Imagine your brain is a buzzing cafeteria, filled with a bunch of quirky characters all working together to keep things running smoothly. Each table and counter represents different tasks, from memory and movement to emotions and focus. In this cafeteria, every chemical, every cell, and every neurotransmitter has a job and they create a lively balance together that keeps you feeling well.

Then there’s coffee, the charismatic guest who occasionally steps in to shake things up and she always comes bearing gifts.

Despite all the brain’s hard work, migraines can disrupt its well-tuned systems, causing absolute chaos. Interestingly, the brain itself doesn’t feel pain because it lacks pain receptors. So, where’s this pain coming from? When a migraine sets in, the tissues around the brain become inflamed or swollen and press against the pain-sensitive areas. It’s this swelling in the brain’s “surrounding neighborhoods” that triggers that unmistakable throbbing pain. As migraine takes over, blood vessels dilate and send out pain signals, creating tension and even nausea.
When caffeine enters the scene, it doesn’t simply bring a burst of energy; it also brings a plan to help the brain restore order. Known for its vasoconstrictive powers, caffeine helps narrow those over-dilated blood vessels around the brain. Caffeine guides these dilated blood vessels back to their proper seats in the cafeteria, reduces swelling and lessens the pressure that creates migraine pain. It’s like coffee’s telling them, “Let’s sit down and quit causing a scene.”

Caffeine’s ability to constrict blood vessels makes it particularly helpful for types of migraines where blood vessel dilation plays a significant role, such as tension-type headaches, some sinus-related headaches, post stress headaches, hypnic headache and post-dural puncture headaches. But it’s important to remember that while caffeine can soothe a mild or moderate migraine, it’s only part of the solution—not a replacement for migraine medications that may be required for more severe cases. The role of caffeine is more of an occasional helper when consumed in low to moderate amounts (preferably <200 mg/day) rather than a permanent fix.

However, every good story has its twist. If caffeine is overused or relied upon daily, it can actually spark a “food fight” in the cafeteria. Regular caffeine intake can lead to dependency, where the body begins to expect caffeine’s effects. And when it doesn’t get that fix, the brain’s cafeteria is thrown into withdrawal—sending blood vessels into a rebound dilation, which can ironically lead to another headache. This withdrawal headache is essentially a side effect of the brain’s “addiction” to caffeine. Why does everything have to be a double-edged sword, right?

Headaches are broadly classified into primary and secondary types according to the International Classification of Headache Disorders. Primary headaches are the ones with no identifiable underlying cause like cluster headaches, tension type headaches and migraines while secondary headaches are the result of an underlying pathology like tumor or infection. Secondary headaches also have associated "red flag signs" commonly referred by the mnemonic "SNOOP" which stands for -

• Systemic symptoms and Secondary risk factors like malignancy or pregnancy.

• Neurological signs and symptoms like gait, speech or vision.

• Sudden Onset of a headache of maximum intensity called as Thunderclap Headaches. The most important cause for this is Sub-Arachnoid Hemorrhage.

• Older age more than 50 years of age.

• Pattern change with a new type of headache and Pressure symptoms like papilledema and precipitation of the headache on Valsalva or coughing.

Unlike most chronic diseases, headache disorders focus on otherwise young and healthy people which makes optimizing migraine rescue therapy even more crucial. Early treatment, Prophylactic medications, Prevention strategies like following a regular sleep and aerobic exercise schedule along with the use of Neutraceuticals like Magnesium, Riboflavin and Caffeine are some measures which help ensure the best treatment plans for patients.

Currently pursuing her PhD in Neuroscience at University of Arizona, Emily McDonald talked about the use of caffeine and its wonder effects of vasoconstriction that help in improving headaches in her latest Instagram video. She also added,

In the end, coffee has its place in the brain’s bustling cafeteria, a friend that can offer help during those chaotic migraines. But balance is key. A small cup when migraine pain strikes can restore a bit of order without causing a dependency-based food fight later on.

So, while coffee can’t entirely replace a doctor’s recommended treatment, it’s good to know that it can be a helpful ally in the right situations—just as long as it doesn’t take over the cafeteria entirely!

1. https://www.mdpi.com/2072-6643/15/14/3170

2. https://www.ncbi.nlm.nih.gov/books/NBK554510/

By Dr. Chhavi Garg

_MSM