Do You Know The Four Stages of Migraine?

Did you know there are different stages of migraine?

Most of us know that migraines = pain but did you know that there are four different stages of migraine? Knowing about these four stages will help you to better treat your headaches. So let’s get to it!

The four stages of migraine:

  1. Premonitory or Early Warning Phase
  2. Aura Phase
  3. Migraine Pain Phase
  4. Postdrome or Recovery Phase

Let’s talk about each of these in detail and how knowing which phase you are in can help you to better treat your migraines.

four stages of migraine headache
How well do you know your migraines? What are the stages of migraine?

Premonitory Phase- What is it?

The first of the four stages of migraine is the premonitory phase. This is where you experience the early warning signs that something has changed in the way the brain is functioning. This phase can last from 1 to 24 hours. Doctors say that dopamine is released and that this causes the warning phase symptoms. Often these early warning signs may go unnoticed or be ignored, however these are your earliest clues that a migraine is coming on.

Here’s what symptoms to look for:

  • mood changes
  •  depression
  •  irritability
  •  neck pain/ stiffness/ soreness
  •  food cravings
  •  light sensitivity
  •  excessive urination
  •  yawning

So what does this mean? Well have you ever thought, for example, that every time you have a migraine it’s after you’ve eaten chocolate? Maybe you’ve come to the conclusion that chocolate is a migraine trigger for you. However, think about this: if you find that you were craving chocolate and you ate it, it could very well be that you were already in this premonitory phase that gave you food cravings.

So the first stage of migraine was already in process, which means that chocolate in itself may not be a trigger for you but just the result of your food cravings from already being in this first phase of the migraine. Basically the attack has already started. So if you find yourself beating yourself up for eating the wrong thing, it may not be that food that caused your headache! What a burden lifted right?
Well what can you do if you are in this phase?

  1. Long-duration anti-inflammatory medication– these can be effective if taken at the right dosage. Some doctors recommend taking for example, 600mg to 800mg of ibuprofen taken with food.
  2. Triptans- medications like Maxalt, Imitrex, Zomig
  3. Drink lots of fluids
  4. Eat something
  5. Experiment with relaxation techniques
  6. Magnesium – 400mg/day
  7. Menthol

Aura Phase

This second stage of migraine usually occurs 30 minutes to 1 hour before the pain actually comes. This phase may also overlap the pain phase, but is not always present for all people.
The symptoms of this phase are:

  • visual disturbance
  • flickering light
  •  decreased vision
  •  black spots
  •  vision distortion
  •  sensory changes
  •  tingling/numbness of face or hands
  •  difficulties speaking
  •  one sided weakness
  •  dizziness
  •  vertigo
  •  double vision

 Attack Phase/Pain Phase

This is the stage when most people say “I have a migraine!” This is the pain phase. The earlier you can treat yourself the better.
Often we may wait to see if the pain will get better before taking any medication or abortive treatment, however the best practice
is the instant you feel pain to take your medication and/or other abortive treatment.
During this phase you may also experience nausea. One important note about nausea: persistent nausea is a sign that the headache
may not respond to medication and that your headaches have a higher risk of becoming chronic. So if you experience nausea with your headaches, the first thing you should do is treat the nausea. As soon as you start to feel nauseated take an anti-nausea medication.


  1.  Triptans
  2.  Anti-nausea medication
  3.  Natural treatments (essential oils, magnesium oil, etc.)
  4.  TMS device (neurostimulation devices)
  5.  Massage

Postdrome or Recovery Phase

This is the last stage of migraine that comes after the pain of the migraine has stopped. One difference from normal headaches is that migraines don’t just stop after the pain subsides. This postdrome phase can sometimes even be more debilitating than the actual pain.
Symptoms of the postdrome phase:

  • fatigue
  •  brain fog
  •  cognitive fog
  •  mood change

Some possible treatments that can help with the symptoms of this phase are:

  1.  Caffeine (this can work for some people, but not all. Caffeine causes headaches for some people)
  2. Stimulants (prescription medications can help if fatigue is a big issue for you)

So as you can see being able to recognize what phase you are in can help you to stop a migraine in its tracks! Please comment below if you found this article helpful and pass it along to someone you think it will help!

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