The Four Stages Of Migraine Headaches


October 12, 2023

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Today, it is estimated that over 12% of the population suffers from migraines, and a large percentage is affected by chronic episodes. While migraines aren’t life-threatening per se, they can have a profound impact on your mental health, physical well-being, productivity, and overall quality of life. 

That’s why, whether you are plagued by chronic headaches or looking to help a loved one diagnosed with migraines, it is vital to understand how this condition manifests itself. 

Migraines differ from other forms of pain in the head in the fact that they are classified as a neurological disorder, which derives from changes in the brain’s chemical reactions and pathways. Also, unlike other types of headaches, migraines occur in four distinct stages:

  • Prodrome
  • Aura
  • Migraine attack (headache)
  • Postdrome 

A lot about migraines isn’t yet well understood. However, educating yourself about the types and stages of migraines can help you improve your quality of life and even stop an attack as it begins to develop. Let’s cover these important topics in the sections below. 


1. Prodrome

The prodrome – also known as “pre-headache” – is often the first phase of a migraine. This premonitory phase is characterized by a range of symptoms and signs, which are usually related to visual changes, mood swings, and dysfunction of systems such as digestion. 

The prodrome phase usually develops within hours or days after you are exposed to a trigger. This phase indicates that a full-scale migraine attack is coming. However, there is a lot that you can do to halt the migraine as it develops, especially during this early stage. 

Some key takeaways include:

  • Identify what triggers your migraine attacks and avoid these lifestyle or environmental factors. Common migraine triggers include lack of sleep, skipping meals, high-stress levels, and hormonal changes, as well as certain foods, drinks, smells, or lights. 
  • Know the symptoms of the prodrome phase to act quickly. Prodrome symptoms and timeline can change from one person to another. Nonetheless, learning to recognize the ones that affect you can help you take preventive measures to block or reduce the intensity of the upcoming migraine attack. 
  • Avoid further exposure to triggers by staying hydrated, avoiding skipping meals, and trying stress management techniques. 
  • Take action to stop the upcoming attack. Some good practices include avoiding strong smells, lights, and sounds, taking a nap or resting, and using heating pads and ice packs to reduce tension. Stick to the treatment plan you’ve developed with your doctor. 

You should also learn to recognize the difference between prodrome symptoms and the signs of an aura. While these two experiences can overlap, they have distinct symptoms and durations. Learn more below.



As we have seen, premonitory symptoms can change significantly from one person to another. Common ones include:

  • Food cravings
  • Neck pain or stiffness
  • Sensitivity to sound, light, or smells
  • Mood changes, such as feeling depressed or irritable
  • Fatigue and lack of focus
  • Hyperactivity 
  • Digestive problems, such as constipation or diarrhea
  • Excessive yawning 
  • Fluid retention or increased urination



Usually, prodrome symptoms start between three days and 24 hours before a migraine, and the abnormal sensations can last for hours or days at a time. 


2. Aura

No two people suffering from migraines will have exactly the same experience. And premonitory signs can vary, too. 

Usually, migraines are divided into three categories:

  • Migraine with aura. These are headaches that are preceded by premonitory signs.
  • Migraine without aura. These headaches develop suddenly and without warning signs. 
  • Silent migraines. These are defined by experiencing an aura, which is not followed by a headache. 


Around a third of people with migraines will experience at least one premonitory sign. These can be abnormal sensations, impaired speech, unexplained mood changes, or visual and motor disturbances. 

Although the causes of aura are not clear, research links these symptoms to abnormal electrical activity in the brain. Below, we’ll look at the distinctive signs and duration of aura.



The aura phase is different from one person to another. However, learning to recognize the symptoms you tend to experience can help you go to a dark room or to rest, which may decrease the intensity of the upcoming headache. 

These symptoms include:

  • Visual disturbances, such as seeing dots, sparks of light, zig-zag lines, or blind spots. You may also have tunnel vision, vision loss, or blurred vision. In some cases, you may also experience hallucinations. 
  • Sensorimotor aura, or motor and sensory disturbances. These symptoms include impaired movement, tingling or numbness in the face and arms, weakness, and changes in smell or taste. 
  • Speech issues, such as impaired or slurred speech, mumbling, trouble writing, communication problems, difficulty understanding what people are saying, and cognitive problems (i.e. problems with your thinking). 

Other symptoms can also develop. For example, some people experience sensations of being touched, ringing in the ears, or feeling like they are looking at objects through water. 



The neurological symptoms of an aura tend to develop in the 24 hours before the headache. In most cases, symptoms intensify shortly before the migraine attack, usually within 10 – 60 minutes. 


3. Headache Or Migraine Attack

The headache is the main phase of a migraine attack. During this stage, you are likely to experience severe throbbing pain, sensitivity to lights and sounds, sleep disturbances, and problems like nausea and vomiting. 

The pain can be so intense that it prevents you from being able to work or concentrate, and it can force you to lie in a dark, quiet room for hours at a time. 

Understanding what symptoms characterize your migraine can help you find a line of treatment that can help ease your symptoms. These are “rescue” treatments that won’t help treat the root cause of migraines but can ease symptoms during flare-ups. 



