Dr. Larry Newman, director of the Headache Institute at St. Luke's-Roosevelt Hospital in New York, says part of the problem stems from how migraine is explained in medical schools.
"So many doctors only get only about an hour of training in headaches in their entire course of medical training," Newman says. "So they're not sure how to diagnose it."
As a result it is important for patients themselves to recognize the symptoms and warning signs of migraines.
Migraine is more than just a bad headache. In addition to pain, it also is accompanied by nausea or vomiting, and a sensitivity to light and sound. The pain, usually a throbbing or pounding of moderate to severe intensity on one side of the head, is often made worse by everyday exercise.
"The good news is, and this comes from recent evidence, the sooner you treat a headache the better you'll do," Newman says. "Many of the people who have migraine, myself included, there's a tendency to wait, maybe it won't be a bad headache. What the study shows is if you take the medication at the first sign of the headache, you're much more likely to get rid of the headache, associated features of the headache and the headache is much less likely to return later in the day."
Some over-the-counter medications are effective for moderate migraines. For severe headaches, Newman says, there are prescription medications that can get rid of the headache in an hour or less in 70 percent of the patients.
Migraines have a number of classic triggers, the doctor says, although not everybody has these triggers. In women, the biggest trigger is the menstrual cycle. About 70 percent of women with migraines have a menstrual precipitator.
Other classic triggers are: