Dilemma regarding acute medication during a migraine attack - "Yes, it will be fine; I'll have a cup of coffee".

Abstract

The purpose of the present study was to explore the experiences and management of migraine pain in patients with chronic migraine. Ten patients with chronic migraine participated in open interviews grounded in functional behavioral analysis within a cognitive-behavioral framework. The interviews were analyzed using systematic text condensation. Participants' experiences and management of pain during a migraine attack were categorized into four concepts: Migraine Pain Signal, Hope of False Alarm, Guiding Assumption, and Delayed Medical Management. The experiences of pain during a migraine attack in are individual; however, common patterns in pain management can be identified. The participants in this study often found it challenging to differentiate migraine pain from other types of pain, automatically dismissed migraine pain signals, utilized non-medical management as their first intervention, and only resorted to their prescribed acute medication when it was no longer optimally effective. Delayed medical intervention and a lack of rest at the onset of the migraine attack in the pain phase can expose participants to significant moderate to severe migraine pain for several days, Clinically, this knowledge can be important as one of several risk markers for the progression from episodic to chronic migraine and for developing individually tailored rehabilitation strategies.