Three Knolls Media

Every small movement sends a jolt of pain through your head. Even brushing your hair is unbearable. You spend the next two or three days in a dark room, nauseous, waiting for the pain to ease and hoping you’ll recover in time for work on Monday.

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This isn’t a rare or exaggerated scenario—it’s real life for over 40 million Americans living with migraine.

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Migraine Is a Pain Disorder

A 2021 report found that 20% of American adults suffer from some form of chronic pain. According to the International Association for the Study of Pain, pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” It’s a critical survival mechanism—but when pain becomes chronic, it stops being helpful and starts disrupting daily life.

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Chronic pain can lead to sleep problems, reduced productivity, increased healthcare costs, and even changes in brain structure. Conditions like arthritis, diabetic nerve pain, and certain cancers fall under this umbrella—as do migraines.

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The International Headache Society recognizes over 150 types of headaches. Migraine is one of the most complex and debilitating among them. It’s not just head pain; it involves intense, one-sided pain, sensory sensitivities, emotional shifts, and cognitive impairments.

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Migraine is also often linked to other conditions such as depression, anxiety, irritable bowel syndrome, and fibromyalgia. People with migraines have a higher risk of stroke and heart attack. The personal toll is enormous—and the economic impact is staggering, with migraine-related productivity loss costing the U.S. an estimated $78 billion per year.

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What Happens During a Migraine?

A migraine attack can last anywhere from a few hours to several days.

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Common symptoms include:

- Nausea and vomiting

- Sensitivity to light (photophobia), sound (phonophobia), and smells (osmophobia)

- Mood changes, fatigue, muscle stiffness, and yawning (prodrome symptoms)

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For about one-third of sufferers, the prodrome is followed by an aura—usually visual disturbances like flashing lights or wavy lines—that occurs just before the pain starts. Based on this, migraines are categorized as either “with aura” or “without aura.”

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After the headache subsides, many people experience a “postdrome,” often described as a hangover-like state.

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Migraines that occur fewer than 15 days per month are called episodic. If they occur 15 or more days per month for at least three months, they’re considered chronic.

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Who Gets Migraines?

Migraines can begin at any age, but they most commonly appear around puberty. They peak during reproductive years (ages 25–45) and tend to decline after menopause or andropause.

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About 70% of those affected during peak years are women, suggesting a strong link between migraines and hormonal changes. Many women experience migraines tied to their menstrual cycle or pregnancy.

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However, the exact relationship between hormones and migraine attacks remains poorly understood.

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Treating Migraine: Two Key Goals

There are two main strategies for managing migraine:

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1. Relieve the Pain

Common treatments include over-the-counter pain relievers (like ibuprofen) and migraine-specific medications. However, up to half of patients find little or no relief. Overuse of pain medications—more than 10 days a month—can actually make migraines more frequent, a condition known as medication overuse headache.

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2. Prevent Future Attacks

In recent years, a new class of drugs called CGRP inhibitors has shown promise in reducing the frequency of attacks. These were first approved in 2018. While they’ve helped many, 20–30% of patients still don’t respond.

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Identifying personal triggers is also essential. Common triggers include stress, certain foods, and lack of sleep, but they vary widely from person to person. Tracking symptoms and habits can help individuals pinpoint what brings on their migraines.

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Why Migraine Research Matters

Until the 1970s, migraines were thought to be caused solely by changes in brain blood flow. Today, we know it is a complex neurological disorder involving multiple systems—but many questions remain:

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- What causes migraine in the first place?

- Why are some people more vulnerable than others?

- Why are women affected more than men during their reproductive years?

- Why do treatments work for some patients but not for others?

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To answer these, researchers at the University of Arizona’s Department of Pharmacology—along with the Comprehensive Center for Pain and Addiction and Banner Health—are exploring how pain signals originate and interact. Their goal is to develop better, more targeted therapies that help more people.

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This article is the first in a series that will explore current research on migraine triggers, underlying mechanisms, and emerging treatments.