VHI’s Dr Bernadette Carr: migraine and hip pain

I am a woman in my mid 30s. I have had migraine headaches for the last ten years and I can control them most of the time. 

Over the last six months, I have had a migraine every month in the days before my period starts and the first couple of days of the period. Could they be related?

Most migraine attacks happen for no apparent reason, however, it is known a range of factors can increase the likelihood of attacks. They are often triggered by periods and what is known as ‘menstrual migraine’ occurs between two days before the start and three days after the start of menstruation in at least two out of three consecutive menstrual cycles. Women who can manage their migraines at other times may find it more problematic at this time. There is a fall in oestrogen levels in the days leading up to a period and it is thought that this drop triggers a migraine.

Migraine headaches are common, affecting about one-in-four women and one-in-12 men at some point in their lives. 80% of people have their first attack before the age of 30, 15% of females with migraine only have attacks around the time of menstruation. They tend to be a throbbing headache on one side of the head often accompanied by nausea, feeling generally unwell and intolerance of loud noise and bright light. Managing these menstrual migraines is the same as managing the migraines you get at other times.

I would advise you to make an appointment with your GP to discuss the recent onset of this type of migraine and to rule out any other reason for the headaches. It would be useful for your GP if you had a migraine diary for the last few months which could show the relationship between the headaches and your periods.

Your GP will be able to review your medication and to suggest the most appropriate management of these headaches for you.

My son is 10 years old, he has complained of a pain in his hip and knee over the last week. He seemed to be limping at one stage. The previous week he had a heavy cold, could these symptoms be related?

I am sure this must be worrying for you. An irritable hip is common in otherwise well children, although usually mild, it can cause pain and limping that gradually resolves. It can sometimes cause what is known as ‘referred pain’ in the knee and a child may be reluctant to put their weight on the leg. It can affect children of any age but is twice as common in boys as in girls particularly boys aged two to 12 years.

This condition develops when soft tissues such as tendons or the lining (membrane) which covers the hip becomes inflamed; the cause for this is often unclear. A fall or injury can also cause an inflammation.

One possibility is the lining of the hip becomes inflamed or irritated as a complication of a viral infection such as a cold or respiratory infection, but there is no evidence which supports this theory.

In the majority of cases the pain will get better within a couple of weeks; resting the leg for a few days may help to ease the pain. Months may elapse between episodes.

I would always advise any parent who notices that their child is limping or if the child is complaining of hip pain to make an appointment with their GP. This is so that a diagnosis can be made and any underlying condition ruled out. Your GP can examine your son and can advise on how best to manage the pain.


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