Recognizing Pre-Migraine Symptoms

By Craig Sorkin, DNP, APN
Medically reviewed checkmarkMedically reviewed
April 14, 2022

A migraine is more than just a bad headache. It is a neurological disorder that can upend your daily activities for hours or even days.

In fact, migraine is the second leading cause of years lived with disability worldwide. 

Given the impact that a migraine attack can have, many individuals who experience this type of headache seek out ways to prevent them.

If you can recognize pre-migraine symptoms, you may be able to stop the progression of a severe headache.

In this article, we’ll first explain what pre-migraine symptoms are and what to do if you notice these signs of a coming migraine headache.

Then we’ll discuss the phases of a migraine.

Lastly, we’ll go over when to see a doctor about any types of migraines or headaches.

Pre-Migraine Symptoms

There are four stages of a migraine attack.

The first stage goes by a few names: pre-migraine symptoms, prodrome phase, pre-headache, and premonitory phase.

Pre-migraine symptoms start a few hours or a few days before the head pain of a migraine sets in.

Prodrome stage symptoms vary from person to person and not everyone experiences them.

You may also experience different symptoms at different times depending on what is triggering your attack.

Pre-migraine symptoms can include:

  • Sensitivity or low tolerance to light and sound
  • Excessive yawning and fatigue
  • Mood changes
  • Food cravings
  • Trouble concentrating
  • Muscle pain, stiffness, or cramping
  • Gastrointestinal changes such as constipation or diarrhea
  • Increased urge to urinate
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What to Do If You Experience Pre-Migraine Symptoms

Being able to identify pre-migraine symptoms can help you take action to lessen the severity or length of migraine or even prevent a full migraine attack.

You may already have a plan from your healthcare provider of what to do when you notice pre-migraine symptoms. Whether or not that is the case, the tips below may help.

Take prescription medications as directed by your doctor

If your doctor has prescribed medication to prevent migraines, take it as directed.

If you take the medication and still experience prodrome, consult your healthcare provider.

Take over-the-counter pain relief medicine

If you notice pre-migraine symptoms, over-the-counter (OTC) pain relievers like acetaminophen (Tylenol), naproxen (Aleve), aspirin, or ibuprofen (Advil, Motrin) may help delay or downgrade the severity of migraine symptoms.

If you already take other medication for migraine, do not take additional pain relievers unless your doctor has approved it.

Avoid any known migraine triggers

There are many possible migraine triggers, including certain foods, stress, and strong odors.

If you notice prodrome symptoms, limiting exposure to your triggers may help prevent a full-on migraine attack.

Rest and relax

It’s easier said than done, but rest and relaxation may help.

Take a nap, go to bed early, or lie down in a comfortable position.

Practicing meditation may also help decrease pain associated with migraine onset.

Find a dark, quiet space

Bright lights and loud noises are common migraine triggers.

If you notice signs of a pre-migraine, finding a dark, quiet space may help reduce the neurological stimulation that can progress to a full migraine.

Take a hot shower or bath to relax muscles

Neck pain and other muscle tension are symptoms of migraine, not causes.

Still, a hot shower or bath may help relax muscles, ease tension, and promote overall relaxation.

Drink a small amount of caffeine

Large amounts of caffeine can negatively affect people who suffer from migraine, but small amounts may relieve pain and support how well OTC pain medication works.

A cup of coffee may be enough to help.

The Phases of a Migraine

Migraines have four distinct phases, although not everyone who gets migraines experiences every phase for the same amount of time.

Prodrome

Pre-migraine symptoms are known as the prodrome phase.

This tends to happen anywhere from a few hours to a few days before a migraine headache begins.

Typical prodrome symptoms include:

  • Light and sound sensitivity
  • Excessive yawning
  • Fatigue
  • Mood changes
  • Food cravings
  • Poor concentration
  • Neck and muscle pain
  • Gastrointestinal changes such as constipation or diarrhea
  • Increased urge to urinate

Sometimes prodrome symptoms are so mild that you may not notice them.

