aura, which can be flashing lights, zigzag lines or blind spots in the vision, sometimes tingling in a hand or the face, arriving in the twenty minutes or so before the pain.
What tends to set a migraine off
Triggers vary from person to person, but several are common here in Trinidad and Tobago. Skipping meals, poor sleep and dehydration are among the most frequent, and our heat makes dehydration easy.
Stress is a major one, and so is the let down after stress, which is why migraines so often arrive at the weekend. Bright sun and glare, strong smells, alcohol, and too much caffeine or a sudden drop in caffeine can all play a part.
For many women, migraines track with the monthly cycle because of changing hormone levels. Keeping a simple diary of when attacks happen, and what came before them, is one of the most useful things you can do.
Warning signs that are not a simple migraine
Most headaches are harmless. A small number are the body signalling something serious, and it is worth knowing the difference.
These features do not mean you definitely have something dangerous. They mean the safe thing is to be examined promptly rather than to wait and hope.
What an assessment involves
The heart of a headache assessment is the conversation. A doctor will ask where the pain sits, how it feels, how long it lasts, what sets it off and what you have tried. That story alone usually points clearly to migraine.
An examination checks your blood pressure, your vision and your nervous system. Blood tests can look for contributors such as anaemia or thyroid problems, and our laboratory is on site.
Most people with typical migraine do not need a scan. When the pattern is unusual, when the examination raises a question, or when the warning signs above are present, CT scanning is available here to rule out other causes.
How migraine is managed
Treatment has two halves. The first is treating an attack when it strikes. Simple pain relievers work for milder attacks, and a class of medicines called triptans, which act on the specific pathways involved in migraine, work for many people when ordinary painkillers do not.
One important warning applies to everyone. Taking pain relief for headaches on most days of the week can itself cause a daily medication overuse headache, a rebound pain that only lifts once the frequent painkillers stop. If you are reaching for tablets more days than not, that is a reason to see a doctor.
The second half is prevention, for people who get frequent attacks. Daily preventive medication, taken every day rather than during an attack, can cut how often migraines come. Alongside it, steady sleep, regular meals, good hydration and managing stress do real work.
What to do next
If a headache today is sudden, severe or comes with any of the warning signs above, come to our Accident and Emergency department now rather than reading further.
If your headaches are a recurring pattern that is wearing you down, book a consultation. Bring a note of when your recent attacks happened and what seemed to trigger them. That simple record, combined with a proper assessment, is usually the start of getting your days back.
Headaches taking over your life? Get assessed at Newtown.
Our doctors can assess your headaches, arrange laboratory tests, and use CT scanning on site at 55 Woodford Street, Port of Spain when imaging is needed. Most assessments can be completed in a single visit, and we can refer you to a specialist if your headaches need ongoing neurological care. Our Accident and Emergency department is open 24 hours if a headache comes on suddenly and severely.
This article is for general education only and is not a substitute for personal medical advice, diagnosis or treatment. Always consult a qualified healthcare provider about your own health. If you believe you have a medical emergency, call or visit our 24-hour Accident and Emergency department immediately.