For most adults, spring and summer thunderstorms bring the annoyance of driving in a downpour.

But others dread this time of year for migraines triggered by the environment.

What are migraines?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, describes migraines as episodic disorders that cause severe, throbbing headaches, usually on one side of the brain.

The list of triggers is, unfortunately, long.

“Emotional stress can trigger migraines. Moving, changing jobs, other stressful life situations,” Dr. Ogun says. “A change in sleeping habits can trigger a migraine. Skipping a meal. Your diet: wine, aged cheese, coffee withdrawal and foods high in nitrates.”

Other common triggers include hormones, bright lights, loud sounds and changes in altitude. A propensity for frequent headaches can also run in the family, Dr. Ogun says.

You can prepare

Dr. Ogun says not much is known about weather-induced migraines. But most medical professionals agree there is some evidence for migraines caused by changes in barometric pressure.

How can you prepare?

“Up and move,” Dr. Ogun says, tongue firmly planted in cheek.

More realistically, watch the weather forecast. If there’s a chance for a lot of dust or smoke in the air (think areas like California or Arizona), plan to limit time outside.

Stock up on medication after talking with your health care provider. Dr. Ogun says over-the-counter medicine like ibuprofen will help with pain and can even be taken ahead of when you know a migraine is coming.

“They could have a headache diary where they write down what causes their headaches, where the pain is located, how long does it last, symptoms and what treatment helps,” Dr. Ogun adds.

If your migraines are more frequent, feel different, or come with other symptoms like confusion, neck rigidity, weakness in the arms or legs, fever or chills, see a doctor right away. Some of those symptoms may be signs of a heart attack or stroke.

Any head trauma, like a sports injury or a car crash, should also be checked on by a doctor.

Interview clips

Previous coverage

One big headache
June is national migraine and headache awareness month
A good calendar may be able to help you fight headaches
Three steps to help with severe or frequent headaches
When should you see a specialist for your headaches?
Weather changes can be a pain for migraine sufferers

Weather changes can play a major role in triggering migraine headaches for some people, according to specialists who treat the condition. In fact, for some people, weather can play a huge role in migraine headaches.

Ashley Workman is an advanced practice registered nurse with OSF HealthCare Illinois Neurological Institute (OSF INI). She works in the headache and cranial facial pain program and explains, “Specific weather changes that we see influence some of our patients’ migraine patterns are changes in barometric pressure, which we identify as any fluctuation or drop in the atmospheric pressure around us in our environment, extreme temperature shifts — so not only extreme heat waves, but also those cold snaps, or any more extreme shift in temperature from high to low.”

Workman says Illinois weather has offered recent examples of those quick changes when it was 90 degrees just a few weeks ago, but now it’s dropping into the 30s and most people have turned their heat on. While scientists understand parts of the migraine process, Workman stresses the relationship between weather and migraine isn’t fully understood.

Migraines are a complex disorder, and there are some theories out there that weather changes influence migraines. Workman points out that researchers have one theory in particular that is centered around the influence of barometric pressure.

“Does that shift in atmospheric pressure actually have an influence on the pressure within our skull? And that can then further influence how our blood vessels constrict and dilate. And those specific changes then can trigger those neurons and nerves signaling the pain process, which then leads to inflammation and causing that migraine headache for patients.”  

Testing those theories can be difficult because the brain and the nervous system are so complex.

“These neurons that we’re talking about are so teensy, tiny and can be influenced by so many factors, migraine being one of those that the sky is somewhat the limit on what triggers them and it’s very individualized to the person so that really adds a layer of complexity of giving someone sometimes a straightforward answer of why they have migraine or what their triggers are, because it can differ so much across the board,” Workman suggests.

• There is no cure for migraine headaches, so Workman says it truly is all about education and managing the condition by being prepared. Here are some approaches:
• Tracking headaches on a calendar can help identify weather-related patterns. She says that’ll help better identify triggers.
• Having medication readily available is also key. Workman emphasizes the importance of always having your medication with you in case a migraine comes on, especially unexpectedly.
• Managing stress and routinely getting enough sleep are important.
• Focusing on a better diet and drinking more water to avoid dehydration is also a key to better management of migraine.

Ultimately, Workman advises that there are things providers can do to help patients live a little better lifestyle, knowing that they have migraine headaches including prescriptions, including acute medications or preventative medications.

