Migraine: Symptoms, Causes and Treatment Options Explained

Anyone who has lived through a proper migraine attack knows the phrase “just a headache” does not come close. A phone screen feels like a floodlight. Sound hurts. Nausea sits at the back of your throat for hours. The whole thing can wipe out a workday, a weekend, or both.

Migraine is a neurological condition, not a low pain threshold, and it is far more common than most workplaces assume. Australian Institute of Health and Welfare reporting on migraine and headache disorders in Australia puts it at almost 1 in 15 Australians living with long-term migraine, which is around 1.7 million people.

This guide covers what migraines actually are, the symptoms worth recognising, what sets them off, and the treatment paths a doctor may discuss with you. If your attacks are getting more frequent or more severe, an online doctor consultation with an AHPRA-registered GP is a sensible first step, and you can do it from a dark room without driving anywhere.

What a migraine actually is, medically speaking

A migraine is a recurring neurological event, not simply pain in the head. During an attack, nerve pathways and chemical activity in the brain change, which is why the symptoms spread well beyond the skull. Vision, digestion, balance, mood and energy all get dragged into it.

That is the practical difference between a medical migraine headache and a tension headache. A tension headache usually feels like a tight band across both sides, and most people push through it. Migraine tends to be one-sided, throbbing, moderate to severe, and it gets worse when you move. Climbing a flight of stairs makes it worse rather than better.

Left alone, an attack typically runs anywhere from 4 hours to 3 days. Some people get a handful a year. Others get them weekly, at which point migraines start shaping how they plan work, travel and family life.

Migraine symptoms: what an attack really looks like

Migraine symptoms tend to arrive in phases. Not everyone experiences all four, and the order is not always tidy.

1. The lead-up (prodrome)

Hours, and sometimes a day or two, before the pain arrives:

• Repeated yawning for no obvious reason
• Food cravings, often sugar or carbohydrates
• Neck stiffness or a sense of tightness across the shoulders
• Mood swings, irritability or unusual bursts of energy
• Trouble concentrating and frequent urination

2. Aura

Around one in four people with migraine get an aura. It usually builds over 5 to 60 minutes and resolves completely. Most commonly it is visual: zigzag lines, flashing lights, shimmering patches or a blind spot that drifts across your field of view. Less often it involves tingling or numbness in the face or hand, or difficulty finding words. Frightening the first time, especially if nobody has explained it to you.

3. The headache phase

• Throbbing or pulsing pain, frequently on one side of the head
• Sensitivity to light, sound and strong smells
• Nausea, and for some people vomiting
• Pain that intensifies with routine movement
• Blurred vision, lightheadedness or a foggy, detached feeling

4. The aftermath (postdrome)

The migraine hangover. For up to a day afterwards you may feel drained, mentally slow, tender around the scalp and neck, and strangely fragile. People often push straight back into a full workload here and trigger the next attack.

Vestibular migraine: when the room spins more than your head hurts

Vestibular migraine is the type most often missed, because the headache can be mild or absent altogether. The dominant complaint is dizziness, so people tend to look at their ears rather than their head.

Common vestibular migraine symptoms include:

• Vertigo, a spinning sensation, or a floating or rocking feeling
• Unsteadiness and difficulty walking in a straight line
• Motion sensitivity, where turning your head, bending down or looking up feels intolerable
• Nausea without an obvious cause
• Pressure in the head or ears, ringing in the ears, or neck pain
• Visual overwhelm in busy environments such as supermarket aisles or shopping centres

Episodes generally last from five minutes up to 72 hours. Unlike a classic aura, vestibular symptoms can appear before, during or after the head pain, or in a completely headache-free period. Headache Australia sets out the recognised diagnostic criteria for vestibular migraine, which include repeated vestibular episodes alongside a current or past history of migraine.

Because vertigo also points towards inner ear and balance conditions, this is one to have properly assessed rather than self-diagnosed. Depending on what your GP finds, they may recommend a specialist referral to a neurologist for further investigation.

What causes migraines?

The honest answer is that there is no single cause. Migraine causes are best understood as a combination of genetics and a nervous system that reacts more strongly to change than most. If a parent has migraines, your likelihood rises noticeably.

