If you haven't found the help you need to manage your headaches, it may be time to see an expert.
A specialist will check your symptoms, look for the cause, and set up a detailed plan to treat your pain and improve your everyday life.
Your regular doctor can help you a lot, of course. But a specialist often has a deeper understanding of headaches and may have access to new, cutting-edge treatments.
"While not everyone needs to see a headache specialist, there are certain times that seeing someone with specialized expertise in migraine and other headache-related disorders is warranted," says Lawrence C. Newman, MD, director of the headache division at NYU Langone Medical Center.
Think about making an appointment if:
You've tried other things, but no luck.
Maybe pain medication doesn't help. Maybe it helps but has side effects. Or perhaps your doctor tried to treat your headaches but the treatment doesn't work.
You get headaches a lot.
It's one thing to get headaches from time to time. But if you get them often, a specialist may help.
How much is too much?
"Headaches persisting for greater than 72 hours, or that occur more than once or twice a week, should signal a checkup," says A.A. Towfigh, MD, medical director of New York Neurology & Sleep Medicine.
If you take medication for headache pain almost every day, or if the regular dose doesn't do the trick, then you should also make an appointment with either your doctor or a headache specialist.
Your headaches are bad.
The worse yours are, the more likely an expert can help you.
See a specialist if your headaches just won't go away, keep getting worse, or are so rough that you can't get things done, miss a lot of work or school, or have trouble keeping up with your family life.
It's possible you have migraines, which are different from tension headaches. Migraines start as a dull ache, then feel like constant throbbing with pain. Migraines often come with nausea, vomiting, noise sensitivity, and light sensitivity. A specialist can diagnose migraines and treat them.
Something is different.
"If you develop a new headache with new symptoms or qualities that differ from your normal headaches, it's a good idea to get it checked out," Towfigh says.
Have you noticed new patterns? Maybe your headaches come more often. Maybe they're worse than usual. Maybe you feel pain in different areas.
You have more than headaches.
If you have other medical conditions, like diabetes or allergies, a specialist can create a plan to manage your pain that's tailored to your needs.
When to Call 911
If a headache comes on suddenly and is severe, call 911 right away.
Another red flag is if you develop a headache with problems like slurred speech, loss of vision, or weakness.
Get help right away if you have:
- Balance problems
- Diarrhea or vomiting that doesn't go away
- Numbness or tingling
- Shortness of breath
- Slurred speech
- Stiff neck
- Symptoms in your ears, nose, throat, or eyes
- Vision loss
What to Look for in a Specialist
If you're ready to see a specialist, look for someone who's board-certified in headache medicine, Newman says.
They're up-to-date on all parts of headache medicine, can diagnose rare headache disorders, know the best treatments, and can break a cycle of long-lasting or acute headaches. They may be involved in clinical trials and can give you access to medication that's not yet available to everyone.
Many headache specialists are neurologists. But depending on the cause, you may see a different kind of doctor.
If your headaches stem from a sinus issue, you may see an ear, nose, and throat (ENT) doctor. If they're caused by vision problems, you may see an ophthalmologist. If it's a neck issue, a pain management doctor may help.
"If the cause the headache is unclear, then a neurologist is frequently the best doctor to start with," says Bina Mehta, MD, director of the Spine and Pain Institute in Kent, OH.
How to Find a Specialist
Ask your doctor to recommend one. The National Headache Foundation also has a list of doctors on its website. Or you can visit a headache center, where teams of doctors work together.