That throbbing pain in your head is causing you discomfort and affecting your daily life, but do you know the difference between a bad headache and a migraine? Do you know when it’s time to get a checkup and/or get further treatment? Unfortunately, most Black people don’t because they are often misdiagnosed or underdiagnosed.
“African American and Hispanic patients are less likely to receive a migraine diagnosis than white patients,” says Dr. Jessica Kiarashi, M.D., medical advisor for Cove. She specializes in treating migraines and reducing health disparities in underserved populations. Blacks, in particular, are 25% less likely to receive a migraine diagnosis than white patients.
Your odds of getting a diagnosis and adequate care only get worse if you are a Black male, according to Dr. Kiarashi.
Approximately 903,000 to 1.5 million Black men are affected by migraine in the United States, according to the American Headache Society. However, they are often left out of the conversation.
Dr. Kiarashi says there’s an image that migraines only affect whites and it has been portrayed in many of the commercials we see on television, but it doesn’t end there. It can be seen in research and clinical trials.
“Part of this is due to a failure in recruiting patients from BIPOC communities,” Dr. Kiarashi adds. “African American, Latino, Alaskan, Native Americans and Indian patients have really been underrepresented in clinical trials. Of course, this can be a problem because if we’re looking at safety and effectiveness of drugs, we want to look across the whole population.”
Chronic migraine or headaches?
So how do you tell if your headache is the occasional headache caused by stress, not getting enough sleep, etc. or if it’s a sign of something more serious?
“If somebody experiences headaches on a regular basis that are severe enough to interfere with their activities – if these headaches are sometimes accompanied by symptoms of lighter sound sensitivity and nausea, it’s like migraine,” Dr. Sara Crystal, MD, Cove Medical Director & Neurologist says.
About 90% of people overall experience tension headaches, according to Dr. Crystal, which means it is unusual to never experience a headache in your lifetime. However, if you are experiencing headaches on a regular basis with more severe intensity, it is highly likely that you are suffering from migraines, and if you are having migraines on a regular basis, chances are you may be suffering from chronic migraine.
So how do doctors diagnose chronic migraines?
Whether or not you have chronic migraines essentially depends on the number of days a month you are having headaches. If you’ve had headaches for 15 days out of the month for at least three months, it is likely that you have chronic migraines.
“Sometimes people think well I don’t get nausea/vomiting every time I get a headache, so maybe it’s not chronic migraine, but if you have headaches half the days of the month and at least eight of those attacks meet migraine criteria, and those are accompanied by the typical migraine symptoms, then that’s chronic migraine,” Dr. Crystal adds. “Sometimes as headaches become more frequent some of them lose their intensity.”
What can the Black community do to get an accurate diagnosis?
The symptoms of chronic migraine seem pretty straightforward, however, many Black people still face challenges getting an accurate diagnosis.
To combat this, Dr. Crystal says it’s helpful for patients to know the criteria doctors use to diagnose migraine. When diagnosing migraine, doctors refer to a “quick and easy tool” called ID migraine. Essentially it is three questions that doctors will ask you to determine whether or not you are suffering from migraines:
- Has a headache limited your activities for a day or more in the last three months?
- Are you nauseated or sick to your stomach when you have a headache?
- Does light bother you when you have a headache?
Did you answer yes on at least two of those questions? The chances that you are a migraine sufferer is high, but the good news is that you are prepared. You can take this knowledge to your doctor and be one step closer to an accurate diagnosis.
Other symptoms to look out for? Sensitivity to sound, worsening pain with activity (i.e. running up and down the stairs), flashing lights, numbness, tingling on one side of the body, or speech disturbances (i.e. not be able to get all your words out during an attack) are all symptoms of migraine that you should pay attention to.
If you take this information to your doctor and still have challenges being heard, Dr. Crystal advises explaining your family history to your doctor. Have you tried every medication the pharmacy has to offer to no avail? It’s a good idea to explain this to your doctor as well. It may be time for a prescription medication.
“If you feel like you’re being dismissed or just told that you need to work on specific lifestyle triggers without being given medications, then you know it’s time to push a little bit more and look elsewhere,” Dr. Crystal adds.