Migraine Relief with a GP Specialist

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As one of several GP specialists in Melbourne interested in treating migraines, I regularly see how disruptive and exhausting they can be.

And it’s not just the head pain; they can affect your work, sleep, family life, and overall well-being.

ON THIS PAGE

• Headaches vs migraines
• Types of migraines
• Migraine triggers & phases
• Treatment options
• What kind of doctor is best for migraines?
• About Dr Michael Macpherson

While some people successfully manage their migraines, many remain underdiagnosed or under-treated.

If that’s you, I want you to know: I understand how frustrating this “invisible condition” can be — and I’m here to help.

I’ve consulted with patients for all types of migraines and firmly believe we must tailor migraine treatments to fit individual needs.

Helping you get back on track starts with a proper diagnosis, identifying your migraine triggers, and then implementing your personalised plan.

Managed by myself, your treatment may involve input from a care team, including a neurologist or migraine clinic.

Headaches vs Migraines: What’s the Difference?

Migraines are often misunderstood. They’re so much more than “just a bad headache.”

We know that migraines come in all shapes and sizes. They’re usually characterised by throbbing or pulsating pain.

In contrast, headaches (especially tension headaches) commonly feel like steady, achy pressure or tightness.

But migraine symptoms don’t stop at head pain. They can also include:

• Nausea and vomiting
• Sensitivity to light, sound, and smells
• Vertigo or dizziness
• Blurred vision
• Slurred speech or difficulty moving (if you unexpectedly experience any of these symptoms, please seek urgent medical attention).

Migraines are a complex neurological condition that can look very different from person to person.

Types of Migraines

There are several recognised migraine types. Here are the most common ones I see in the clinic.

Common migraine (migraine without aura)

Experienced by up to 75% of sufferers, a common migraine usually attacks one side of the head with pulsating and throbbing head pain.

It can be severe enough to limit movement or physical activity. The best many can do is lie in a dark and quiet room.

Vomiting and light or sound sensitivity are also symptoms.

Migraine with aura

Around 30% of people experience warning symptoms (called an aura) before their migraine begins.

Auras may include:

• Visual distortions
• Tingling in arms or legs
• Muscle fatigue
• Dizziness

Sometimes the aura occurs without significant head pain.

Vestibular migraine

These migraines don’t always involve headache. Instead, symptoms include:

• Vertigo
• Unsteadiness
• Dizziness

Many patients have a history of motion sickness since childhood.

Menstrual migraine

As the name suggests, this migraine occurs before or during menstruation. Hormonal changes are often to blame, mainly a drop in oestrogen.

What Can Trigger a Migraine Attack?

Migraine triggers vary widely between people. Often, it’s not just one trigger, but a combination.

Common triggers reported by my patients include:

• Certain foods and beverages, including those with additives like MSG
• Poor sleep
• Hormonal changes and menstruation
• Certain medications
• Sensory stimuli, such as bright/flashing lights, sun glare, smells and noise
• Alcohol and drugs
• Exercise

One of the most helpful tools I recommend is a migraine diary. Tracking sleep, stress, diet, and timing can uncover patterns that aren’t immediately obvious.

There are many apps available to help track migraines and headaches.

The Four Phases of a Migraine Attack

Unlike headaches, migraine attacks often occur in stages or phases:

Stage 1 – Premonitory or prodromal (early warning) phase

Early warning signs of a migraine can occur up to 24 hours before it hits. These signs include:

• Mood swings
• Sudden appetite changes
• Neck and shoulder stiffness
• Frequent urination

Stage 2 – Aura phase

Lasting 5-60 minutes, many people experience visual or sensory disturbances, or auras, in both eyes. Auras can come in the form of:

• Blind spots and visual disturbances
• Difficulty focusing or speaking
• Numbness and weakness
• Confusion

Stage 3 – Headache phase

Though not all sufferers experience headaches, this phase is when severe pain is most likely to occur, along with one or multiple of these symptoms:

• Light, sound, and smell sensitivity
• Nasal congestion
• Insomnia
• Nausea and vomiting

Stage 4 – Postdrome phase

Also known as the migraine hangover, this marks the start of recovery.

Some patients report feeling drained and wiped out for up to 24 hours. Others feel invigorated and energised.

Migraine Treatment Options

Migraine treatments and management options are plentiful.

There’s no one-size-fits-all solution. The best results come from a structured, personalised plan.

Depending on your diagnosis and the type of migraines to which you’re prone, this plan may involve a combination of:

• Relief (acute) treatments
• Preventative medications, if necessary
• Complimentary therapies
• Lifestyle changes

Relief (Acute) Treatments

These medications aim to help relieve symptoms when taken at the onset of a migraine, and include:

• Paracetamol
• Ibuprofen
• Aspirin

People experiencing more severe attacks may benefit from triptans (migraine-specific medication) or prescription painkillers.

There are also a variety of medications for nausea, including nasal sprays for those who suffer from vomiting with their migraines and may have difficulty swallowing tablets.

Preventative Medication

Aimed at preventing migraine attacks or at least reducing the severity of symptoms, preventative medication centres around taking prophylactics at regular intervals, usually daily.

Examples include:

• Beta-blockers
• Antidepressants, including anti-serotonergic medicines
• Anti-seizure treatments.

For chronic migraine sufferers, neurologist-prescribed treatments such as Botox or injectable drugs like Emgality (available on the PBS) may be considered.

Complimentary Therapies

Some patients prefer a medication-free approach to treatment, or one that combines natural treatments with their prescribed medication.

The trick is to find what options work best for you and your budget:

• Physiotherapy works for some people, depending on their migraine type
• Massage and derivatives such as myofascial trigger point therapy
• Cognitive behavioural therapy
• Acupuncture
• Biofeedback
• Supplements such as magnesium and vitamin B2

We’ll always discuss what’s evidence-based and appropriate for your situation.

Lifestyle Changes

Small, sustainable changes can make a meaningful difference:

• Improving sleep routines
• Managing stress & mental health
• Adjusting exercise patterns
• Optimising diet & nutrition
• Reducing alcohol & stopping smoking

Migraine management is often about strengthening your baseline health while reducing triggers.

What Kind of Doctor is Best for Migraines?

Most people self-diagnose and self-medicate when they first start getting migraines, often with good results.

But it’s time to see a GP if:

• Migraines are affecting work, sleep, or relationships
• Over-the-counter medications aren’t helping
• Attacks are becoming more frequent or intense
• You’re unsure about your triggers
• Your instincts tell you something isn’t right

You don’t always need to see a neurologist.

An experienced GP can diagnose, start treatment, and coordinate specialist care as needed.

You Don’t Have to Push Through the Pain

Migraines are real. They’re debilitating. And they’re treatable.

With the right diagnosis, careful trigger identification, and a personalised treatment plan, we can reduce the frequency and intensity of your attacks and help you regain control.

Dr Michael Macpherson (BAppSc, MBBS, FRACGP) is a local GP at Doctors of South Melbourne.

His special interests include chronic disease management and minor surgical procedures.

You can make an appointment online with Michael or call us on 8579 6838.