Getting Your Headache Diagnosis Straight

-from Suzanne Simons, NHF Executive Director

The term "headache" is often overused. "Headache" means different things to different people. Some sufferers say they have a "sick" headache or a "stress" headache, but regardless of what you call it, determining what type of head pain disorder you have is the first step to finding appropriate treatment.

In a recent online survey by the National Headache Foundation (NHF), 73% of headache sufferers reported experiencing more than one type of headache. To develop a specific treatment regimen, it is essential to determine exactly which type (or types) of headache or Migraine you have. While migraine was the most common and well-known type in the survey, it is important to get a diagnosis by a healthcare professional to determine what type of head pain disorder you actually have.

The first step in obtaining an accurate diagnosis is to make an appointment with your healthcare provider to specifically to talk about your headache problem. Too often, headache sufferers only mention their headaches when being seen for another health condition. The "oh by the way, doctor, I have these headaches" approach does not allow the healthcare provider (HCP) adequate time to address the headache problem and your doctor may not recognize the impact the headache has on the patient's life since it was mentioned as an "add on" to a visit for another problem.

A visit to your family or primary care physician is a good starting point. She or he knows your medical history the best and you have an existing relationship with this person. Come to the visit with a completed headache diary (a free downloadable diary is available at www.headaches.org). In addition to a thorough medical history and physical exam, the diary contains useful information that may assist in coming to the diagnosis.

Information contained in the diary should include the frequency, location, intensity and duration of the pain. You should also note your emotional state before the headache began, what medications you took for the headache and the effect it had on the pain and/or associated symptoms. If you are a woman, you should note the dates of your menstrual cycle. Including a list of the foods you have eaten can also be helpful for determining your migraine or headache triggers.

Your HCP may order lab tests such as blood work, urinalysis, CT or MRI or X-Ray. Keep in mind that these are tests of exclusion to rule out other potential problems. Once a diagnosis is made, your HCP should work with you to determine the right treatment regimen for you. This may include prescription medication, lifestyle changes or a combination of the two.

Oftentimes, finding the most effective treatment plan requires patience. It may mean finding the right medication in a specific drug class, the right combination of medications and/or the right dose(s) of medication(s). Some medications may take up to three months to reach their peak effectiveness.