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What is migraine?
Migraine is a neurological disorder causing attacks with varied symptoms. Mechanisms involving the nervous system and its interactions with blood vessels contribute. It is not explained by a displaced vertebra or lack of willpower.
A family predisposition is possible. Frequency and severity vary greatly between people and within one person over time. Diagnosis relies on the history of episodes and medical assessment.
Chapter sources [2]
Understand the picture
An attack is more than the pain phase
Before or at onset
Fatigue, neck discomfort or aura may sometimes occur.
During
Pain and associated symptoms can restrict activity.
After
Fatigue or sensitivity may remain for a while.
Chapter sources [2]
What can an attack feel like?
Pain is often throbbing and moderate to severe, sometimes on one side but not always. Ordinary activity may worsen it. Nausea, vomiting and sensitivity to light or sound may make you seek a quiet place.
An untreated attack can last from hours to several days. Some people also experience fatigue, concentration difficulties or neck pain before, during or after it. Not every attack follows the same sequence.
Chapter sources [2]
What is aura?
Aura involves temporary neurological symptoms, most commonly visual changes such as shimmering lights or an altered area of vision. Unusual sensations or language difficulties may also occur. In a typical aura, symptoms develop gradually and are reversible.
Do not self-diagnose a first aura. Sudden weakness, new speech difficulty or loss of vision can indicate another emergency. Call 112 for sudden neurological signs rather than waiting to see whether they resemble a familiar migraine.
What is the difference between triggers and causes?
A trigger may favour an attack in someone who is susceptible; it is not the sole cause of migraine. Irregular sleep, skipped meals, hormonal changes or a demanding period may play a role, with substantial individual differences.
Looking for patterns can help, but avoiding every food or activity for fear of an attack may unnecessarily restrict life. Discuss repeated observations instead of adopting a long list of prohibitions.
Chapter sources [2]
What does the doctor look for?
Assessment considers attack features, symptoms between episodes, health history and treatments used. A diary clarifies frequency and impact. It also helps identify possible overuse of medicines taken for attacks.
Imaging is not routine for a typical assessed migraine without warning signs. It may become useful if the pattern changes or examination raises another question. A normal MRI does not make migraine any less real.
Chapter sources [1]
When should you seek urgent or prompt help?
A sudden exceptionally severe headache, confusion, a seizure, sudden weakness, speech difficulty or high fever with stiffness needs urgent help. Call 112 in Luxembourg. Do not drive yourself if your abilities are impaired.
A very prolonged attack, unusual or longer-lasting aura, or new headaches during pregnancy or after childbirth need prompt advice. Having migraine does not protect against another cause of headache.
Treating an attack and preventing future attacks
Acute treatment aims to reduce symptoms of the current episode. Preventive treatment aims to reduce the frequency or impact of future attacks. Depending on the situation, a doctor may suggest medicines and non-drug approaches and assess their effect.
Choices depend on health history, possible pregnancy, other treatments and the level of difficulty. Frequent use of acute medicines can maintain headaches. Review the days of use and do not change a prescription yourself.
Where do the neck and physiotherapy fit?
Neck pain may be part of an attack or a separate associated problem. Its presence does not automatically make migraine a cervicogenic headache. Assessment can establish whether neck limitations need specific support.
A physiotherapist may then address those difficulties within coordinated care. This does not replace migraine management or promise a cure through massage, exercise or manipulation. Goals should distinguish neck function from the course of migraine attacks.
What can you do in everyday life?
More regular sleep and meal times, adequate hydration and suitable physical activity can be part of the plan. During an attack, some people need quiet and darkness. There is no need to force an exercise session when it worsens symptoms.
Gradually return to tolerated activity between attacks. Seek advice if exertion causes a new or unusual headache. A simple diary helps assess changes without turning each day into a search for something you did wrong.
Chapter sources [2]
In everyday life
Preparing your migraine review
Record days
Headaches, limitations and treatments used.
Notice changes
Describe symptoms different from your usual attacks.
Review the plan
Discuss acute treatment and prevention with your doctor.
How can improvement be measured?
Count headache days, days when an attack prevents activity and days of treatment. Shorter attacks, easier recovery or fewer absences can be progress even if attacks do not disappear completely.
Follow-up is useful when attacks remain difficult to control or become more frequent. Several adjustments may be needed. Report concerning changes immediately rather than waiting for a planned review.
Chapter sources [1]
Your questions
Can aura occur without headache?
It can, but a first event or a change needs assessment. New neurological symptoms should not automatically be called aura.
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Does neck pain mean my migraine originates in my neck?
No. It may accompany migraine or be a separate problem. The relationship needs assessment rather than being inferred from both pains occurring together.
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Should I remove every suspected food?
No. Triggers are individual and sometimes difficult to confirm. Numerous exclusions can complicate eating without clear benefit. Discuss repeated observations rather than a general list.
Chapter sources [2]
Can physiotherapy replace migraine treatment?
No. Support for associated neck problems complements medical care. Do not change medicines because of an exercise or temporary improvement.
Chapter sources [2]
Sources and references
- [1] NICE CG150 — Headaches in over 12s: recommendations
- [2] NHS — Migraine
- [3] NHS · Stroke symptoms
- [4] CGDIS Luxembourg · 112
- [5] International Headache Society — ICHD-3: cervicogenic headache
- [6] DEGAM / AWMF · S3 Nicht-spezifische Nackenschmerzen (2025)
Text updated on
Medical review: awaiting Hasib Selimovic.