The Truth About Non-Headache Days

Real experiences from Move Against Migraine members

For many patients living with migraine, symptoms don’t disappear when the head pain subsides. Migraine is more than just a headache, which means that symptoms often persist during the non-headache phase, or interictal state. Juliana VanderPluym of the Mayo Clinic in Phoenix explained the phenomenon of migraine and headache symptoms on non-headache days in this article and video. Now, read on to hear about our Move Against Migraine Facebook members’ experiences with symptoms on non-headache days.

“Foggy brain, tiredness, aches and neck pain,” – Karen L.

During the non-headache phase, patients can experience migraine-related symptoms that they may attribute to other factors. For example, a common symptom is mental and physical fatigue, as support group member Karen mentions when describing her non-headache days. Another Move Against Migraine member, Peggy J., said, “I have a tough time pulling up words I need. My memory isn’t sharp.”

Dr. VanderPluym recommends tracking these symptoms in a headache journal. Even though they don’t take place during the headache or migraine attack, understanding these interictal symptoms can inform your migraine management. Detailed information about your migraine helps your primary care provider or headache specialist prescribe the most effective course of treatment for you and potentially reduce your symptoms.

“Fear of another attack.” – Michelle E.

Migraine attacks are difficult to predict and patients often worry about when their next one will strike and how it’ll upend their plans. Anxiety is a commonly reported symptom of the interictal state, and a study found that 10% of people reported experiencing anxiety related to their migraine. Move Against Migraine member Betsy P. explains that fear of the next attack inhibits her from enjoying the time in-between.

Fortunately, psychological symptoms of migraine like depression and anxiety can be treated with medications and non-pharmacological therapies. Dawn Buse, PhD, Director of Behavioral Medicine at the Montefiore Headache Center, recommends cognitive behavioral therapy to help patients manage stress. Relaxation therapy and meditative exercises can also calm the nervous system and help patients feel less anxious between attacks.

“I can tell when a migraine comes on.” – Kayla S.

According to Dr. VanderPluym, the appearance of interictal symptoms could help patients forecast imminent migraine attacks early enough for them to minimize the risks. Support group member Kayla said she knows a migraine attack is coming when her energy level falls. Similarly, Susan C. said, “If I have problems speaking, stumbling for words, mispronouncing words, stumbling over my own feet, bumping into walls, I know I’ll have a migraine the next day.”

To better understand how to minimize head pain, make note of your migraine-related symptoms in a headache journal and consult a headache specialist. Effective preventive treatments may also minimize interictal symptoms and tracking them can be useful in determining the most effective preventive treatment for you. The FDA recently approved the first of a new class of drugs for preventing migraine, and preliminary evidence suggests that these anti-CGRP monoclonal antibodies can suppress interictal symptoms as well.

A significant proportion of those with migraine report experiencing a variety of these symptoms between attacks. While the symptoms can be used to predict migraine attacks, many of them are disruptive and can cast a dark shadow on a day without headache. Learn more about new findings and treatment options by visiting the American Migraine Foundation’s Resource Library.