Migraine pain only occurs on one side? How can I stop the pain immediately?

Author: Yu Shengyuan, Chief Physician of the First Medical Center of the General Hospital of the Chinese People's Liberation Army

Chairman of the Pain Science Branch of the Chinese Medical Association

Reviewer: Li Jingjing, Chief Physician, Beijing Tiantan Hospital, Capital Medical University

Epidemiological survey data from 2010 showed that the annual prevalence of migraine among people aged 18-65 in our country was approximately 9.3%.

Among them, migraine is most common in young and middle-aged people, and the incidence in women is about 2.1 times that in men. In addition, migraine is also relatively more common in people with particularly high and low educational levels, as well as in obese people.

When we mention "migraine", we subconsciously think that it is a unilateral headache. Is this really the case?

1. What are the characteristics of migraine?

Migraine headaches usually have the following characteristics:

First, it is called migraine because it has a unilateral characteristic, but not all migraine patients have unilateral pain. Statistically, 60%-80% of patients have unilateral headaches, and 20%-40% have bilateral headaches. Some of them may start with pain on the left side, then on the right side, alternating pain, so it has a unilateral characteristic.

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Second, it has a pulsating characteristic. Nowadays, some people still habitually call migraine a vascular headache because it has a pulsating characteristic, including throbbing pain, which is also a characteristic manifestation of migraine.

Third, migraines often get worse after activities. Once an attack occurs, patients like to lie in bed and sleep and don’t want to do anything.

Fourth, the pain of migraine is relatively severe, generally moderate to severe, and patients usually also experience nausea and even vomiting.

Fifth, patients are often hypersensitive to other senses. For example, when they sleep with their eyes closed, they don’t want to see lights or hear sounds. Some patients’ symptoms will get worse when they hear noise. This is also a characteristic of migraine.

Sixth, it tends to be episodic, with each attack lasting 4-72 hours. If left untreated, the pain will last for more than 4 hours, but it will generally heal on its own within 72 hours.

2. What are the common factors that trigger migraine?

There are many triggers for migraine, and they may be different for each person. Even for the same patient, the triggers for each migraine attack may be different.

Generally speaking, the most common cause of migraine in my country is sleep disorders. People who have poor sleep are prone to headaches, which is relatively common.

There are also changes in emotions. For example, if a couple quarrels and is in a bad mood, they are more likely to have a migraine the next day. This is also quite common.

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For women, a very important factor is menstruation. Migraines are prone to occur before and after menstruation.

There are many other factors, such as fatigue, including physical fatigue, long-term brain fatigue, and psychological fatigue. Excessive fatigue can also easily induce migraines.

For some people, smelling certain odors or even drinking alcohol may trigger a migraine.

3. How to relieve pain during an acute migraine attack?

Once a migraine occurs, it may affect the patient's normal work and life. Therefore, we need to immediately relieve pain during the acute phase.

There are two major categories of painkillers now. The first category is non-specific, that is, non-steroidal anti-inflammatory drugs, including aspirin, acetaminophen, or some compound preparations, such as painkillers, etc. Various painkillers are now non-steroidal anti-inflammatory drugs.

In addition, there are some specific drugs for migraine, such as ergotamine, which was used in the past, but due to its serious side effects, it is rarely used now.

Another is the triptan drugs. There are three of them on the domestic market: rizatriptan, zolmitriptan, and sumatriptan. There are more of these drugs in the world, and we are constantly developing new drugs. Overall, there are more and more methods now.

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When it comes to medication, many patients have two tendencies:

In one case, I dare not take it because I am afraid. Many people say that taking painkillers is not good. I will just bear it first and take it when I can't bear it anymore. In fact, this concept is wrong. I must take it as soon as possible. If I wait until the migraine is very serious, the effect will be poor and the dosage will also need to be increased.

The second situation is that people get used to taking the medicine and use it repeatedly. If you use it more than twice a week, it is easy to cause medication overdose headache. In addition, painkillers themselves can also cause headaches. Current epidemiological surveys show that about 60% of chronic headaches are caused by repeated use of painkillers. This problem is very serious. So this situation is also undesirable.

Therefore, for patients with migraine, painkillers are not terrible and need to be used as early as possible, but not frequently. More importantly, we must use them correctly under the guidance of a doctor to better control their dosage and frequency and reduce the occurrence of side effects.