Managing Migraine in Primary Care: 5 Things to Know

Globally, migraine is second among leading causes of years lived with disability. Migraine affects about 15% of the US population and is one of the most common and debilitating conditions encountered by primary care providers (PCPs). About 1 in 10 patients present with a complaint of headache to their PCP and 75% of these patients have migraine. Yet, this condition often goes undiagnosed.

Here are five things to know about managing migraine successfully in primary care.

1. Migraine is a chronic neurologic disorder, not an episodic headache.

As our knowledge of the pathophysiology of migraine has evolved, we've come to understand that this condition is an inherited, chronic neurologic disease with recurrent episodic attacks.

Migraine is a disabling brain condition influenced by both genetics and environment, and it is characterized by attacks of throbbing head pain and sensitivity to movement as well as visual and auditory stimuli. Symptoms of irritability, yawning, fatigue, and difficulty concentrating can precede migraine attacks by 1-2 days; attacks are followed by hours of feeling tired and unwell. They can last for 4-72 hours, with 90%of patients reporting moderate to severe pain and more than 50% reporting severe impairment or reduced productivity. Furthermore, migraine is a chronic disorder across a life span, with age-dependent changes in clinical presentations and prevalence.