America’s migraine problem

If you want to know where someone’s priorities lie, take a look at how they spend their money.

Take, for instance, the federal government.

In 2018, the National Institutes of Health spent $303 million on asthma research and $989 million on autoimmune disease studies. That same year, the agency allocated $23 million to the study of migraines.

This, despite the fact that migraines are 50 percent more prevalent than both of the other illnesses. Migraines affect more than 39 million Americans, and about 4 million of them suffer from the chronic form of the disease (15 or more migraine days a month).

There is indeed a gross inequity in funding migraine research compared to other illnesses, said Jared Pomeroy, MD, a headache specialist with Spectrum Health Medical Group Neurology.

In pointing out the federal data, Dr. Pomeroy said one of the main reasons for the lack of funding is stigmatization—migraine patients are more stigmatized than patients who suffer from more diagnosable diseases such as asthma.

Medical tests can help determine the presence and severity of diseases such as asthma. There are no such tests for migraines.

“A lot involves patients reporting their symptoms,” Dr. Pomeroy said. “If someone is missing an arm or a leg, you can see the problem. It’s obvious there’s a disability.

“But headaches are harder to see and diagnose,” he said. “Doctors must rely mostly on what a patient reports, as opposed to relying on their own observations.”

The human condition

Migraines aren’t just an American issue—they’re a human issue.

The World Health Organization lists migraines among the Top 20 illnesses that cause a disability.

The disorder has a disproportionate economic impact as well, typically affecting people in the prime of their lives.

A bout with migraines can cause an otherwise healthy person to miss work or school, and in some cases it can lead to job loss. It can also cause a person to miss out on precious family time.

It’s truly an ailment that knows no social or economic boundaries, striking the rich and famous just as often as it strikes everyday people.

People with migraines can sporadically—and temporarily—escape the battle.

When they seek treatment, however, they sometimes find it difficult to gain understanding from people who have never suffered a migraine, Dr. Pomeroy said.

“A lot of people who don’t suffer from migraines see them as a character flaw, not as a physical ailment,” the doctor said.

Society’s conventional knowledge of migraines doesn’t always mean the public, or even employees in the medical field, will understand the nature of the beast.

Generally, migraines can be accompanied by nausea, vomiting or pulsating on one side of the head. Routine activity can aggravate them.

A migraine patient is often sensitive to light and sound.

Some patients will also experience numbness in their face or body, and the headaches may cause weakness in an arm or leg. Seeing a flashing light, experiencing tunnel vision or even temporarily losing sight are also symptoms.

Treatments

While science is still pursuing a full understanding of migraines, there are treatments available.

They usually entail over-the-counter or prescription drugs. For more severe pain, doctors have used injections or other specialized drugs to provide immediate relief.

“In the 1990s, Triptan medications were developed for acute treatment of migraines,” Dr. Pomeroy said. “Since then, we haven’t had any new classes of pharmaceutical agents developed specifically for migraines.”

Researchers have developed new drugs within existing pharmaceutical classes, the doctor said, and some medicines meant for unrelated disorders have been used effectively for migraines.

Botox has become a godsend for some, although it involves 31 tiny injections that must be repeated every 12 weeks. Others may find relief simply by placing an ice pack on the back of the neck, or on the primary location of the pain.

Patients may also see symptoms improve by changing lifestyle factors such as diet and exercise, Dr. Pomeroy said. Cutting out caffeine and nicotine can be a big help.

Interestingly, the migraine sufferer’s keen intuition is often one of the best defenses.

People who frequently experience migraines can sense when a new one is approaching.

When it strikes at work or at school, they’re better prepared—even if they know their best course of action means returning home to rest in a dark, quiet room.

Some experts think migraines may be hereditary. This much is certain: There’s typically no known cause, and there is no cure.

And until there’s enough funding to help researchers develop a cure, migraine suffers must muddle through the attacks. With guidance from a good doctor, their outlook can improve.