A Complete Guide to Symptoms, Causes, and Management of Migraines

A Complete Guide to Migraines: Symptoms, Causes, Triggers and Management

Important Disclaimer

This guide is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a healthcare professional for personalised guidance, especially if migraines are frequent, severe, or new.

Updated for 2026 with the latest treatment insights and practical advice.

What a Migraine Really Feels Like and Why It Matters

If you've ever had a migraine, you know it's not "just a headache." It's an intense, often debilitating experience that can turn a normal day upside down. At The Card Project UK, we've spoken to many customers over the years who describe the frustration of unpredictable attacks—missing work, family time, or simply feeling "off" for days. Drawing from those real stories (shared anonymously) and trusted sources like the American Headache Society, this guide is here to help you recognise what's happening, spot patterns, and find practical ways to manage it. You're not alone, and there are more effective tools than ever to regain control.

Recognising the Four Stages of a Migraine Attack

Not every migraine looks the same, but many follow these four phases. Spotting them early can make a big difference in heading off the worst symptoms.

• Prodrome (The Warning Signs): Hours or even a day or two before the pain hits, you might notice subtle changes like yawning a lot, mood swings (irritability or sudden energy), food cravings, neck stiffness, or feeling unusually thirsty. Customers often tell us these are their "red flags"—ignoring them means a tougher attack ahead.

• Aura (For About 25-30% of People): This temporary phase lasts 5-60 minutes and involves neurological disturbances, usually visual (zigzag lines, flashing lights, or blind spots). Less commonly, it can include tingling, speech issues, or (rarely) motor weakness—note that significant weakness might point to a rarer subtype called hemiplegic migraine, so mention it to your doctor.

• Headache Phase: The classic throbbing pain, often one-sided, with nausea, vomiting, and extreme sensitivity to light, sound, or smells. Movement usually makes it worse.

• Postdrome (The "Hangover"): After the pain eases, you might feel drained, foggy, or oddly euphoric for up to a day or two.

Typical symptoms include pulsating pain (rating 6-10 on a 10-point scale), nausea, and sensitivities. Attacks last 4-72 hours untreated.

Episodic vs. Chronic Migraines: Why the Difference Matters

Migraines are often split into episodic (fewer than 15 headache days per month) and chronic (15 or more days per month, with at least 8 having migraine features). Chronic migraines tend to cause more disability and often overlap with other conditions (like anxiety or sleep issues). Management can differ—chronic cases may need stronger preventive approaches sooner.

What Triggers Migraines—and How to Track Yours

Genetics play a big role (if a parent has them, your odds are higher), but triggers are personal. Common ones we've heard from customers:

• Stress (especially the "let-down" after a busy period)

• Hormonal shifts (e.g., menstrual cycle or perimenopause)

• Sleep changes (too little or too much)

• Dehydration or skipping meals

• Certain foods/drinks: Alcohol (red wine), caffeine changes, chocolate, aged cheeses, processed foods with MSG

Practical Tip: Start a simple migraine diary (app or notebook)—jot down sleep, meals, stress levels, and symptoms. Patterns emerge quickly, helping you avoid triggers.

Common Overlaps: Migraines and Other Conditions

Migraines often don't come alone. Many people also experience:

• Anxiety or depression (up to 50% in chronic cases—treating one can help the other)

• Sleep disorders (poor sleep worsens attacks)

• Fibromyalgia or other chronic pain conditions (shared sensitivity pathways)

If you notice these, mention them to your doctor—integrated care can improve everything.

Everyday Strategies for Relief and Prevention

During an Attack

• Find a quiet, dark room to rest

• Apply a cold compress to your forehead or neck

• Stay hydrated and breathe deeply

Long-Term Habits

• Aim for consistent sleep and meals

• Manage stress with walks, yoga, or short meditations

• Regular moderate exercise (studies show aerobic activity can reduce attack frequency by up to 50% in some people—start gently)

Medical and Non-Drug Options (Talk to Your Doctor)

• Acute Relief: Triptans, gepants like rimegepant (Nurtec ODT), ubrogepant (Ubrelvy), or newer options for faster relief

• Prevention: CGRP monoclonal antibodies (e.g., erenumab/Aimovig, fremanezumab/Ajovy) are often first-line per AHS guidelines—highly effective with good tolerability. Oral gepants like atogepant (Qulipta) are popular alternatives.

• Non-Drug Neuromodulation: Devices like Cefaly (forehead TENS), Nerivio (arm remote electrical neuromodulation), or gammaCore (neck stimulation) offer drug-free options supported by recent guidelines.

Special groups: Children often need gentler approaches; many improve during pregnancy (safe choices like acetaminophen); perimenopause fluctuations can temporarily worsen attacks.

When to Seek Help—Including Red Flags

See a doctor for frequent or severe attacks or pattern changes. Seek emergency care immediately if any of the following happen:

• Sudden "thunderclap" onset (worst-ever pain)

• Fever, stiff neck, confusion, or rash

• Neurological changes like weakness, vision loss that persists, or speech problems

These could signal something serious like stroke or infection.

FAQs: Quick Answers to Common Questions

Are migraines hereditary?

Yes, genetics play a strong role—if one or both parents experience migraines, your likelihood increases significantly. That said, environment and lifestyle triggers still matter a lot. Knowing your family history can help you be more proactive about tracking patterns early.

Can stress cause migraines?

Stress is one of the most commonly reported triggers, often sparking attacks through changes in brain chemicals and blood vessels. Interestingly, many people notice migraines during the "let-down" period after stress passes. Simple stress-management habits like short daily walks or breathing exercises can make a real difference in reducing frequency.

How long do migraines typically last?

The main headache phase usually lasts 4–72 hours if untreated, but the prodrome (warning signs) and postdrome ("hangover") can extend the overall impact to several days. Treating symptoms early and resting in a dark, quiet space often shortens the duration.

Is there a hormonal link?

Absolutely—many people experience menstrual migraines or changes around perimenopause due to fluctuating hormone levels. Tracking your cycle alongside migraine episodes can reveal clear patterns, and some find relief through lifestyle adjustments or discussing hormonal options with their doctor.

Are dietary triggers the same for everyone?

No, they're highly individual. Common culprits include alcohol (especially red wine), caffeine withdrawal, chocolate, aged cheeses, and processed foods containing MSG—but what affects one person might not bother another. The best approach is keeping a simple food and symptom diary for a few weeks to identify your personal triggers.

When should I see a doctor?

Seek medical advice if migraines are frequent (more than a few per month), severe enough to disrupt daily life, suddenly worsen, start after age 50, or come with unusual symptoms like confusion, vision loss that doesn't resolve, or weakness. Early specialist input can open up more effective preventive options.

One Practical Tool for Severe Attacks: Medical ID Cards

If a migraine ever leaves you unable to communicate clearly (severe pain, nausea, or confusion), having vital information readily available can make all the difference to first responders or medical staff. Our eco-friendly, customisable Migraine Medical ID Cards are wallet-sized and many customers tell us they give genuine peace of mind for daily life, travel, or work.

It's just one option among many supportive tools. Explore our range at thecardproject.uk if it feels like it could be useful for you.

Last updated: December 2025 – reviewed annually for latest guidelines. Content reviewed in line with American Headache Society (AHS) and International Headache Society (IHS) guidelines.

Further Resources

For more in-depth information and support, here are some trusted external sources:

• Mayo Clinic migraine overview

• NHS (UK) advice on migraines

• Migraine Trust (UK charity with support and info)

• National Institute of Neurological Disorders and Stroke (NINDS) migraine page