She adds, “A lot has evolved in the migraine world over the last five to seven years, with newer treatments on the market that we haven’t had that have been really, really so impactful for patients and leading to better migraine control.”

If you have been struggling with migraine headaches, Workman says there’s no need to suffer without support. Make an appointment with your primary care provider.

Ashley Workman

B-roll for migraine headaches

For millions of people living with migraine, getting the proper diagnosis can take years, sometimes even decades. A new digital tool developed by a team at the University of Illinois College of Medicine Peoria (UICOMP) and OSF HealthCare aims to change that by helping primary care and other first-contact healthcare providers to identify patients with migraine quickly and accurately.

Hrachya Nersesyan ​MD, PhD, a headache neurologist and the director of the headache clinic at the OSF Illinois Neurological Institute (INI) in Peoria, Illinois and co-developer of the MIGRO (migraine referral optimization) application says primary care providers might frequently experience time constraints to accurately diagnose migraine.

“Well, they have to deal with 55 different problems, all at the same time, and the time constraint is a significant barrier in properly obtaining the history of the headache to be able to correctly and accurately diagnose, not just migraine, but also its sub-types, and decide what to do about that.”

Unlike conditions that can be confirmed with blood tests or imaging, migraine is diagnosed based on presenting symptoms and patient history. That makes accuracy of diagnosis highly dependent on the provider’s time and expertise.

Migraine is one of the most frequent and most disabling types of primary headaches, and what is often misunderstood about migraine is that it is a disorder of the central nervous system. So, it is not just a bad headache but frequently presents with many other symptoms, such as sensitivity to light and sound, nausea and vomiting, disturbances of mood and emotions, and so on. And these disturbances – sometimes called most bothersome symptoms (MBS) – also can happen outside of the actual headache attacks, causing significant discomfort and even prolonged periods of disability to migraine sufferers. Therefore, timely diagnosis and subsequent proper treatment of migraine as a disorder rather than a symptom is important.

In an analysis of randomly selected 150 patients referred to the headache program at OSF ,in 2022, researchers found that primary care providers correctly identified migraine types only about half the time and did not  correctly define the migraine subtypes in most cases due to incomplete information and lack of documentation on the quality and behavioral patterns of reported headaches.

“Some of them, it took five, eight, even 10 years to even being diagnosed and receiving the treatment. We had a couple of patients that mentioned their headaches over 20 years ago and just 20 years later (they) were able to be finally diagnosed with the proper type (of migraine) and be introduced to treatment.”

To address that care gap, the research team created an app called MIGRO, built around a decision-tree algorithm based on the current International Classification of Headache Disorders (ICHD-3). The app guides patients through a series of self-directed questions about their symptoms, headache quality and the patterns of headache behavior. Within minutes, it generates a summary of suspected headache diagnosis for the provider to review.

It simply walks the patient and provider through the key points needed to determine whether a headache is migraine, what type of migraine it might be, or if it’s something else entirely. Most people can complete the assessment in less than five minutes.

Through incorporated safeguards the app also helps to flag potentially dangerous conditions with headache as a symptom that might require immediate attention and reliably diagnoses medication overuse headaches, a significant cause of a headache changing from occasional to chronic.

After early development and more testing at INI with more than 300 patients, the app outperformed referring providers in diagnostic accuracy of the headache type across the board, especially in detecting migraine subtypes and medication overuse headache. In cases of medication overuse headache, the app identified the condition in 65% of patients, compared to 0% recognition by referring clinicians.

Time to validate

Now entering phase two, the team plans to validate the tool in primary care settings across the OSF HealthCare Ministry, including at several rural sites where access to specialists is limited. Dr. Nersesyan explains the app will also help primary care providers in those settings to know if a patient can be managed locally or absolutely needs to be referred to a headache specialist.

“Because a majority of the migraineurs can be managed with very simple medications and interventions as long as they have the right diagnosis and the right treatment and they don’t necessarily need to see a headache neurologist or any other headache specialist.  they can be very well managed by primary care providers.”

This study is supported by a Community Health Advocacy (CHA) grant through OSF and the University of Illinois Chicago. The digital development work is supported by the OSF Digital Innovation Development and Medical Visualization teams, which created the coding and are now refining the app’s language and design for broader public use. The goal is to make the patient questionnaire portion of the application easy to comprehend for every user, regardless of their educational background, and seamlessly integrate this tool into routine clinical workflows.

