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Migraine? Tension? Mixed??

Hello- I am brand new here, so apologies if this is a topic that has been well and truly covered many times.

I have suffered from bad headaches for some 20 years (I am 40 year old female), and only in the last year have I sought help for them from my doctor. I kind of thought everyone got headaches like these, but then my husband very kindly said they probably were a bit beyond the norm, and hence my medical journey has begun.

My doctor recently diagnosed them as migraines, which felt validating. She has put me on Zomig, and it is awesome. As long as I take it early enough, it totally stops the migraine, for that day at least.

But I would really like to know what I can to do prevent these migraines, and to do that I need to understand what exactly they are, and in truth I do question how much of a tension element they have to them. I store all of my tension in my neck and shoulders, and usually when I have a bad headache, I have extremely tight shoulder/neck and can often trace the pain up from there.

And yet, the pain and general debilitating effects of these headaches are severe enough to suggest migraine- especially since they mess with my vision. At least this is what my doctor tells me.

I usually get them every two weeks (hormone related), and they generally last for several days.

All in all I am confused and want to do more to help myself, but don't know where to begin. I have just read about mixed migraine/tension headaches and wonder if that's what I get?

If they were tension headaches, would the triptans help?? Should I go for a course of physio/osteo or similar?

Thank you so much, I am so new to all of this.

  1. Hi amberj5,

    Thank you for reaching out to us and being part of our discussion forum - we're glad you're here! Let's see what information I can give you that will help.

    It's possible to have multiple types of headache disorders. For example a tension-type headache can trigger a migraine attack.
    I know patients who have migraine with aura, migraine without aura, tension-type headache and more!

    Fluctuating hormones can trigger migraine attacks. If they center around menses, you may want to discuss taking Frova prophylactically (short term) a few days before,during and after your period. You can read more about that here;

    I would encourage you to keep a detailed migraine diary for at least three months. Doing so will help you determine if your attacks have any patterns, what your triggers are and which medications work or don't work. This is a good article on keeping a diary;

    Learning what our migraine attack triggers are and then avoiding the ones we can, will hopefully reduce migraine attack frequency and severity. Migraine triggers can include but are not limited to dehydration, certain foods, changes in the barometric pressure, irregular sleep schedules and many others. When you get a moment take a look at this information about migraine triggers; This link is a general search on our site regarding migraine triggers;

    And finally, so I don't totally overwhelm you, here is information tension-type headache -

    Let me know if this helps,

    1. Check out this article from a Harvard professor on urgent vs non-urgent headaches. It also has a pretty cool quiz you can take when you have a headache.

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