Understanding the Difference Between Acute and Chronic Migraines

Migraines are common, affecting about 39 million Americans. However, the number is likely higher since many who experience migraines don’t seek treatment or an accurate diagnosis.

Dr. Wade Steeves founded Valley Neurology in Spokane Valley, Washington. He’s the only neurologist in Eastern Washington and Northern Idaho who focuses solely on diagnosing and treating headaches of all types.

Known these days as the Headache Guy, Dr. Steeves is greatly encouraged by advances in migraine treatments and is happy to pass those benefits along to his patients.

Read what Dr. Steeves and his Valley Neurology team say about the differences between acute and chronic migraines.

Understanding migraine symptoms

Migraines are a common, complex, and often misunderstood neurological disorder. Sometimes migraine pain strikes suddenly with little warning. However, many people experience warning signs and symptoms days to hours before the pain begins.

A day or two before the migraine sets in, you may develop warning signs such as mood swings, muscle stiffness, generalized fatigue, frequent yawning, and food cravings. That’s known as the prodrome stage of a migraine.

Shortly before or during a migraine, many people experience visual disturbances (flashing lights or blind spots), tingling or numbness in the face, and difficulty speaking. Collectively known as an aura, these symptoms usually start gradually, build for up to 60 minutes, and then fade.

The next phase can include moderate to severe throbbing head pain and extreme sensitivity to light, sound, and odors. Nausea and vomiting are also typical during a migraine. Without treatment, a migraine can last four to 72 hours or more.

Once the pain and other symptoms resolve, you may feel exhausted, fuzzy, or confused for a day or so, like you’re recovering from a virus or experiencing a hangover. Conversely, some people report feeling elated or energized afterward.

Not everyone experiences each phase, but sorting through what happens before, during, and after your migraine helps Dr. Steeves design an effective treatment strategy.

The difference between acute and chronic migraines

The symptoms of acute (episodic) migraines and chronic migraines are essentially the same. However, episodic migraines occur less frequently, sometimes every few weeks or only once or twice a year.

Technically, anyone experiencing migraine symptoms less than 15 days a month lands in the acute category. That means you could lose half of every month to acute migraines. Episodic migraines can also evolve into chronic migraines.

You have chronic migraines if you have headache symptoms 15 days a month or more for three months. Some people with chronic migraine disorder experience nearly continuous symptoms.