What does migraine feel like?

Migraine is a medical condition that can affect anyone, although it affects more women than men. One common migraine symptom is headache, a painful experience that usually affects one side of the head. A migraine episode often comes with many other symptoms, such as nausea and light sensitivity.

The duration of a migraine attack — including the period before the headache starts and the period after — can last from hours to several days at a time. There are many physical and mental signs of an attack, including tiredness and trouble concentrating.

Prescription medications are available if over-the-counter (OTC) pain relievers don’t work for your migraine episodes. Many people also find that lifestyle measures and nonmedical treatments help prevent migraine. 

Symptoms

There are many types of migraine, but two of the most common types are migraine with aura and migraine without aura.

The timeline of a migraine attack can last several days. It begins with a period called prodrome, which comes before a migraine. The last period is called postdrome. 

Each phase can last several hours or days, except aura. In those who experience aura, it lasts for about 5–60 minutes and occurs before headache symptoms. 

Pain

Many people associate the pain of a migraine attack with headache. However, you may also experience other pain in the prodrome phase, such as:

• neck pain
• muscle stiffness

During a migraine episode, the pain may be moderate or severe. It may feel like:

• throbbing
• drilling
• stabbing pain in the head

With a headache, the pain usually occurs on one side of the head. It may get worse over the first few hours of the headache phase.

Aura

Research shows that about 25% of people with migraine experience aura. These usually happen about an hour before the main symptoms, such as headaches. 

Common symptoms of migraine aura include:

• flashing lights
• zigzag lines
• loss of vision in some areas, or “blind spots”
• mental disorientation
• numbness or tingling
• sensory changes, such as smell, taste, or touch

Sometimes, people have aura as their only migraine symptom. In these types of attacks, there’s no headache after the aura. 

Other symptoms

There are many other possible symptoms of migraine. One 2019 study of over 6,000 people who experience migraine found that the majority of participants (64.9%) experienced headaches, light sensitivity, and sound sensitivity during episodes.

Here are some examples of what else you might experience in different migraine phases:

Prodrome:

• irritability
• depression
• light or sound sensitivity
• nausea
• problems with sleep or concentration
• food cravings

Headache:

• headache pain
• nausea/vomiting
• insomnia
• light, smell, or sound sensitivity
• anxiety/depression
• giddiness
• neck pain and stiffness

Postdrome:

• fatigue
• depression
• euphoria
• concentration or comprehension problems
• numbness and tingling

What can be mistaken for migraine?

Other conditions may look like migraine. A person may receive a migraine diagnosis when they have something else.

Other conditions that may be mistaken for a migraine attack can include:

• headache disorders, such as cluster headaches
• tear or inflammation in the lining of an artery
• stroke or mini-stroke
• blood clots
• meningitis 
• sinus conditions, such as sinusitis
• neck or jaw disorders

Aura may also result in a misdiagnosis of migraine when it’s from another cause. Other causes of aura include:

• stroke 
• acute glaucoma
• temporary loss of vision (amaurosis fugax)
• occipital epilepsy

Migraine treatment

Treating migraine usually involves strategies to prevent attacks as well as methods to reduce symptoms during an attack.

Acute treatment

You can take over-the-counter (OTC) medication at the onset of migraine symptoms. If those don’t work, a healthcare professional may prescribe medication for migraine treatment. 

Prescription drugs, such as triptans, are usually most effective if you take them as soon as possible after symptoms start. 

While triptans and OTC pain relievers are first-line treatments, other medications such as ergot derivatives and antiemetics are second-line treatments if first-line treatments don’t work. 

OTC medications can include:

• aspirin 
• acetaminophen 
• nonsteroidal anti-inflammatory drugs (NSAIDs)

Prescription triptans include:

• almotriptan (Axert)
• eletriptan (Relpax)
• frovatriptan (Frova)
• naratriptan (Amerge)
• rizatriptan (Maxalt)
• sumatriptan (Imitrex)
• zolmitriptan (Zomig)

Need a refill for sumatriptan succinate (Imitrex)? You may be able to get an online prescription through Optum Perks in as little as 15 minutes. Learn more here.

Prescription ergot derivatives may include:

• ergotamine tartrate
• dihydroergotamine

Prescription antiemetics may include:

• metoclopramide
• prochlorperazine
• droperidol
• chlorpromazine 

Prescription gepants may include:

• rimegepant (Nurtec)
• ubrogepant (Ubrelvy)

One prescription ditan is lasmiditan (Reyvow).

Preventive treatment

Many people use preventive strategies to reduce how often they have a migraine attack. These include lifestyle measures and prescription medications.

Lifestyle measures may include:

• avoiding migraine triggers
• keeping a regular sleep–wake schedule
• eating regular, healthy meals
• getting regular exercise
• limiting consumption of alcohol and caffeine
• reducing stress

Prescription medication for migraine prevention may include:

• antidepressants, such as venlafaxine (Effexor)
• anticonvulsants, such as divalproex sodium (Depakote) or topiramate (Topamax) 
• beta-blockers, such as propranolol (Inderal)
• calcitonin gene-related protein (CGRP) monoclonal antibodies, such as galcanezumab (Emgality) or fremanezumab (Ajovy)
• CGRP receptor antagonists, such as atogepant (Qulipta)
• Botox

Rather than using specific medications (or perhaps in addition to them), people may use some other treatments:

• biofeedback
• cognitive behavioral therapy for depression and anxiety

People with migraine also use integrative strategies (strategies that aren’t mainstream medical treatments) to help manage the condition. These options include:

• acupuncture
• massage
• nutraceuticals (also known as functional foods), such as magnesium and riboflavin

You may want to speak with a healthcare professional to discuss the best options for you.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Summary

Migraine is a medical condition that can cause symptoms such as severe headache, confusion, fatigue, nausea, and light sensitivity over a period of several hours or days.

Long-term management of migraine usually involves acute treatment for use during an attack, as well as preventive strategies to reduce how often you have an attack. 

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.