Burden of migraine: what should we say more?

Several international campaigns to increase awareness on the high burden of migraine stimulated population-based studies in the last few years that provided broader data on prevalence, correlates, and impact of migraine. The last version of the Global Burden of Disease 2010 posed migraine with a twofold increase with respect to the previous version as one of the first disabling diseases. Migraine, and in general headache disorders are among the top ten causes of disability because they are common and disabling: that is now clear. It is also clear that the descriptive epidemiology of migraine has reached its maturity. The prevalence rates and sociodemographic correlates have been stable across 50 years. Last but not least, despite international efforts an illness that can be relieved does not, and the heavy burden that it poses at individual and societal levels, persists when it could be mitigated. Describing and accounting the burden of migraine worldwide is not enough anymore, we need to change our paradigm again and move towards new pathways. The opportunity is provided by the biopsychosocial approach that enables to act on the environment once the most adequate medical therapy has been provided. To reduce the burden, international efforts should focus certainly on development of new drugs but mainly on improving health care systems' response to millions of migraine and headache sufferers.