Conditions We Treat
Headaches
Overview
A headache is one of the most common health complaints there is, and it can be more complicated than it seems. Headaches cause pain or discomfort in the head, scalp, or neck, ranging from mild to severe enough to disrupt daily life.
Headaches are grouped into two categories. Primary headaches, such as migraine, tension, and cluster headaches, are not caused by another illness. Secondary headaches are a symptom of another condition, such as a sinus infection, high blood pressure, or a head injury. Migraines in particular can run in families.
The good news is that most headaches can be managed. Identifying the type of headache and what triggers it is the first step toward relief.
Symptoms
What headaches feel like
The main symptom is pain in the head or face, which can be throbbing, constant, sharp, or dull. Migraines often bring additional symptoms:
- Throbbing pain, often on one side of the head
- Nausea or vomiting
- Sensitivity to light and sound
- Visual aura, such as flashing lights or wavy lines, before the pain
Types
Common types of headache
Most headaches fall into a few categories:
- Migraine, with or without aura
- Tension headache, the most common type
- Cluster headache, brief but severe, often around one eye
- New daily persistent headache (NDPH)
Headaches can also be secondary, meaning they are caused by another condition such as sinus infection, high blood pressure, or head injury.
Triggers
Common migraine triggers
Triggers vary from person to person, and a headache diary can help you spot yours. Common ones include:
- Stress or a change in routine
- Poor or irregular sleep
- Skipped meals, dehydration, or alcohol
- Bright lights, loud noises, or strong smells
- Weather changes and hormonal shifts
Diagnosis
How headaches are evaluated
Most headaches are diagnosed from your history and exam. Testing is used mainly to rule out other causes:
- A detailed headache history and neurological exam
- MRI or CT imaging when a secondary cause is suspected
- Blood work to check for contributing conditions
- Urgent imaging for a sudden, severe, or worst-ever headache
Treatment
How headaches are treated
Because migraines vary, treatment is tailored to you and often combines several approaches:
- Lifestyle changes to manage stress, sleep, and triggers
- Over-the-counter or prescription medicine to relieve attacks
- Preventive medication to reduce how often headaches occur
- BOTOX for chronic migraine (15 or more headache days a month), an FDA-approved preventive treatment given about every 12 weeks
Our Approach
How we help
Migraines and headaches are complex, and the right plan is different for everyone. Our board-certified providers take a careful history, examine you, and use testing when needed to rule out other causes. From there we build a treatment plan, which may include lifestyle changes, medication, and preventive options such as BOTOX for chronic migraine.
Good to Know
Headaches: Frequently Asked Questions
What are the main types of headaches?
The most common are migraine (with or without aura), tension headaches, and cluster headaches. New daily persistent headache (NDPH) is a less common type. Headaches can also be secondary, caused by another condition such as an infection, high blood pressure, or a head injury.
What triggers migraines?
Triggers vary from person to person and can include bright lights, loud noises, emotional stress, poor sleep, dehydration, skipped meals, weather or pressure changes, certain medications, alcohol, and hormonal changes around the menstrual cycle. Keeping a headache diary can help identify your triggers.
When is a headache a medical emergency?
Seek emergency care for the sudden 'worst headache of your life,' or a headache with weakness or numbness, trouble speaking, confusion, vision loss, or a stiff neck and fever. These can be signs of a serious problem such as a stroke.
When should I see a neurologist for headaches?
Consider a neurologist if your headaches are frequent or severe, are getting worse, do not respond to over-the-counter medicine, come on suddenly, or are accompanied by seizures, vision changes, or neurological symptoms.
Can BOTOX help my migraines?
Yes, for chronic migraine, meaning migraines on 15 or more days a month. BOTOX is an FDA-approved preventive treatment given as small injections around the head and neck about every 12 weeks. It reduces how often migraines occur but does not stop a migraine that has already started.
How are migraines treated?
Treatment usually combines lifestyle changes (managing stress, sleep, and triggers), medications to relieve or prevent attacks, and, for chronic migraine, preventive options such as BOTOX. Because migraines vary, your provider may adjust the plan over time to find what works best for you.
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