Migraines: Causes, symptoms, and treatments

What is a migraine?

A migraine is a neurological condition that commonly causes episodes of moderate to severe headache, often accompanied by a range of other symptoms.

Many people describe migraine pain as a throbbing or pulsating sensation that may affect one side of the head, although it can affect both sides. For some people, migraines can interfere with work, family life, and everyday activities.

Migraine attacks can occur occasionally or frequently, and symptoms can vary significantly between individuals.

What are the symptoms of migraines?

Migraine symptoms can differ from person to person, and not everyone experiences the same symptoms during every attack. 

The most common symptoms of an attack can include, but aren’t restricted to: 

• Intense headaches that are often one sided 

• Problems with vision, such as seeing flashing lights 

• Heightened sensitivity to light, sounds, and smells 

• Nausea and sickness 

• Exhaustion and lethargy 

 
Call 999 immediately if you experience: 

• A sudden, extremely painful headache that reaches maximum intensity very quickly 

• A seizure (fit) 

• Loss of consciousness 

• Severe confusion, marked drowsiness or difficulty staying awake 

• New weakness affecting one side of the body 

• New speech difficulties 

• Sudden changes in vision such as blurred or double vision 

• A severe headache following a recent head injury 

Seek urgent medical advice from NHS 111 or your GP if: 

• A migraine attack lasts longer than 72 hours 

• Aura symptoms last longer than one hour 

• You are pregnant or have recently given birth and develop severe headache symptoms 

• Symptoms are significantly different from your usual migraine pattern 

• You develop new symptoms you've not previously experienced during an attack 

Seek routine GP advice if:

• Attacks are becoming more frequent 

• Symptoms are becoming more severe 

• Treatment is becoming less effective 

• Migraine is affecting work, study or daily life

Migraine aura 

Around one in three people with migraine experience an aura. An aura consists of temporary neurological symptoms that can occur before or during a migraine attack. 

These symptoms may include: 

• Flashing lights or zigzag lines 

• Blind spots or temporary vision changes 

• Tingling or numbness in parts of the body 

• Dizziness 

• Difficulty speaking 

Aura symptoms usually develop gradually and typically last between five minutes and one hour. If you experience aura-like symptoms for the first time, symptoms that develop suddenly, symptoms lasting longer than one hour, or symptoms such as weakness, speech difficulties or visual disturbance that are different from your usual migraine symptoms, call 999 for urgent medical attention as these symptoms can have causes other than migraine.  

Types of migraine 

There are several different types of migraine, including

• Migraine without aura 

• Migraine with aura 

• Silent migraine (migraine aura without headache) 

• Chronic migraine (headache occurring on 15 or more days per month for longer than three months, with migraine features on at least eight of those days) 

How long do migraines last?

Migraine attacks vary in duration from person to person, but migraines can last anywhere between four hours and three days. Symptoms may begin before the headache itself starts and can continue after the pain has improved.

Some people notice early warning symptoms, sometimes called the prodrome phase, hours or up to 2 days before a migraine attack begins. These can include:

• Tiredness

• Mood changes

• Food cravings

• Difficulty concentrating

• Neck stiffness

Between attacks, many people experience no symptoms at all.

What are the causes of migraines?

The exact cause of migraine is not fully understood. Current evidence suggests that migraine is a complex neurological condition involving changes in brain activity, nerve signalling and the way the brain processes sensory information. Genetics are also thought to play an important role, and migraine often runs in families. Research suggests that inherited factors may increase a person's susceptibility to migraine.

What triggers migraines?

Migraine triggers vary between individuals. Some people find that certain factors may increase the likelihood of a migraine attack. 

Factors commonly associated with migraine attacks include: 

• Stress or anxiety 

• Missing meals 

• Low blood sugar 

• Alcohol 

• Changes in sleep patterns 

• Hormonal fluctuations, including those linked to periods and menopause 

• Bright lights or strong smells 

• Changes in temperature or weather 

• Dehydration 

Understanding your personal triggers may help you identify patterns and manage migraine attacks more effectively. Keeping a migraine diary can be useful for tracking symptoms and identifying potential triggers.

Who gets migraines?

Migraines can affect people of any age, including children.

They are most common between the ages of 25 and 55 and are around two to three times more common in women than men. Hormonal factors are thought to contribute to this difference, particularly fluctuations in oestrogen levels during the menstrual cycle.

However, migraine can affect anyone regardless of age or gender.

How are migraines treated?

Although there’s currently no cure for migraine, treatment can help manage symptoms and reduce the impact of attacks. 

The most appropriate treatment will depend on: 

• The type of migraine 

• How often attacks occur 

• The severity of symptoms 

• Individual medical history 

• Self-care measures 

• The person's preferences 

• Any medicines they take 

Some people find the following strategies helpful during an attack: 

• Resting in a quiet, dark room 

• Staying hydrated 

• Using sunglasses, eye masks or ear plugs if light or noise worsens symptoms 

• Medicines used to treat migraine 

Longer-term measures that may help reduce the likelihood and frequency of attacks include: 

• Practicing relaxation techniques and cognitive behavioural therapy 

• Getting plenty of sleep (between 7-9 hours each night for most adults) 

• Maintaining a healthy weight 

• Getting regular exercise 

• Eating at regular times 

• Trying to manage stress 

• Keeping a diary to help identify and avoid triggers where possible 

Several medicines may be recommended to help manage migraine symptoms. 

Treatment options can include: 

• Pain relief medicines 

• Anti-sickness medicines 

• Migraine-specific medicines 

• Preventive medicines prescribed by a healthcare professional for people with frequent or severe migraines 

Some medicines may work best when taken early in an attack. Always follow the instructions in the patient information leaflet and seek advice from a healthcare professional if symptoms persist, worsen or change. Using painkillers too often can sometimes make headaches worse and may result in medication overuse headache. NHS guidance advises avoiding the regular use of painkillers for headache on more than two days a week. If you find you need them more frequently, speak to a healthcare professional. 

Preventing migraines 

For people who experience frequent attacks, healthcare professionals may recommend preventive treatments or lifestyle measures to help reduce the frequency and severity of migraines. 

These may include: 

• Managing stress 

• Maintaining regular sleep patterns 

• Eating regular meals 

• Staying hydrated 

• Identifying and managing triggers 

Some people may also benefit from approaches such as behavioural therapies, migraine devices or acupuncture. Speak to your GP for advice about whether these options may be suitable for you.

When should you seek medical advice?

Speak to your GP if: 

• Your migraines are becoming more frequent or lasting longer than usual 

• Symptoms are becoming more severe 

• Over-the-counter medicines are not helping 

• Your migraines are affecting your daily life 
   

Seek urgent medical advice by contacting NHS 111 or ask for an urgent GP appointment if you have a migraine attack and: 

• it's lasted longer than 72 hours 

• aura symptoms last longer than 1 hour at a time 

• you're pregnant or have just had a baby 

Call 999 immediately if you or someone you’re with has a headache that came on suddenly and:

• is extremely painful 

• have problems speaking or remembering things 

• lose your vision, or have blurred or double vision 

• feel drowsy or confused 

• have a seizure or fit 

• have a very high temperature and symptoms of meningitis 

• cannot move or have weakness in the arms or legs on 1 side of your body, or 1 side of your face 

• have recently had a head injury 

Useful resources

NHS: migraine 
Migraine Trust 
NHS 111 
Your GP practice