What most people really want to know is what causes migraines to fire on a particular Tuesday, and that comes down to triggers. Triggers are individual, and they often stack rather than acting alone. A poor night of sleep on its own might be fine. A poor night of sleep plus a skipped lunch plus a deadline is a different story.

Frequently reported triggers include:

• Sleep disruption: too little, too much, or shift work that keeps moving
• Stress, and the let-down after stress, which is why weekend migraines are so common
• Hormonal changes around menstruation, pregnancy or menopause
• Skipped meals, low blood sugar and dehydration
• Alcohol, particularly red wine, and any sudden change in caffeine intake
• Aged cheeses, cured or processed meats, and food additives for some people
• Bright, flickering or fluorescent light, screen glare and long unbroken screen sessions
• Strong smells such as perfume, petrol or cleaning products
• Weather shifts and changes in barometric pressure
• Neck and jaw tension, teeth grinding, or a badly set up desk

A headache diary is genuinely useful here, and it does not need to be complicated. Date, time, duration, what you ate, how you slept, what was happening that day. Two weeks of notes usually reveals more than months of guessing, and it gives your doctor something concrete to work with. If stress or low mood turns out to be a recurring trigger, it is worth asking about a GP mental health plan, since managing the trigger and managing the attack are two different jobs.

How to get rid of a migraine once it has started

There is no off switch. But what you do in the first 30 minutes matters more than people expect, and acting early generally beats waiting to see whether it passes.

What tends to help during an attack:

• Get somewhere dark and quiet as soon as you reasonably can
• Cold pack on the forehead or the back of the neck; some people prefer warmth across the neck and shoulders
• Sip water steadily, in small amounts if nausea is strong
• Sleep if the opportunity is there, since for many people sleep ends the attack
• Take anything your doctor has prescribed at the first sign, exactly as directed
• Step away from screens, and do not attempt to push through a workout or a long drive

One thing worth flagging: reaching for over-the-counter pain relief on most days of the week can backfire. Frequent use is associated with medication overuse headache, where the pattern becomes self-sustaining and the relief window keeps shrinking. If you are taking something for head pain more than two or three days a week, that is a conversation to have with a doctor rather than a habit to manage alone.

Migraine treatment: the two approaches a doctor may discuss

Migraine treatment usually falls into two categories, and plenty of people end up using both.

Acute treatment is used at the first sign of an attack, with the aim of limiting how severe it becomes and how long it lasts. What is suitable depends on your symptom pattern, how quickly your attacks escalate, whether nausea is a major feature, and any other health conditions you have.

Preventive treatment is considered when attacks are frequent, long, or not responding well to acute options. It is taken on an ongoing schedule rather than during an attack, and the goal is to reduce how often attacks happen. Preventive approaches need time before they can be fairly assessed, so doctors generally review them over weeks rather than days.

Alongside any medication, management commonly includes sleep regulation, consistent meal timing, hydration, stress management, and in some cases physiotherapy where the neck is contributing. Only an AHPRA-registered doctor can assess which of these is appropriate for you, and any prescribing decision is made case by case after a proper consultation. If you already have a management plan in place and simply need to continue it, you can request a repeat prescription online after a telehealth consultation, where the doctor will assess whether it remains clinically appropriate.

Red flags: when a headache needs urgent care, not a GP appointment

Call 000 or go to your nearest emergency department if a headache comes with any of the following:

• Sudden, severe pain that peaks within seconds, often described as the worst headache of your life
• Neck stiffness, fever, confusion or a rash
• A head injury in the preceding days
• Weakness or numbness on one side, a drooping face, or slurred speech
• Loss of vision, or vision changes that do not resolve
• A new headache pattern that starts after age 50, during pregnancy, or while your immune system is compromised

Telehealth is not appropriate for any of the above. Those situations need in-person emergency assessment.

Getting migraine assessed without leaving the house

A migraine consultation does not require a waiting room, which is fortunate, because a waiting room is close to the worst possible environment during an attack. Over a secure phone or video consultation, an Australian-registered GP can go through your symptom history, look at your headache diary, discuss triggers, and advise on next steps or further investigation.

If an attack has already cost you a day of work or study, you can also request a medical certificate for migraine or headache following your consultation, which takes some of the awkwardness out of explaining an invisible condition to an employer. Bulk billed GP consultations are available for eligible patients, so cost does not have to be the reason you keep putting it off.

Frequently Asked Questions