Is it covid-19 or migraine? Here we explain how to know and what to do about it

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Too much pain relievers causes headaches 2:00

(CNN) - Does it seem like your migraines are more frequent or worse and more difficult to bear since the pandemic started? That is not just in your head. Doctors say they are now seeing far more complaints from migraine sufferers, and for good reason.

“The current environment we are in is certainly quite stimulating for people who have migraines. People are worried and have more migraine headaches, ”said Dr. Rachel Colman, director of the Low Pressure Headache Program at the Icahn School of Medicine at Mount Sinai in New York.

Also, "many of us have the boundaries of our workhouse blurred right now," said Dr. Merle Diamond, president and director of the Chicago Diamond Headache Clinic.

"We are working from home, and many times that makes it more difficult to have an on and off switch," he said. Change at work can be a trigger because "people with migraines have highly sensitized nervous systems who don't like the change."

We also don't get up and move, stretch, hydrate, or sleep as we should, which can be a significant trigger, Diamond said. She is the daughter of Dr. Seymour Diamond, who was known to destroy common medical assumptions that migraines were psychosomatic, a sign of depression, or simply an excuse to avoid chores or work.

“Lack of activity makes migraine worse. The time change worsens the migraine. Sleep has been affected, which always worsens the migraine. And if you get dehydrated, that certainly doesn't help, "said Diamond.

READ : Migraines, asthma and shingles: how physical stress related to the coronavirus affects your body and how to fight it

My headache is covid-19?

In today's reality, the first thing that hits the head of any patient with a headache is: do I have covid-19?

People who have suffered from migraines for a long time may know the difference, but what if you are a novice in the world of headache? From what is known now, Diamond said, a covid-19 headache presents much differently than a migraine.

"You can have a fever, you can have a persistent cough, and all of those things can predict a headache," said Diamond, a board member at the National Headache Foundation.

"However, the covid-19 headache is described as a tight, almost squeezing sensation, and generally worsens with a cough and fever," he said.

That feeling occurs when our immune system recovers in response to the virus, releasing chemicals called cytokines. Cytokines produce inflammation, which is perceived as pain by the cerebral cortex.

But a migraine presents very differently, Diamond said, with shooting pain that is moderate to severe and may be accompanied by sensitivity to light and noise and vomiting.

READ : Do genetics and the environment explain the differences in the intensity of symptoms in patients with covid-19?

"The best way to describe a migraine is that it is a severe headache," said Diamond. "Patients describe it as their brain is too big for their skull."

Then there is the hangover from the migraine. For many patients, the headache part can last eight hours, 12 hours, 14 hours, but after the headache goes away, they have cognitive clouding, "added Diamond.

"They are lethargic, irritable, they may still have sensitivity to light or nausea. The whole process of some migraines can take several days, "he said.

While migraines, tension, and cluster headaches are the most common forms, there are hundreds of different subtypes of headaches.

Categories include abdominal, hormonal, caffeine, hypertension, post-traumatic and rebound headaches, allergies, sinusitis, medication, cough, sex, or exercise-induced headaches; as well as headaches defined by symptoms, such as stabbing, thunder, ice pick or explosive head syndrome.

Two severe and dangerous types of headaches are caused by meningitis, where the membranes that cover the brain and spinal cord swell or become inflamed, and encephalitis, an inflammation of the brain caused by a viral infection, with stiff neck and fever.

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In covid-19 cases, the most severe and dangerous headaches appear to be in people who are extremely ill with covid-19, said Colman, who is a member of the National Pain Foundation Health Professionals Leadership Council of Head.

"There have been some really bad headache disorders with covid-19," said Colman. "It is too early to know for sure, but it seems that very sick patients who have very sick lungs and who are really struggling in the ICU tend to be the ones with the most serious complex neurological complications."

What to do?

Anyone suffering from constant or debilitating headaches or migraines should ask a headache specialist for help, according to experts. Most are treating patients by telemedicine and will work with you to get to the root of the problem.

"I am trying to fix some of the problems that occur during isolation," Colman said. “Is it the fact that they are not sleeping, they are not leaving work at work, they are no longer exercising? Or is it the fact that they are so stressed out by financial worry and personal and family obligations? So trying to find the cause of why the worsening is trying to work on it, "he said.

There are also preventive things you can do to keep headaches at bay.

"Make sure you have good hydration where you are sitting and get up, breathe, and stretch at least once an hour."

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Meditation and relaxation exercises are extremely helpful, as is biofeedback, Diamond suggested.

"I think that's really useful and it doesn't take long. You can do it in five to 10 minutes and it just resets itself, which is what we want to do, "said Diamond." Then making sure you don't skip meals and that you're not working too hard. You have to have a day off if you can. "

Migraine