Migraine: Symptoms, Phases, Triggers and Treatment
Migraine is a common brain condition, not just a bad headache. Attacks can bring throbbing pain, nausea and strong sensitivity to light and sound, and they can affect your whole day.
What is migraine?
Migraine is a neurological disease, meaning it starts in the brain and nervous system. The American Migraine Foundation (AMF) calls it the third most common disease in the world. Some attacks come with little or no head pain.
Headache experts sort migraine by how often it happens:
- Episodic migraine: 14 or fewer headache days a month.
- Chronic migraine: 15 or more headache days a month for more than three months, with at least 8 of those days having migraine features. About 3 to 5% of U.S. adults have it. Read more on our chronic migraine page.
Episodic migraine can turn into chronic migraine over time, especially when it is not recognized or treated. A rising number of headache days, or needing rescue medicine more often, can be early signs of that change.
The four phases of a migraine attack
Not everyone goes through every phase, and the phases often overlap. Most full attacks last one to two days.
- Prodrome (the warning phase): This can start hours to days before the pain. You might notice yawning, tiredness, mood changes, food cravings, trouble focusing or needing to urinate more often. About 60% of people with migraine have a prodrome.
- Aura: A set of temporary nervous-system symptoms, most often visual, such as sparks, flashes or a growing blind spot. Some people get numbness, tingling or trouble speaking. Aura builds over at least five minutes and lasts up to an hour. Only about 25 to 30% of people with migraine have it. See migraine with aura.
- Headache: Moderate to severe pain on one or both sides of the head, often throbbing and worse with movement. Nausea, vomiting, neck pain and sensitivity to light and sound are common. This phase lasts about 4 hours to 3 days.
- Postdrome (the “hangover” phase): About 80% of people feel drained afterward, with fatigue, poor concentration, dizziness or body aches for one to two days.
Common symptoms
- Pounding or throbbing head pain, in the front, back, sides or around the eyes
- Sensitivity to light, sound, smells or touch
- Nausea or vomiting
- Brain fog, trouble reading or finding words
- Neck, jaw, face or scalp pain or tenderness
- Dizziness, motion sensitivity or vertigo (a false sense of spinning or movement)
You do not need every symptom to have migraine.
Common triggers
A trigger is something that can set off an attack in a person who already has migraine. Triggers vary a lot between people. The AMF lists these as some of the most common:
- Stress: reported by almost 70% of people with migraine.
- Irregular sleep: nearly half of attacks start between 4 and 9 a.m.
- Hormone changes: up to 75% of women notice attacks around their period. See menstrual migraine.
- Caffeine and alcohol
- Weather changes, such as storms, heat or shifts in air pressure
- Certain foods and skipped meals
- Dehydration: about one third of people with migraine name it as a trigger.
- Bright or flickering light and strong smells
- Overusing pain medicine: taking acute medicine more than 10 days a month can lead to medication overuse headache, which can bring on more attacks.
A headache diary can help you and your doctor spot your own patterns.
How migraine is diagnosed
A doctor diagnoses migraine from your history: how often attacks happen, how long they last, what the pain feels like and what comes with it. Notes from a headache journal help. Steady head pain lasting more than three months can point to other headache disorders, so a careful review matters.
Acute vs preventive treatment
Acute treatment is taken when an attack starts, to ease symptoms and stop it from getting worse. Treatment tends to work best early in an attack. Options the National Headache Foundation describes include:
- Over-the-counter pain relievers such as ibuprofen, naproxen, acetaminophen and aspirin
- Triptans, prescription medicines made for migraine
- Gepants, a newer class that blocks a migraine-related protein called CGRP
- Dihydroergotamine (DHE) and anti-nausea medicines
- Rest in a dark, quiet room, cold packs and extra fluids
Preventive treatment aims to cut how often attacks happen, how bad they get and how long they last. It may also help acute treatment work better. The AMF suggests considering it when attacks become frequent or severe enough to disrupt work or daily life. Options named by the AMF include CGRP-blocking medicines, some blood pressure medicines, some antidepressants, some anti-seizure medicines, supplements such as magnesium and riboflavin (vitamin B2), nerve stimulation devices and Botox for chronic migraine. Benefits can take 2 to 3 months to show. Lifestyle changes and behavioral approaches, such as biofeedback, may also help.
What patients say
5.0 from 21 Google reviews
★★★★★
Dr Park is warm, kind, and most importantly knows her stuff! She recommended her injection protocol and though it’s intense and expensive, due to lack of insurance coverage, it did significantly decrease my migraine frequency. I’ve tried everything under the sun and this feels like the first thing that has made a meaningful difference. I would definitely recommend this to anyone who feels like they’ve tried everything, but can’t put a dent in their headaches or migraines.
★★★★★
Dr. Park is the most caring doctor that I have ever had the pleasure of seeing. Not only is she an extremely bright and highly knowledgeable neurologist who specializes in migraines, but she also genuinely cares about her patients and takes the time necessary to provide excellent care to them. As someone who has suffered for years with often debilitating migraines, I don't know what I would do without her and am very grateful to her for everything that she has done to help me. I feel that with her treatment and care, my quality of life has greatly improved and I know that she is honestly concerned about my well-being.
Reviews are shared from Google in the patients’ own words. Individual experiences vary.
How Dr. Park can help
Dr. Hannah Park is a dual board-certified, fellowship-trained headache medicine neurologist with over 10 years of specialized experience. She has lived with migraine herself. Your care starts with a 90-minute new patient consultation with Dr. Park: a full history review, a neurological exam, a diagnosis and a personalized treatment plan.
The practice focuses on targeted injection treatments rather than a cycle of prescription medicines, and does not prescribe opioids. In-office options include an occipital nerve block, an SPG block (no needles) and Botox injections. If appropriate, an injection can be done at your first visit for an added fee. See services and fees. Appointments are Monday to Friday, usually within days.
When to get emergency care
Call 911 or go to the nearest emergency room if you have a severe headache that peaks within about a minute for the first time; new, sudden weakness on one side of the face or body, numbness, trouble speaking, vision changes, unusual dizziness or trouble walking; or a high fever or stiff neck with headache. Also get urgent care if your pain is very different from your usual attacks or much more severe.
Related
Sources
This page summarizes patient information from these organizations, in our own words. It is general education, not medical advice.
- Webinar Recap: The Phases of Migraine, American Migraine Foundation
- How Long Does a Migraine Attack Last?, American Migraine Foundation
- Common Types of Migraine and Related Symptoms, American Migraine Foundation
- Top 10 Migraine Triggers and How to Deal with Them, American Migraine Foundation
- Migraine Prevention 101: What It Is, When To Use It and Why, American Migraine Foundation
- Migraine in the Emergency Department: When to Go to the ED for Migraine, American Migraine Foundation
- Understanding Acute Migraine Treatments: What’s Available and How They Work, National Headache Foundation
- Migraine Symptoms, National Headache Foundation
Last updated October 27, 2026.
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