It begins with the auras - tiny flashes of light in the peripheral vision, so quick you almost think you're imagining them.

You gulp a litre or two of water, in the hope you'll stave off an attack.

Then comes the sharp, insistent pain in the right temple. Like a tiny little man is tapping away in there. With an ice pick.

When he arrives, you know you've just lost a day.

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That's the reality of a migraine for millions, including this writer.

Migraine is the third most debilitating medical condition on the planet, according to the World Health Organisation.

Helpful non-sufferers suggest the latest miracle treatments: piercing the middle of the ear, Botox, diet changes, hormones and acupuncture.

The unhelpful ones, clearly suspicious that you might be having a nice day off on the lounge, say nothing. Or tell you to harden up and take a tablet.

Fact is "you can't pop a pill and get over it," says Gerald Edmunds, Secretary General of Headache Australia and the Brain Foundation.

"The prevailing attitude that people should simply 'pop a pill' only adds to the complexity of this issue; medication overuse is rife," he says.

Fact is, migraines are far more than a "big headache". They are a disabling. There's no cure.

Non-sufferers should care, Edmunds says, because migraine takes a toll on far more than direct sufferers.

Headaches are responsible for 20 per cent of all working days lost.

"There is a stigma associated with migraine, and a lack of understanding in the community about how far reaching it's impact is," Edmunds, who does not suffer migraines, says.

"An attack causes significant disruptions. Sufferers can't attend events. They miss work. People trivialise it as a headache they don't realise how difficult it is for those in the grip of an episode to do anything else. It's a disability in that it prevents you from doing normal things for a time."

His comments come during Headache and Migraine Week, which wants headache sufferers to register with Headache Australia's national headache register.

"We have 10,000 people, but if we can get to one million we can exert political pressure for more research and new treatments," he says.

"OF COURSE I WAS THROWING UP"

Take a tablet and carry on? Try telling that to Hugh Jackman. Or Serena Williams, Kanye West, Ben Affleck, and Janet Jackson, who are among the more recognisable names among migraine sufferers.

In 1998, migraine struck as Jackman performed the musical Oklahoma in London.

"I was going into the wings and throwing up whenever I was off stage, and afterwards Tony Blair came backstage to meet the cast, and of course I was throwing up," the X Men Origins: Wolverine star told a Britain's FHM magazine.

Williams - the most successful female tennis player in the professional era, with 23 grand slam singles titles under her belt - battled menstrual migraines for five years before speaking out - six months after trying a drug, Frova, which eased them, and she now endorses.

When the dull ache built to a throb, the back of her eyes started hurting and her ears started ringing, she'd "want to just crawl under your bed and stay there", she told ESPN.

"I know it doesn't look like it affected my tennis. But especially in the sun, playing with a migraine makes it worse. I remember playing Martina Hingis in Sydney, and I was just out of it.

"Some doctors tell you it's mental. One of my doctors told me that - 'You have to get over it. There's nothing really wrong with you. You just think it is when it gets to
be that time of the month.' - I was thinking, 'I've got to be more mentally tough."'

CAN A PIERCING FIX IT?

Migraine is a crippling neurological condition which can cause paralysis, pain, vomiting, speech and vision problems during an attack.

Preventive and pain-relieving medication - prescription and over-the-counter - can help, but there's no cure and nobody is sure yet what causes them.

The degree of disability associated with migraines, which can last for days, has been found comparable to conditions like dementia, quadriplegia and psychosis.

Neurologists don't know what causes migraines, but there's no shortage of products, in addition to over-the-counter and prescription medications thought to alleviate them.

Daith piercing - a piercing through the ear's innermost cartilage fold - has surfaced recently as a treatment providing some with relief.

The theory is the piercing targets a specific pressure point, much like acupuncture. While neurologist and trustee of the Migraine Trust, Dr. Fayyaz Ahmed, says "there is no evidence that daith piercings work to help migraine", some sufferers on blogs and in small studies report otherwise.

Botox, injected into the scalp, has helped some.

In Australia, only one per cent of sufferers get access to migraine-specific medication.

Part of the reason for that is misdiagnosis, part is people treat themselves, because they feel nobody wants to buy into their headaches, says Edmunds.
He says there's a lack of funding for research.

In the past five years the National Health and Medical Research Council has allocated $2.6 million to research in the area, compared to $91 million spent on drug addiction, according to The Herald Sun.

New treatments on the horizon include precisely-engineered migraine preventive drugs have been cleared for the final phase of clinical trials.

"None of the medications that we have thus far have actually been designed to act against migraine," Professor Tissa Wijeratne, chair of the Department of Neurology at Western Health in Melbourne, told AAP.

"But in the last couple of years clinical trials have come out which will help us to have a bunch of medications to treat migraine which are actually designed for migraine."

Sydney's Liverpool Hospital is currently calling for participants in a Headache Prevention Project using small doses of blood pressure and cholesterol lowering drugs as treatment.

HOW IT REALLY FEELS

Losing roughly a day every five weeks to the migraine monster is like having the worst hangover of your life. Without doing the drinking to get there.

And you know it's going to get worse before it gets better.

As ice pick man gets more insistent, nausea hits, vision blurs, bright light hurts, and the right eye can twitch shut in a macabre wink.

At this point there's nothing for it but to find a dark room, load up on the painkillers, and ride it out. And hope you can sleep.

Mid-attack, speech may be slow and slurred. And when it happens to me, I won't make much sense.

Ice pick man is joined by a dude who is live-testing small explosives inside my head. His detonations never quite manage to make my head explode. Sometimes I wish they would.

Hours - sometimes a lot of them - later, I emerge, groggy. Mercifully the pounding has stopped.

Trust me, if there was a pill, I'd take it.