Migraines and Headaches: Understanding the Disorders

VHA and Tennessee Valley Healthcare System (TVHS) host many services, programs, and treatments to aid Veterans who suffer from different types of headache disorders, including the development of the VHA Headache Center of Excellence. 

As we observe Migraine and Headache Awareness Month, it is crucial to understand the significant impact these conditions can have on individuals and Veterans, with more than half of adults developing a headache at least once within the last year. 

The Numbers

From Oct. 1, 2007, to Sept. 30, 2022, almost 1.9 million Veterans were diagnosed and treated within VHA for migraines and headaches.  

• In 2022, nearly 460,000 Veterans sought care in the VHA for a headache disorder 
• Between 2008 and 2022, there has been a 122% increase in the number of Veterans using VA Medical Centers for headache care  
• More than 20% of Veterans with a headache diagnosis accessed VA Emergency Department services for headache pain treatment  

As Veterans, it is important to know the affects burn pits can have on migraines and headaches. Living near burn pits and having burn pit duties during deployment was associated with being: 

• 56% more likely to be diagnosed by a health care provider with a headache condition, and;   
• 93% more likely to self-report having severe headache or migraine   

Living near burn pits and not having burn pit duties during deployment was associated with being:  

• 16% more likely to be diagnosed by a health care provider with a headache condition, and;   
• 23% more likely to self-report having severe headache or migraine  

More information about migraine challenges of Veterans can be found here.

What are Headache Disorders? 

Migraines are a neurological condition characterized by intense, throbbing headaches that can last for hours or even days. Headaches are a common occurrence for many people and can range from mild to severe in intensity.  

Symptoms may include nausea, vomiting, and sensitivity to light and sound.  

There are two general types of headache disorders: primary headache and secondary headache.  

• Primary headache disorders happen more than once and are not caused by another condition  
• Secondary headache disorders are linked to a certain cause or injury, medicines, substances, or body disorders 

There are many different forms of primary and secondary headaches. The most common primary headaches include tension-type headache, migraine headache and cluster headache. Secondary headaches can include posttraumatic headache, cervicogenic headache, and drug induced headache.  

All disorders can be debilitating and can interfere with daily activities, work, and relationships, leading to decreased quality of life and productivity.  

Learn more about the different types of headaches here.  

Migraines and headache disorders can develop for many different reasons. Some contributing factors of a headache include:  

• Stress 
• Sleep issues  
• Skipped meals 
• Delayed meals 
• Caffeine  
• Alcohol and more.

If you struggle with headaches and migraines, try to keep a headache log. It is not uncommon to have more than one type of headache and the headache log is crucial to determine issues and treatment. 

Headache Management 

Some headache treatments are meant to immediately halt a headache when it develops. These can be pills, injections, dissolvable tablets, medical devices, or nasal sprays. It is best to use these treatments as soon as the headache begins.  

• Do not “wait out” the headache 
• The longer you wait, the less the treatment may help your headache 

Preventive treatments are those that you use on a regular basis to reduce headache frequency and decrease severity of symptoms. These can include medications, devices, or even some non-drug options like mindfulness, cognitive behavioral therapy, or other treatment options. Your provider may suggest a preventive treatment if you have frequent headaches that affect your work, family, or social activities. Talk to your doctor about the best treatment for you. 

At home steps to treat a headache: 

• Relax in a quiet, dark room 
• Drink water and stay hydrated 
• Place a cool damp cloth on your head 
• Take headache medicine as recommended by your healthcare provider 
• Try to limit your use of pain-relief medication. Avoid using it more than two times a week (both prescribed and over-the-counter pain-relief medication)  
• Many pain medicines can cause more headaches. The pain can also get worse after taking several doses

What to Know at Your VA Appointment 

If you or someone you know is struggling with migraines or headaches, it is important to seek help from a health care provider. There are a variety of treatment options available, including medications, lifestyle changes, and alternative therapies that can help manage symptoms and prevent future attacks.  

Here are some questions to ask your provider: 

• How do I know what type of headache I have? 
• What are my treatment options for the type of headache I have? 
• I would prefer to not take medications if I don’t need to; what other treatments are available? 
• What can I do on my own to manage my headache? 
• Could changes in my diet help my headache? 

During a VA appointment, the provider will ask certain questions for diagnosis. Do the best you can to describe your headache pain by using descriptive works like:  

• Throbbing  
• Pounding  
• Burning  
• Stabbing  
• Aching  

Make sure to give an accurate description of your treatments, medical and family headache history, and impacts on life. The frequency you experience a headache is crucial for diagnosis and treatment.   

Learn about the VHA Headache Center of Excellence here. This program aims to provide Veterans with the highest-quality headache care. 

Visit here for TVHS services.