What are Headaches & Migraines?
Headaches are pain or discomfort in the head, scalp, or neck, and represent one of the most common medical complaints. While occasional headaches affect nearly everyone, frequent or severe headaches significantly impact quality of life and may indicate underlying health issues requiring medical evaluation. The most common types include tension headaches (characterized by a tight band-like sensation around the head), migraines (intense, throbbing pain often on one side of the head, typically accompanied by nausea, light sensitivity, and sometimes visual disturbances called auras), and cluster headaches (severe pain around one eye occurring in clusters over weeks or months). Secondary headaches result from underlying conditions such as sinus infections, high blood pressure, medication overuse, or rarely, serious problems like brain tumors or aneurysms. Professional evaluation helps identify your headache type, triggers, and appropriate treatment to reduce frequency, severity, and impact on your daily life.
Why is it Important?
While most headaches aren't dangerous, chronic or severe headaches deserve medical attention for several important reasons. Frequent headaches significantly diminish quality of life, causing missed work or school, limiting social activities, interfering with family responsibilities, and contributing to depression and anxiety. Many people suffer unnecessarily when effective treatments could substantially improve their situation. Additionally, healthcare providers can distinguish between benign primary headaches and secondary headaches indicating potentially serious underlying conditions. Warning signs requiring immediate evaluation include sudden, severe "thunderclap" headaches, headaches with fever and stiff neck, headaches after head injury, new headache patterns after age 50, headaches accompanied by confusion or vision changes, and progressively worsening headaches. For migraine sufferers, frequent attacks increase stroke risk, particularly in women who smoke or take estrogen-containing birth control. Proper diagnosis prevents medication overuse headaches, a common problem when over-the-counter pain relievers are used too frequently, actually causing rebound headaches. Your provider can identify triggers specific to your headaches—such as certain foods, stress, sleep disruption, or hormonal changes—and develop a comprehensive management plan including preventive strategies, acute treatment, and lifestyle modifications.
What to Expect
Your headache evaluation begins with a detailed discussion of your symptoms: pain location, quality, and intensity; how suddenly symptoms develop; how long they last; associated symptoms like nausea, vomiting, sensitivity to light or sound, or visual changes; and what triggers, worsens, or relieves your headaches. Your provider will ask about your headache frequency, family history of headaches, medications you're taking (including over-the-counter pain relievers), and how headaches impact your daily functioning. A neurological examination assesses your reflexes, coordination, strength, sensation, and mental status. In most cases, imaging studies like CT or MRI aren't necessary, but your provider may order them if your history or examination suggests a secondary cause. Treatment depends on your headache type and frequency. For occasional tension headaches, over-the-counter pain relievers and stress management techniques may suffice. Migraine treatment typically involves both acute medications to stop individual attacks (such as triptans or newer CGRP antagonists) and, for frequent migraines, preventive medications taken daily (including certain blood pressure medications, antidepressants, or anti-seizure drugs) to reduce attack frequency and severity. Your provider will help you identify and avoid personal triggers, discuss the importance of regular sleep and meal schedules, and recommend keeping a headache diary to track patterns and treatment effectiveness. Follow-up appointments assess whether your treatment plan is working and allow for adjustments.
How to Prepare
Before your appointment, keep a detailed headache diary for at least two weeks, recording when headaches occur, their duration and severity (rate pain on a 1-10 scale), location and quality of pain, associated symptoms, potential triggers (foods, stress, sleep changes, weather, menstrual cycle), and what medications or remedies you tried and whether they helped. Bring a complete list of all medications, supplements, and vitamins you take regularly, as some can trigger or worsen headaches. Note your family history, particularly if close relatives suffer from migraines. Be prepared to describe how headaches impact your life, including missed work or activities. If you're currently experiencing frequent headaches, avoid stopping your usual treatments before your appointment—your doctor needs to understand what you're currently doing. However, if you're using over-the-counter pain relievers more than twice weekly, inform your provider, as this can lead to medication overuse headaches. Bring any previous medical records related to your headaches, especially if you've had imaging studies or seen specialists. Consider what questions you want answered, such as whether your headaches could indicate a serious problem, what treatment options are available, and when you should seek emergency care.
Have questions about headaches and migraines? Contact Advanced Cardiovascular Specialists & Primary Care at (203) 334-2100 to schedule your appointment.