This is especially true if you are already tired, stressed, or feeling unwell.

Aura phase

People who have migraines with aura typically experience the aura phase after prodrome symptoms.

Aura may happen shortly before or up to a few hours before a migraine attack.

Sometimes aura starts at the same time as the migraine.

Aura can involve visual, auditory, sensory, or motor symptoms:

  • Visual: Flickering, jagged lights, bright lines, or a blind spot
  • Auditory: Tinnitus, music, or other noises
  • Sensory: Tingling, numbness, pins and needles feelings, trouble finding the right words or speaking, or changes to the way things taste
  • Motor: A rare form of migraine known as hemiplegic migraine may cause balance problems or weakness on one side of the body or face.

Attack phase

The attack phase is what most people refer to as “having a migraine”.

This is when moderate to severe head pain sets in.

The pain is typically concentrated on one side of the head rather than all over.

It may be throbbing and worsen during movement, activity, or sensory exposure.

Migraines can last anywhere from a few hours to a few days.

Besides head pain, migraines may cause other symptoms such as:

  • Nausea
  • Vomiting
  • Sensitivity to light, sounds, smells, and/or tastes

Postdrome phase

The postdrome phase is also referred to as the post-migraine or resolution stage.

It begins after the head pain has resolved and may last for a few hours or a few days.

Postdrome migraine symptoms tend to include:

  • Fatigue
  • Dizziness
  • Difficulty concentrating
  • Stiff neck

Even though the migraine is over, continue avoiding migraine triggers and taking care of yourself as if you still have a migraine.

If you have chronic migraine, it is possible to get another migraine headache if something triggers it.

Experiencing migraines? Chat with a medical provider through K Health.
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When to Seek Medical Attention

While it’s easy to downplay headaches, migraines are not just head pain.

They are a result of neurological changes in the brain.

If you experience recurrent moderate to severe headaches and any of the below applies, see a healthcare provider:

  • OTC pain relievers do not help reduce the pain
  • Head pain becomes disabling or prevents you from functioning
  • You have other neurological symptoms

A doctor can identify the cause of your head pain and diagnose if you’re having migraines.

In many cases, preventive treatment options are available.

If you have trouble speaking or notice weakness on one side of your body, seek emergency medical care.

Although this can be a sign of a hemiplegic migraine, unless you have been diagnosed with this rare migraine disorder, visit an ER to ensure you are not having a more serious medical emergency like stroke.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

How do you tell if a migraine is coming on?
Pre-migraine symptoms can sometimes indicate a migraine could start in the next few hours or few days. Symptoms may include sensitivity to lights or sounds, yawning, fatigue, mood changes, muscle pain, and frequent urges to urinate. If you think a migraine is coming, it may help to take OTC pain relievers or prescribed migraine medication.
What does pre-migraine feel like?
Pre-migraine symptoms don’t usually feel like a headache. Instead, pre-migraine causes sensory sensitivity, such as being bothered or aware of lights, sounds, and tastes. It can also trigger agitation, mood swings, fatigue, or problems concentrating.
What are the four stages of a migraine?
The four stages of migraine are: prodrome (pre-migraine), aura, attack, and postdrome.
What do you do when you feel a migraine coming on?
If you feel a migraine coming on, take OTC or prescribed medication. Avoid your known migraine triggers, and do your best to rest, relax, and limit sensory stimulation. (Try to turn down the lights, keep the room quiet, and relax your muscles.) It may also help to have a small amount of caffeine such as the equivalent of one cup of coffee.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Craig Sorkin, DNP, APN

Craig Sorkin, DNP, APN is a board certified Family Nurse Practitioner with over 15 years experience. He received his Undergraduate and Graduate degrees from William Paterson University and his doctoral degree from Drexel University. He has spent his career working in the Emergency Room and Primary Care. The last 6 years of his career have been dedicated to the field of digital medicine. He has created departments geared towards this specialized practice as well as written blogs and a book about the topic.

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