The science of headache disorders

Long before Amaal Starling became a physician herself, her doctor diagnosed her with recurring migraines.

"I went to, you know, Rite Aid down the street and basically downed bottles of Excedrin until I got to medical school, when I realized there were other options available for me," she says.

Starling now treats the increasing number of people with severe headaches.

New research finds that over half of the world’s population struggled with a headache disorder during the past year. But there's so much we still don't know about why.

Today, On Point: The science of headache disorders.

Dr. Amaal J. Starling, associate professor of neurology at Mayo Clinic who studies primary and secondary headache disorders, including migraines and post-traumatic headaches. (@AmaalStarlingMD)

Dr. Peter Goadsby, president of the American Headache Society. Professor of neurology at the University of California, Los Angeles. (@petergoadsby)

Margarita Gokun Silver, dealt with recurring headaches. Author of i named my dog pushkin (and other immigrant tales). (@MGokunSilver)

For much of her life, Margarita Gokun Silver dealt with headaches, mostly run of the mill stress headaches treatable with over-the-counter painkillers. She outgrew her twenties, and things changed.

MARGARITA GOKUN SILVER: I think I was about maybe in my late thirties when I started getting really bad migraines. I went out to lunch with my daughter and it just suddenly appeared, it just came with such intensity that I barely made it home from lunch. I drove as fast as I could. I ran upstairs and I just tore up everything.

The pain cut Margarita down. She couldn't get out of bed for 7 hours, and when she reached for that bottle of ibuprofen, it did nothing.

GOKUN SILVER: I think it felt like a train, maybe. It usually feels like lots of pressure right around my eyebrows and around my temples. And it's just as if somebody is just squeezing and pressing on those areas really, really hard. And all of that begins resonating in the back of my head.

So from then on, it was just years and years of trying to figure out what can help. And they were coming quite often, although whenever I've seen doctors, they would be like, Oh, well over two weeks, that's not too bad. And I was like, Huh, pretty bad every two weeks if you're out of commission for three days. Because my migraines would last about three days.

So she did know she was experiencing migraines, but Margarita never got a clear diagnosis for why she was suddenly experiencing these headaches. But doctors did not hesitate to offer her possible treatments.

GOKUN SILVER: I know when I started going to doctors and, you know, people would throw medications at me, or one time I tried Botox. Just basically tried to maybe prescribe a pill that would prevent it. You know, every medication at some point would either stop working or give me terrible rebounds. The headache would come back much worse.

So after several failed attempts, Margarita tried acupuncture.

GOKUN SILVER: You know, I think I went to an acupuncturist for I want to say six months. And it did help. They started spacing out my migraines and they lasted a little less. So I continuously go back to acupuncture. I haven't done it in a while, but at this point my migraines are a little better.

They don't come as often. So I am able to manage them just basically, I guess, giving myself a rest for one or two days and using cold compresses that really helps on my head and just, you know, trying to keep away from the screens, as I said. But if it gets worse, then yeah, I'm definitely going back to acupuncture.

So Margarita found some solutions that mostly work for her, but the solutions don't answer the questions she still has. Why did the headaches come on so suddenly? Why did so many medications not work for her? And why was acupuncture working?

GOKUN SILVER: I mean, no doctor has told me. Acupuncturist obviously tell me that it's been proven to help. But as far as cold compresses, it just feels good. It's kind of I feel what I need at the moment. And you may laugh, but for me, for example, is cans of some beverage, coke or beer or anything. If you put it in the refrigerator, they have the right amount of coldness when you apply it to that area of their eyebrows, and it just helps.

That's writer Margarita Gokun Silver. If Margarita's experience sounds familiar, even down to pressing that cold can of Coca Cola against your forehead, that's because it's incredibly common. New research finds that over 52% of the world's population, more than half, experienced a headache disorder in just the past year.