As we approach the Fourth of July, it's important to remember those who have served our country amidst our celebrations. Veterans face a higher risk of health issues as a result of deployment, and migraines are no exception. Various aspects of deployment can increase the risk of migraine headaches in veterans.

Many combat veterans and active military personnel have suffered some form of head injury. The Defense and Veterans Brain Injury Center reported that more than 499,852 U.S. servicemen were diagnosed with traumatic brain injury (TBI) from 2000 to 2023. It is estimated that 45% of veterans who suffered a TBI experience frequent headaches. One study showed that 36% of combat veterans who served in Iraq under a 12-month deployment were either diagnosed with or suffered symptoms of migraine headaches. In contrast, only about 12% of the civilian population suffers from migraine headaches. Veterans often experience more severe pain and disability from their attacks than non-veterans, and migraines can reduce their “return to duty” rates as well

Along with the physical injuries that increase the potential for migraines, mental health issues can also cause or worsen migraine symptoms. Roughly 18% of combat veterans experience PTSD, a percentage largely believed to be underreported due to the stigma surrounding mental health. Of those who reported migraine headaches to the VA, 50% met the criteria for PTSD. PTSD can cause physical symptoms that exacerbate migraines, such as stress, sleep interruption, lack of sleep, and muscle tension. Veterans may be eligible to receive VA disability benefits for their migraine headaches due to PTSD if they are already service-connected for PTSD.

CHALLENGES FACED BY VETERANS WITH MIGRAINES

Veterans are uniquely susceptible to certain health conditions that can exacerbate headaches and migraines. Studies have found that veterans suffering from headache disorders frequently have co-occurring conditions such as other chronic pain issues, sleep disturbances, traumatic brain injuries (TBI), and PTSD. For female veterans, there is also a notable link between headaches and experiences of military sexual trauma. Sometimes, headaches do not start right after the trauma but can develop weeks or months later. Exposure to environmental hazards, such as airborne toxins and burn pits, further elevates the risk of developing headaches.

The prevalence of headaches post-TBI is significant, with approximately 90% of individuals experiencing headaches after a TBI, and up to 53% potentially developing chronic headaches. Notably, TBI doesn't always result from a direct impact to the head but can also occur from blast exposures. Research indicates that about 36% of veterans deployed to Iraq for a year reported migraines, with these headaches persisting even after their return home. Combat veterans generally show higher incidences of new onset headaches compared to those who did not engage in combat.

Seasonal Considerations

The Fourth of July can be a particularly challenging time for veterans who suffer from migraines. Fireworks and loud celebrations are significant migraine triggers due to both the loud noises and the bright, flashing lights. For veterans with PTSD, these elements can also trigger distressing memories and heightened anxiety, often reminiscent of combat experiences. Veterans may find it helpful to plan ahead for the holiday by identifying quieter locations to celebrate and using noise-canceling headphones or other protective measures. Communities can also support veterans by creating designated quiet zones or notifying residents in advance about fireworks displays to allow veterans to prepare or make alternative plans.

Treatment Options

Migraines are often underdiagnosed among veterans, partly due to stigma and the challenges in accessing specialized care. About 75% of veterans receive their headache treatment from their primary care providers. The Veterans Health Administration (VHA) offers several treatment options, including referrals to neurology specialists, neuromodulation devices, pain psychology, physical therapy, and holistic treatments like acupuncture and tai chi. Additionally, polytrauma clinics offer comprehensive care for veterans dealing with multiple injuries.

Veterans might also consider seeking care from one of the 28 VA Headache Centers of Excellence, which provide specialized and multidisciplinary treatment for headache disorders. These centers offer access to headache specialists and may also provide telehealth services for remote consultations.

Hope for Relief

Migraines significantly affect the lives of military personnel, causing both neurological and emotional distress that can last for years. Studies show that 20% of soldiers with deployment-related concussions develop chronic daily headaches. Despite this, there is hope for relief through proactive and comprehensive treatment plans. Consulting a neurologist or headache specialist is an essential first step. Developing a personalized treatment plan can help manage symptoms more effectively. This plan might include a combination of medications for prevention and acute treatment, lifestyle modifications, and alternative therapies such as:

• Botox injections for chronic migraines
• Professional acupuncture
• Tinted glasses for protection against indoor light triggers
• Polarized sunglasses for outdoor light sensitivity
• Dietary adjustments
• Regular sleep patterns
• Stress management techniques

Community Support

Communities play a vital role in supporting veterans with migraines. Simple actions like creating designated quiet zones or providing advance notice of fireworks displays can help veterans avoid potential migraine triggers. Additionally, offering resources and support groups can significantly improve their overall well-being.

For veterans seeking specialized care, centers like the Migraine Relief Center can provide individualized treatment plans and the latest advancements in migraine management.