Each migraine attack varies in intensity and nature. Some of the most common symptoms you may experience include are:


  • Severe throbbing pain. The pain is usually localized to one side of the face, but it can move from one side to the other during an attack. Painful sensations can spread to the neck and shoulders and be so severe to interfere with daily activities and sleep. 

Migraine pain derives from abnormal waves of activity among excitable brain cells. These cells signal chemicals (such as serotonin and estrogen) to narrow blood vessels and nerve endings, which causes throbbing pain. 

  • Sensitivity to light, sound, and smell. During a migraine attack, you may be over-sensitive to stimuli, including noise, odors, taste, and light. This symptom develops due to changes in how the brain processes stimuli. Lying in a dark, quiet room can help. 
  • Nausea and vomiting. These symptoms occur in around a third of migraine attacks. Vomiting may represent the last stage of a headache, and it may have a stimulating effect on the vagus nerve, which may help relieve pain. 
  • Fatigue and cognitive difficulties. During a migraine attack, you may feel extremely fatigued, tired, and unable to concentrate. Suffering from chronic migraines can also have a long-lasting impact on your cognitive abilities and increase the risk of dementia and other psychiatric disorders. 

These symptoms are often a consequence of the pain, nausea, sleep deprivation, and hypersensitivity you experience during a migraine. 


Other symptoms that may occur during a migraine attack include:



A migraine attack can last from several hours to a few days. In particular, the most intense symptoms last around four hours. However, if left unaddressed, pain, vomiting, dizziness, and hypersensitivity can last up to 72 hours. 


4. Postdrome

The postdrome phase – also known as “migraine hangover” – occurs after the headache and pain have subsided. During this stage, you’ll experience muscle weakness, feel tired or confused, and suffer pain and discomfort anywhere in the body.

Although this stage signals the end of a migraine attack, it can increase your recovery time or delay your return to work. To reduce the syndrome of postdrome, follow best practices such as:

  • Staying hydrated
  • Practicing mild stretching
  • Reducing stress
  • Keeping safe from migraine triggers (e.g. skipping meals, or bright lights)
  • Using medications as instructed by your doctor



Postdrome symptoms include:

  • Fatigue
  • Sore body or muscles
  • Unexplained mood changes or sensations, such as feeling euphoric or depressed
  • Brain fog
  • Dehydration 
  • Lack of focus



The timeline and duration of a migraine attack can vary from one person to another. However, studies have shown that postdrome symptoms occur in around 88% of cases and last an average of 24 hours. Some residual symptoms – such as weakness and confusion – can linger for up to 48 hours after the headache.


When To Seek Medical Help For Migraines

While migraines are not necessarily life-threatening, they can profoundly impact your life. Those battling this condition miss an average of 4.4 days of work per year and have a further 11 days of reduced productivity. Increased medical costs, lack of sleep, and excessive stress can also contribute to declining mental and cognitive health. 

To make things worse is the fact that episodic migraines, which occur less than 15 times a month, can become chronic and cause people to deal with over 15 days of headache a month. In this case, seeking adequate treatment can help your condition regress into episodic headaches, which are milder, less disruptive, and easier to manage. 

You should also seek immediate medical care if, at any stage of your migraine episode, you experience symptoms such as numbness, vision loss, shortness of breath, chest pain, nosebleeds, high fever, or slurred speech. These symptoms can indicate another underlying and potentially life-threatening condition, such as a stroke.

The signs that you should see a doctor without delay include: 

  • Several headaches per month that last for hours or days. These indicate a chronic condition that, unless properly managed, can interfere with your daily life. 
  • Headaches that affect daily functions. If you are unable to sleep, go to work, or concentrate on a task due to your headaches, you should find a line of treatment that can help you reduce the frequency and intensity of your attacks. 
  • Nausea, vomiting, or sensory disturbances. These symptoms are common in some people with migraines. But if your migraine attacks don’t usually come with nausea, vomiting and sensory disturbances, and you suddenly experience these symptoms, they may indicate complications such as neurological problems
  • Severe headaches with stiff neck. A headache accompanied by stiffness and pain in the neck can indicate trauma, infections, or pinched nerves, which require a different line of treatment.
  • Pain around the ear or eye. Pain around an eye can indicate a case of ocular or retinal migraine, which is a rare condition that can lead to temporary vision changes or vision loss.
  • Headaches starting without warning. Headaches that strike suddenly and without warning (known as thunderclap headaches) can indicate severe, potentially life-threatening problems such as bleeding in and around the brain. 


Find Relief For Migraine At Any Stage With Relatyv

Migraines can interfere with your personal and professional lives. To make things worse is also the fact that doctors may recommend treatments that do very little to treat the root cause of your disease, while exposing you to unnecessary side effects. 

Fortunately, there’s another path to regaining your health. The Neurofunctional Pain Management protocol pioneered by Relatyv can help you tackle the systemic inflammation at the root of most migraine attacks – without medications or surgery. 

Through electroanalgesia, IV therapy, and lifestyle counseling, you can also better manage your stress levels, improve your sleep quality, and fine-tune your environment to reduce sensitivity to triggers.

About the Author

Will is a healthcare executive, innovator, entrepreneur, inventor, and writer with a wide range of experience in the medical field. Will has multiple degrees in a wide range of subjects that give depth to his capability as an entrepreneur and capacity to operate as an innovative healthcare executive.

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