The truth about migraines: what causes them - and how to find relief

Key Points:

• Migraines have been recognized as a distinct ailment for millennia, but understanding and treatment have only significantly advanced in the last decade, moving beyond outdated theories like vascular causes or emotional fragility.
• Migraines are now known to originate from the activation of the trigeminovascular system, specifically involving the trigeminal nerve releasing the pain-inducing chemical CGRP, which has led to new targeted treatments.
• Migraines typically progress through four phases: prodrome (warning symptoms like cravings), aura (experienced by about 30% of sufferers), the migraine attack itself, and postdrome (recovery phase), highlighting the complex neurological nature of the condition.
• Despite affecting a large portion of the population—particularly women—and being classified by the WHO as one of the top 10 most disabling diseases globally, migraines still face stigma and under-treatment, partly due to historical misconceptions and gender biases.
• Recent advances include CGRP inhibitors and monoclonal antibodies, which have revolutionized migraine care, though access remains limited by cost and availability; improved healthcare provider training and patient education are needed to enhance treatment accessibility and outcomes.