More than a ‘trivial headache’. In addition, those who suffer from it can experiment nausea, vomiting, discomfort with light, noise and smellssymptoms so disabling that you have to stay in bed for a day or even two. No school or work or leisurepractically a social blackout. It’s called migraine and affects more than one in 7 Italians. With one in two sufferers not knowing they have it. Understanding how to recognize it and deal with it is the first step to overcoming it, warn the experts Italian neurology society (Sin) and of Italian society for the study of headaches (Sisc), announcing the XVI Headache Day which occurs tomorrow, Saturday 18 May. For the occasion, Sin and Sisc will publish on their social channels Facebook, X and Instagram informative videos. Taking inspiration from the doubts and most frequently asked questions on the subject, the neurologists of the two scientific societies will shed light on diagnoses, treatments and false myths.
What is headache
The term headache – the specialists explain – refers to any pain perceived in the head: it is essentially a synonym, in medical jargon, of the more popular ‘headache’. Headaches are one of the most frequent ailments of all. Taken all together, including the proverbial circle at the head of the hangover, the vast majority of the population has experienced it firsthand at least some of their lives. Within the headache galaxy, the largest group is that of primary headaches, i.e. not caused by an organic problem (trauma, vascular disorders, inflammation, infections). In primary headaches the headache symptom itself constitutes the disease and any instrumental investigations do not reveal any anomalies.
What is migraine
Zooming further, within the large chapter primary headaches, the lion’s share is given to migraines. Both for its diffusion (it affects approximately 15% of the population, with an imbalance of at least 2 to 1 against women), and for the disability it can cause. “According to the Global Burden of Disease Study, which measures the burden that all diseases cause on humanity, migraines rank in second place overall for years lived with disabilities and in first place even for women between 15 and 49 years old”, warn experts.
“It is therefore an important disorder – states Alessandro Padovani, president of Sin – which causes unpleasant consequences both at an individual level”, due to the violence of the attacks and the symptoms associated with pain, and at a social level with “phenomena such as absenteeism and presenteeism ‘, that is, presence at work or school, but in conditions of reduced efficiency. In more serious cases, migraines “can lead to the need to switch to a part-time job or to request early retirement a disorder that is not ‘visible’ from the outside nor detectable with tests, but rather an intimate experience, not communicable like all pain – underlines the specialist – exposes those who suffer from it to the frequent occurrence of a social stigma: those who suffer from it often hear belittling phrases like ‘come on, it’s a bit of a headache…’, which in many cases leads to hiding the disease and delaying access to effective treatments.”
Diagnosis, treatment and false myths
It is no coincidence, neurologists report, “many studies have documented that Approximately half of the subjects with migraines do not know they are suffering from it, but think they are suffering from a banal headache (many women, for example, think that menstrual migraine attacks are ‘normal’, part of the physiology of the menstrual cycle) or are the victim of widespread and unfounded beliefs (the infamous ‘cervical’)”.
“There first barrier that opposes correct management of migraines is therefore that of knowledge, of the awareness of being affected by them – highlights Franco Granella, president of the Sisc – and it is above all on this barrier that Headache Day aims to act by spreading, through the social channels Sisc and Sin, videos of experts who express their opinion regarding the most common questions that people suffering from headache ask about their condition”. But “the second barrieronce a correct diagnosis has been formulated, is represented by taking charge of a doctor who has the necessary knowledge on the subject and is willing to follow the patient over time”.
“Italy – continues Granella – has an excellent network of headache centers distributed throughout the national territory, where patients can receive the most appropriate care. However, since it is a disorder that affects millions of people, it is not imaginable that all patients should and can turn to a headache centre: this would result in operational paralysis and endless waiting lists”.
“The first bulwark against migraines – Sin and Sisc point out – must be made up of general practitioners, who must be able to make the diagnosis and treat less complex cases with therapies for the acute attack, but also with prophylaxis. In this regard, it could be useful to train family doctors who are particularly expert in this field, who would work in health homes, where the aggregation of several general practitioners allows each doctor to acquire in-depth skills in a particular sector of medicine. “.
“Another fundamental contribution – add the two scientific societies – can be provided by the network of outpatient neurologists, present in a widespread manner throughout the territory and perfectly capable of managing the majority of cases of migraine and other primary headaches. At this point the centers headaches could carry out their main task: treating ‘difficult’ cases, migraines resistant to multiple treatments, chronic migraines (i.e. those in which the headache recurs for at least 15 days a month) and those complicated by the excessive use of symptomatic (so-called Medication Overuse Headache), also using recent specific drugs for migraines, whose effectiveness and tolerability have represented a turning point in the fight against this insidious disease”.
