Demystifying migraines and headaches

headache
A man hold his head in his hand.
Peggy Marco | Pixabay

Many of us get a skull-pounding headache now and then, maybe from stress or after getting dehydrated on a hot day.

But some people get recurring headaches that are serious enough to keep them from school or work. About 1 in 5 people get migraines, a type of headache often accompanied by nausea and extreme sensitivity to light and sound. Cluster and tension headaches can also interfere with daily life. And, for some people lingering headaches may be part of long-haul COVID-19

MPR News host Angela Davis spoke with two neurologists about what causes migraines and other headaches and new research into how to treat them. 
Guests: 

  • Dr. Narayan Kissoon is a neurologist at Mayo Clinic in Rochester and an assistant professor of neurology at the Mayo Clinic College of Medicine. He specializes in treating headaches and facial pain.  

  • Dr. Yoon-Hee Cha is a neurologist with M Health Fairview and an associate professor at the University of Minnesota Medical School. She specializes in treating headaches and gait and balance problems.

Important questions about chronic migraines

Is there a genetic connection?

"If someone has migraines, their children have about a 50 percent chance of also having migraines,” Kissoon said. “So it's a pretty strong connection. It's due to a lot of different genetics, and it's multiple genes that play a role, but there's a very strong association.”

Can a concussion be connected to it?

Kissoon said a lot of research has looked into head injuries and concussions in connection to chronic headaches, noting that some studies show similar brain activity that appears during a migraine can appear in “animal models after a head injury.”

“We very commonly see people that have headaches after a head injury,” he said.

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What about our diet? Could that be connected to chronic migraines?

Cha said that food can potentially trigger migraines for some patients, and it’s not always clear which foods can set it off. That’s why a common practice for patients is to chronicle their experiences in a “headache diary” to help narrow down the possible causes.

“Sometimes people have unusual food triggers, they’re not always the classic ones like red wine and aged cheeses and chocolate, but they are things like asparagus. I had a patient who had migraines triggered by peaches and she had to give up peaches. It's hard to figure these things out unless you look at them prospectively.”

How do those who suffer from migraines manage it without it affecting their mental health?

“Our general principle is to control what you can and to get help with the parts that you can. Even if you don't have headaches every day, just the lack of predictability of when that next headache can come can have an outsized role in the quality of your life.” Cha said. “Our brain likes predictability.”

Finding control can involve getting regular sleep, eating healthy and at the right times of the day, and modulating activity levels.

Use the audio player above to listen to the program.

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Correction (Aug. 12, 2022): A previous version of this feature had an incorrect title for Dr. Yoon-Hee Cha. The story has been updated.