When should I see a neurologist for my headaches?

woman holding her head

After a stressful day, due to a change in the weather, because you haven't had enough water—there are a variety of reasons you might end up with a headache.

Headaches are common, and for some people, frequent. Characterized by pain or discomfort in your head, neck or scalp, headaches can range from mildly annoying to severely debilitating. In some cases, they can keep you from going about your daily routine.

Roughly half of all adults in the world have had a headache in the past year.

According to Bushra Malik, MD, "While headaches may seem like a fact of life, there's usually something that causes them. This means there are ways to relieve and even avoid these painful experiences. Headache disorders, which are headaches that you experience frequently, are also treatable. Even though headache disorders are one of the most common disorders of the nervous system (which consists of your brain, spinal cord and nerves that connect to the rest of your body), too few people are properly diagnosed and able to find relief."

Headaches and headache disorders can both be treated—whether at home or with the help of a healthcare professional, like a neurologist. Here's an overview on headaches and headache disorders—and how to finally get some relief.

Headaches and headache disorders

Anyone can experience headaches, and unfortunately, plenty of people do. It's one of the most common forms of pain, and it's a frequent reason for missed work, absences from school and disruptions to your daily life.

A headache every now and then might not throw a major wrench in your routine. However, frequent headaches—also known as headache disorders—can lead to serious burdens. These include financial strains, impaired relationships, increased risk of other health conditions (such as anxiety and depression) and overall reduced quality of life.

Most headache disorders fall under one of these four categories:

  1. Migraines: Recurring headaches that are moderate to severe, one-sided, pulsating, made worse with certain activities and often accompanied by nausea.
  2. Tension-type headaches (TTH): Headaches that are usually related to stress or neck problems and are characterized by pressure or tightness in the head and sometimes in the neck.
  3. Cluster headaches: Brief but severe headaches that occur up to several times a day and are typically centered around one eye, leading to tears, redness or drooping of the eyelid.
  4. Medication-overuse headaches (MOH): Headaches that are caused by overusing medication to treat headaches, are severe and have their worst symptoms upon waking up in the morning.

How can I ease headache pain at home?

The occasional headache, such as after a particularly stressful day, may not be cause for alarm. In these cases, try some at-home headache relief, such as:

  • Napping or resting your eyes in a dark, cool room
  • Using a cool cloth or ice pack on your forehead
  • Drinking extra fluids
  • Taking over-the-counter medications, such as ibuprofen, aspirin or acetaminophen

When should I see a neurologist for my headaches?

Some headaches are a sign of a more serious condition, such as a headache disorder or other health concerns.

"If you experience two or more headaches a week or a headache that gets worse over many days or weeks, talk to your primary care provider. If necessary, they can refer you to a neurologist, who has special training in diagnosing and treating disorders of the brain and nervous system, including headache disorders," explains Dr. Malik.

Certain headache symptoms may also be a sign of a medical emergency. Seek medical attention right away if you experience a:

  • Severe and sudden headache that feels like the worst of your life
  • Severe and sudden headache along with a stiff neck
  • Severe headache accompanied by nausea, vomiting or fever that is not because of another illness
  • Severe headache along with confusion, loss of consciousness, weakness or double vision
  • Headache after a head injury
  • Headache along with by weakness or loss of sensation in any part of the body
  • Headache accompanied by shortness of breath

If you're ever unsure about your headache symptoms, talk to your healthcare provider. They can help you identify possible causes and discuss next steps.

What to expect from your first appointment with a neurologist

"Seeing a neurologist is a lot like seeing other healthcare specialists. They'll review your medical history, talk to you about your headache symptoms and work with you to get to the root of the problem," says Dr. Malik.

A neurologist may also perform a neurological exam, which helps them diagnose disorders of the central nervous system, including headache disorders. A neurological exam consists of tests that check things like muscle strength, balance, coordination and reflexes.

At Main Line Health, we use the latest diagnostic approaches to determine the root cause of your headaches, including:

  • Electroencephalography (EEG), which measures your brain's activity
  • Evoked potential (EP) tests, which check how quickly your brain responds to sound, light and touch
  • Electromyography (EMG), which measures the electricity from the nerves in your muscles
  • Nerve conduction studies, which look at the nerves in various parts of your body
  • Ultrasonic vascular studies, which check for blood clots that could lead to a stroke

In order to get the most of your neurologist appointment, come prepared with details about your headache experiences, including:

  • What they feel like
  • Where they cause pain
  • When you're most likely to get them
  • How long they last

You may also want to bring notes about your medical history, including medical conditions, current and past medications and any family history of headaches or other health conditions.

Finding relief from headaches

Headaches may be common, but that doesn't mean you have to live with them. If your headaches are taking a toll on your well-being or daily life, talk to your healthcare provider. They can discuss ways to find relief, which may include a visit to a neurologist.

With the right resources and support, your headaches can become a thing of the past—so you can focus on your headache-free future.

Next steps:

Schedule an appointment with Bushra Malik, MD
Learn more about neurology care at Main Line Health
Treating hormone-related migraines one life stage at a time

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