The dreaded migraine attack. If you’ve had one (or several), then you know. They’re no joke and often feel like they last forever. But how long does the average migraine attack actually last? And is there a way to shorten it?
Let’s find out.
While there’s no crystal ball that can predict the length of an individual migraine attack, on average one can last anywhere from 4 to 72 hours. That’s right: up to 3 freakin’ days. (That’s longer than Britney’s 2004 marriage to her childhood friend Jason Alexander.)
Migraine attacks happen in four stages. The stages vary in length — you may spend more time in one stage than another or even skip a stage. Just as every person is unique, so is every migraine attack.
The four common stages are:
- Premonitory or prodrome phase
- Aura
- Headache or “main attack” (followed by a resolution period, which isn’t an actual phase)
- Recovery or postdrome phase
1. Premonitory or prodrome phase (aka the “warning phase”)
You may experience some warning signs leading up to the actual headache portion of a migraine attack.
These symptoms are often completely unrelated to headaches, so they can be difficult to identify. They typically last anywhere from 1 to 24 hours before you move on to the next phase.
Warning symptoms include:
- fatigue
- mood changes, such as irritability
- increased thirst or cravings for certain foods
- anxiety
- stiff neck
2. Aura phase
Now, don’t think we’re trying to get all woo-woo here (though there’s nothing wrong with a little woo!). The aura phase is a legit occurrence that affects up to 25 percent of people who experience migraine attacks.
Auras have a wide variety of neurological symptoms, which generally happen before the main attack in adults. But they can sometimes happen at the same time as the headache portion of the migraine attack, especially in children.
If you’re experiencing an aura, you might notice:
- flashing lights
- colored or dark spots
- zigzag lines
- sparkles (or “stars”)
You may also feel:
- tingling or numbness
- dizziness
- anxiety
- confusion
- weakness
Auras can also impact your hearing or speech and, in rare instances, cause fainting or partial paralysis. Aura symptoms typically last anywhere from 5 minutes to an hour and will sometimes occur without a headache ever happening.
3. The headache (or main attack)
“The main attack” sounds like a cool name for a wrestler, and the pain can certainly feel like you’re being hit over the head with a chair, but this is actually the crescendo of a migraine attack.
Because many attacks don’t include aura symptoms, this stage can happen right after the premonitory phase. You’ll likely have the same symptoms in the headache phase whether or not you experience an aura beforehand.
Headache phase symptoms are:
- sensitivity to noise, light, odor, or touch
- throbbing head pain on one or both sides
- increased pain caused by movement or physical activity
- blurred vision
- nausea or vomiting
- lightheadedness
- loss of appetite
This is the most unpredictable stage and can last anywhere from a few hours to a few days. Symptoms can become so severe that you may be unable to do daily activities like work, exercise, or hobbies.
3A. Resolution period
There’s some debate as to whether this counts as an official phase. The resolution period is when the main headache symptoms fade.
More research is needed, but a study in the ’80s suggested that sleep could play an important role in dissolving symptoms and moving into the recovery phase. Even just a couple of hours of rest can help knock out that headache.
4. Recovery phase or postdrome (also known as the “migraine hangover”)
The worst is over, but this phase can come with a variety of symptoms. You may notice effects opposite of those you experienced in the warning phase. For instance, after feeling like you couldn’t stand the sight of food for hours or days, you may suddenly be starving.
These symptoms may last a day or two:
- exhaustion and fatigue
- moodiness
- depression
- euphoria
- weakness
- dizziness
- confusion
While over-the-counter meds like ibuprofen, aspirin, naproxen, or acetaminophen (or migraine-specific options like Excedrin) may work wonders for the occasional migraine attack, they aren’t one-size-fits-all.
Some attacks require something a bit more powerful, while others can be defeated through the use of non-medicinal home remedies.
Here’s a look at common treatment options.
Prescription meds
For more severe migraine attacks, your doctor may prescribe pain relievers like ergot, opioids, or triptans as well as medications to treat nausea.
If you have frequent migraine attacks, you and your doctor may want to discuss preventive measures. Some prescription meds can help keep future attacks at bay, including:
- anitconvulsants
- antidepressants
- calcium channel blockers
- beta-blockers
- CGRP antagonists
Home remedies
There are several ways to deal with your migraine at home without medication. Here are some strategies to try:
- Avoid harsh lighting and loud sounds. Find a quiet space, dim the lights, draw the shades, and try to relax.
- Use pressure points. Applying pressure to certain areas of your body or to your temples may help relieve pain.
- Drink water! Hydration is important all the time, but it can be especially critical during a migraine attack.
- Reach for essential oils. Lavender and peppermint are great soothing options for migraine pain.
- Add a cool compress. The cold helps narrow your blood vessels and ease pain.
- Try a little caffeine. Caffeine constricts blood vessels and is commonly used to treat headaches. Research shows caffeine can have powerful effects (both positive and negative) on migraine attacks. Too much or too little caffeine can cause headaches, but if you find the sweet spot, it can ease pain and even prevent pain from returning.
- Limit screen time. The light from your digital devices can make symptoms worse, so unplug and unwind.
Migraine attacks have many possible triggers, so determining your specific triggers could help in prevention. Some common triggers:
- stress
- certain meds
- irregular sleep patterns
- hormonal changes
- changes in the weather
- certain foods
- alcohol
- caffeine
- head injuries
First migraine attack? The home remedies or OTC meds mentioned above may do the trick. But make an appointment with your healthcare provider if:
- you’re over 40 and this is your first migraine attack
- your symptoms last longer than 72 hours
- symptoms occur after you’ve experienced a head injury
If you’re having frequent migraine attacks, scheduling time with your doc may help. Together, you can work on a treatment plan to help prevent attacks, help soothe them at the start, or simply make them more bearable.
tl;dr
One thing anyone who’s had a migraine attack can agree on: They feel like they last forever.
In reality, a typical migraine attack can last anywhere from 4 to 72 hours and may include some or all of these phases:
- warning (premonitory) phase
- aura (not everyone experiences this one!)
- headache (aka the “main attack”), followed by a resolution period (which isn’t an actual phase)
- recovery phase (or the “migraine hangover”)
The phases vary in length, and the headache phase itself typically lasts the longest (bummer).
There are a variety of methods to relieve or prevent migraine symptoms, including OTC meds, prescription pain relievers, and home remedies. You can work with your healthcare provider to find the best course of action for you.
If you experience your first migraine attack after age 40, or if an attack lasts longer than 72 hours or pops up after a head injury, call your doc ASAP.