long lasting migraine

Overview

A long-lasting migraine is a migraine headache that lasts longer than usual — often more than 72 hours, even with treatment. It can also refer to chronic migraine, where you have frequent headaches (15 or more days per month) for at least three months, with at least eight of those days having migraine features.

Yes, migraines are very common, affecting about one in seven people worldwide. Long-lasting migraines are less common but still affect many people, especially those with frequent or severe migraines.

It can affect anyone, but it is more common in women, people in their 30s and 40s, and those with a family history of migraines. It also tends to affect people who have had migraines for many years.

Symptoms

Common symptoms

• Severe, throbbing headache that lasts more than 72 hours
• Nausea or vomiting
• Sensitivity to light, sound, or smells
• Blurred vision or seeing flashing lights (aura)
• Fatigue or trouble concentrating

Symptoms in children

• Children may have shorter but still long-lasting migraine attacks, often with stomach pain and dizziness.
• They might complain of a pounding headache and want to rest in a dark, quiet room.
• Some children may have trouble describing their symptoms — look for changes in behaviour or mood.

Symptoms in older adults

• Older adults may have less typical migraine symptoms, like visual disturbances without a headache.
• They might be more likely to feel dizzy or have trouble with balance.
• Long-lasting migraines in older adults can sometimes be mistaken for other conditions like stroke.

Causes

Main causes

• The exact cause of migraines isn't fully understood, but they are thought to involve changes in brain chemicals and nerve pathways.
• Long-lasting migraines may happen when the processes that normally stop a migraine attack don't work properly.

Risk factors

• Having a family history of migraines
• Being female (hormonal changes can trigger migraines)
• Having frequent or severe migraines
• Stress, poor sleep, or skipping meals
• Certain foods or environmental triggers

When to see a doctor

See a doctor urgently if:

• If your migraine lasts more than 72 hours and your usual treatments aren't helping
• If you have any emergency symptoms mentioned above

Book a routine appointment if:

• If you have frequent migraines (more than one per week) that affect your daily life
• If you need to take painkillers for migraines more than twice a week
• To discuss prevention options and rule out other causes

Diagnosis

A doctor will usually diagnose a long-lasting migraine based on your symptoms and medical history. They will ask about the frequency, duration, and nature of your headaches, and may perform a physical exam.

Tests that may be done

• No specific test for migraines — the diagnosis is mainly based on symptoms.
• Your doctor may order scans like an MRI or CT scan to rule out other causes (like a brain tumour or stroke) if your symptoms are unusual.

What to expect at your appointment

Your doctor will likely ask you to keep a headache diary, noting when headaches happen, what they feel like, and any triggers. This helps confirm the diagnosis and plan treatment. The process is usually straightforward and not painful.

Treatment

Treatment aims to stop a long-lasting attack and prevent future ones. A combination of self-care, medicines, and sometimes other therapies can help. It's important to work with your doctor to find what works best for you.

Self-care at home

• Rest in a dark, quiet room
• Apply a cold or warm compress to your head or neck
• Drink plenty of water to stay hydrated
• Try gentle massage or acupressure
• Use relaxation techniques like deep breathing or meditation

Medical treatments

Doctors may prescribe medicines to stop a migraine attack, such as triptans (taken as a pill, nasal spray, or injection) or anti-nausea medicines. For long-lasting attacks, a doctor may give a steroid injection or intravenous fluids in hospital. For prevention, they may suggest medicines that are taken regularly to reduce the frequency and severity of migraines, such as beta-blockers or antidepressants (used for migraine prevention, not depression). Always take medicines as prescribed and never exceed recommended doses.

When is surgery considered?

Surgery is very rarely needed for migraines. In some cases, procedures like nerve blocks or Botox injections (used for chronic migraine) may be considered. Surgery is usually only for very severe, treatment-resistant cases and should be discussed thoroughly with a specialist.

Living with this condition

Living with long-lasting migraines can be challenging, but many people find ways to manage. Keeping a headache diary can help identify triggers. Plan ahead for attacks — have your medicines and comfort items ready. Communicate with family, friends, and employers so they understand what you need.

Lifestyle tips

• Try to keep a regular sleep schedule — go to bed and wake up at the same time every day.
• Manage stress with yoga, meditation, or talking to a therapist.
• Avoid known triggers, such as certain foods (aged cheese, processed meats), alcohol, or strong smells.
• Stay hydrated and don't skip meals.

Diet and exercise

A balanced diet can help. Some people find that certain foods trigger migraines, so try to eat regularly and avoid fasting. Gentle exercise like walking, swimming, or cycling can reduce stress and improve overall health, but intense exercise may sometimes trigger a migraine — listen to your body.

Mental health and emotional wellbeing

Long-lasting migraines can cause frustration, anxiety, depression, and feelings of isolation. It's normal to feel down when you're in pain often. Talk to your doctor if you notice mood changes — they can offer support or refer you to a mental health professional.

Prevention

While you can't always prevent a long-lasting migraine, you can reduce the risk of frequent attacks. Avoiding triggers, managing stress, and taking preventive medication as prescribed can help. For chronic migraine, a preventive plan can make a big difference.

Complications

If left untreated

• Persistent pain and disability that can affect work, school, and relationships
• Overuse of pain medicines, which can lead to medication-overuse headaches
• Increased risk of anxiety and depression

Long-term outlook

Most people with long-lasting migraines can manage their symptoms with the right treatment and lifestyle changes. While there is no cure, many people find significant relief. Working closely with your doctor and staying proactive can help you regain control and improve your quality of life.

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