People with migraine also might frequently hesitate to seek early medical care due to variety of reasons, including social stigma associated with this disorder. The app creators believe that MIGRO can help primary care providers make timely and accurate migraine diagnosis., dramatically shortening the time to implementing an effective treatment. They also believe it could help these patients to overcome societal prejudice about headaches.

“It allows and gives the ability to providers, in a fairly short period of time to hit all the key question marks and points that one needs to come to the diagnosis of migraine or to say, ‘Well this headache is not a migraine,’ or to define between different types of migraine that exists out there.”

The research team expects to begin primary care testing by the end of 2025, with plans to expand the app for general public use once validation of diagnostic accuracy in primary care setting is completed.

Dr. Hrachya Nersesyan 

B-roll of MIGRO app

Some creators are promoting the “McMigraine meal,” a recommendation to go to McDonald's and purchase a Coke, along with French fries, to provide relief from a migraine.

The thought process? Creators are suggesting the caffeine from Coca-Cola, mixed with salt in fries, could work together to take major headaches away.

Ashley Workman is an advanced practice registered nurse with OSF HealthCare Illinois Neurological Institute (OSF INI). She works in the headache and cranial facial pain program and spends time as an advanced practice provider clinical educator for OSF HealthCare.

According to the American Migraine Foundation, approximately 39 million Americans live with migraine.

While there’s some surface level truth to the claim about caffeine, ordering a large soda isn’t your best bet, Workman says.

Caffeine is known as an adjunct therapy to help reduce migraines. Sometimes over-the-counter medications that have caffeine in them provide relief as well.

"In theory, purchasing a Coke from McDonald's is still not the healthiest option. But I can't argue that caffeine doesn't have a benefit when someone is having a migraine headache," Workman says. "Caffeine can also help with vasoconstriction. There is a vascular side of migraines, so that's where that comes in, to provide benefit." 

French fries: Full of salt

Sodium is both a mineral and an electrolyte (when mixed with body fluids), that along with potassium and magnesium, is known to fight dehydration. These electrolytes are known to prevent or help manage headaches. Salt (sodium chloride) is approximately 40% sodium, but Workman says a stack of fries, once again, shouldn’t be your go-to for sodium intake.

While this McMigraine combo might provide short-term relief for some people, the long-term risks are far greater. 

Long-term risks of ultra-processed foods

"Ultra-processed foods are connected with a higher risk of obesity, developing Type 2 diabetes and cardiovascular disease," Workman says. "It can also impact people to live a sedentary lifestyle, which can affect our mental health. So, it can really have a spiral effect on our health from a long-term perspective." 

Migraines are very individual to the person. "What works for one person might not work for another," Workman adds. 

Instead of rushing through the fast-food line for a quick fix, it's important to get to the root of the problems and find a solution. Many causes of migraines, Workman says, come from lifestyle choices and environmental issues.

"We need to think about what in our lives could influence migraines. Whether that be our sleep pattern, stress levels, what we're eating and drinking and caffeine intake," Workman says. "From a female perspective, hormonal influence. We really need to step back and figure out what influences our migraines and then alter our lifestyle if we can." 

Exercise can benefit migraine patients:

"Any form of exercise is going to be beneficial for those with migraines,” Workman says. "So, it's about finding what works for you. Because some exercise, if it's too rigorous, can trigger a migraine."

Workman adds that keeping a consistent routine is also extremely important.

“That means getting up at the same time each morning and not sleeping in too much on the weekends. That can also trigger migraines,” she says.

The importance of drinking water

Swap the soda out with an ice cold glass of H2O.

"Water is so important. Drink lots of water, 40 to 80 ounces depending on the person. Especially if you exercise or are working outside, you need to be drinking more water and maybe even mixing in electrolyte drinks," Workman says. "And avoid artificial sweeteners because those can trigger migraines as well." 

Magnitude of magnesium

Workman calls magnesium a wonderful supplement that can be implemented in a day-to-day routine. She will recommend magnesium oxide (400 mg a day) to certain patients who are undergoing migraines. Sometimes it can be hard on the stomach, so it needs to be taken with food. Magnesium complex is sometimes handled better from a stomach perspective, which is a mix of different types of magnesium. 

If pharmacy-based options aren't working, there are some devices available that can be used to treat migraines. 

Neuromodulation

Neuromodulation is a non-pharmacologic option for migraine management.

