They’re the Mother of all headaches. The Big Daddy. The pounding that can pounce without warning, make you retreat to a silent, still place, and render you horizontal for days. We’re talking about the tyranny of migraines.

Alice, twenty-five, has had them since she fell off a horse at age eleven. “I jolted my neck,” she says. “The migraines started once a week after that.”

Like 10 percent of sufferers, Alice experiences migraines with “aura” (or classical migraine). This almost mystical name describes the strange neurological disturbances that occur before the throbbing headache (which is almost always worse in one side of the skull) takes hold.

Typical neurological disturbances include flashing lights, blind spots, or zigzag patterns. But in Alice’s case, the weird aura sensation made her feel as if she had been “poisoned and was about to be sick.”

Next the intense pain would develop, always behind Alice’s left eye. She’d have no choice but to go to bed, often staying there two to three days.

Not surprisingly, Alice’s mom was frantic. “She insisted I was sent for a brain scan,” Alice recalls. “But I was diagnosed with nothing more sinister than a migraine—although that didn’t seem a bonus at the time.”

It’s estimated 10 percent of both the American and British population live with migraines. For some it’s no big deal and symptoms are few. But for others, they make life a misery. Yet despite the notoriety, the mechanisms of migraines remain hazy.

It’s pretty much accepted that migraines are related to complex changes in the levels of neurotransmitters in the brain, especially serotonin. It’s also established that three times as many women as men develop migraines, and many report their headaches tie in with their period. But the exact whys and hows of this hellish headache remain unknown.

Perhaps we can link this lack of certainty with the skepticism so often seen in the eyes of employers when they take a sick day phone call? It seems many people are reluctant to accept the authenticity of migraines at all.

This is something that Tamara, thirty-one, certainly had to deal with. With Tamara there was no aura (common migraine), just a terrible hammering that rendered her unable to get out of bed.

“Of course most of the time, I looked totally well,” Tamara says, “so it’s really hard to explain to people why I’ve let them down because of a migraine. I’ve even missed a good friend’s wedding.”

“But the trickiest thing was dealing with my boss. It was obvious he thought I was faking whenever I called in sick. In the end, the atmosphere was so unpleasant, I quit—which is a shame because I really enjoyed being an office administrator.”

Absence, due to migraines was also a problem for Alice. Her teachers became concerned about all the course work she was missing. Her mother paid for counseling (in case stress was a trigger), acupuncture, even faith healing hoping to cure her daughter.

But the only thing that helped Alice was a constant supply of Paracetamol and Nurofen (which contains ibuprofen). She even spent her pocket money on them. “I took the maximum dose for days at a time, and Mum didn’t know,” Alice recalls.

When she was at university, and still taking large amounts of analgesics, relief for Alice came in the unlikely form of a beauty treatment. “Mum read that Botox, often used to treat wrinkles, can alleviate migraines. She offered to pay for me to have it done,” she says.

Alice had the botulism toxin injected into her forehead. The doctor who did it said because it would stop her frown muscles contracting, it would prevent her headaches, too.

The theory may not work for everyone—indeed there may be Botoxed women reading this attempting to raise a quizzical eyebrow. But Alice believes the shots helped her.

“The relief was amazing,” she enthuses. “After so many years of headache hell, I had fourteen weeks of freedom. Then the effect wore off and I needed injections again.”

Tamara too, tried many therapies before hitting on one that worked for her.

“My doctor sent me to a migraine clinic, where I had the homeopathic remedy feverfew. But it did nothing for me. Neither did reflexology. But my migraines were less intense when I took an herb called butterbur.”

Tamara took butterbur for two years, and her migraines were less intense during that time. Then for some reason the benefit stopped. “I’d taken a new job in marketing,” she explains. “And I couldn’t afford to lose it. So I went back to my doctor.”

This time, she was prescribed beta-blockers, which relax the blood vessels. “It works better than anything I’ve tried before,” says Tamara. “My migraines are rare, and so are my sick days.”

Migraines, like all headaches, and the people they afflict, are unique. It can take years to discover the combination of triggers that launch a migraine. And it may take just as long to hit upon relief.

But Alice and Tamara show it is possible.