“There are several different types, and they can vary significantly in cost. Specifically, the Cefaly is an FDA-approved, over-the-counter neuromodulation device, which can be used for migraine prevention or acute relief. It utilizes external trigeminal nerve stimulation (eTNS) by delivering mild electrical impulses through an adhesive electrode placed on the forehead,” Workman says. “For individuals seeking a non-pharmacological approach to migraine management, this is certainly one option. The device is available for purchase online without a prescription, providing greater accessibility for patients.”

If you're missing work or family functions due to migraines, Workman says to seek care from a medical provider. There are treatment options available, and you shouldn't be in pain when you don't need to be. 

To learn more about resources available for those with headaches or craniofacial pain, visit the OSF HealthCare website.

Video Interview Clips

Migraines are a part of life for many. From stress to dehydration to a woman’s menstrual cycle and even more serious issues such as a stroke, the headaches can pop up often. And they’re something you should know how to manage.

Amber Oberheim, APRN, a primary care provider at OSF HealthCare, says migraines can often be treated with ibuprofen (Advil is a common brand name) or naproxen (Aleve), plus lifestyle changes including better sleep. But, an online search will also yield plenty of non-medicinal, at-home remedies. Experts will remind you that these aren’t cure-alls. But it’s important to know what works and what doesn’t.

Myth vs. fact

• A cold or warm cloth on the head and neck: Stick to cold, Oberheim says.
  
  “One of the theories for why migraines happen is vasodilation, or increased blood flow to your brain,” Oberheim explains. “So we talk about using a cold compress over your eyes, on the back of your neck or at the top of your head. That cold sensation constricts blood vessels, thereby decreasing blood flow.”
  
  Oberheim adds that there are even migraine caps that stay in the freezer until use. Those are available over the counter at retail outlets.
   
• Rest and deep breathing: Oberheim says there’s no guarantee that your migraine will be gone when you wake up from a nap. But, she says rest and deep breathing can’t hurt. Take a break in a cool, dark room, and avoid screens and loud noises.
   
• Caffeine: It’s good general advice to ingest caffeine in moderation for heart and mental health. But, Oberheim says a soda might help with that headache.
  
  “We look at medications in Excedrin Migraine [pills]. Caffeine is one of them,” Oberheim says. “Caffeine has been proven to be effective sometimes in early management of migraine headaches.”
   
• Supplements: There’s a lot to choose from in this aisle of the pharmacy. And experts warn that you should choose with provider guidance since supplements aren’t regulated like others under the eye of the United States Food and Drug Administration. However, Oberheim says some research has shown that taking vitamin B2 (also called riboflavin) and magnesium daily can help with the number of migraines.
   
• Massaging your head: It’s a tactic some of us learned when we were kids. Massaging your temples (the area between your eyes and the top of your ears) could help with head pain.
  
  “I don’t think there’s any data that would support that. I think it’s more of a comfort,” Oberheim says. “When you’re experiencing pain and you can have a sensation that’s not pain somewhere on your body, it might help lessen the pain.”
  
  For example, Oberheim says when her patients are getting a blood draw through an IV in their elbow, a provider might scratch their upper arm (between the point of pain and the brain) to “confuse” the pain signal and lessen the discomfort. The same logic applies to rubbing your head during a migraine.
   
• Taking a shower: It depends, Oberheim says.
  
  “I could see if stress or muscle tension is creating a headache. Taking a warm shower or bath to relax might help,” Oberheim says. “However, if we’re thinking about a classic migraine with the theory of increased blood flow to the brain, taking a hot bath or shower might actually make it worse.
  
  “It never hurts to try, but I think it’s going to be patient-specific,” she adds.

When in doubt

Oberheim says some people have a history of migraines and know how to manage them. But if the headaches suddenly increase in frequency or intensity, you should see a health care provider. Also, talk to a provider if you have questions about starting or changing at-home treatment. The provider can determine what works for you. You don’t want new medications to negatively interact with drugs you’re already on, for example.

“Often, a migraine can last for longer than a typical headache. It can be accompanied by symptoms like nausea, light sensitivity and noise sensitivity,” Oberheim says, warning of the dangers if migraines are not treated quickly. “There are certain types of migraines that can also affect your vision.”

Temporary decreased function of your limbs is another rare, but possible side effect, Oberheim says.

Learn more

Read more about how to spot and treat a migraine on the OSF HealthCare website.

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