• Headaches
• Heads Up

Who Ya Gonna Call When Your Head Really Hurts?

Most headaches are pretty routine. We take a pain reliever, maybe get a little rest, and before we know it, the pain is gone and we’re back to business.

But what if self-care isn’t enough? If your headache feels more intense than previous headaches or lasts longer than you’re used to, it’s time to call in a headache-buster.

Start with your primary care doctor. If she can’t figure out what’s wrong, or thinks you need additional help, she’ll likely refer you to a specialist.

Here are the various kinds of specialists that might be able to help, depending on the cause and type of headache you’re experiencing.

Headache or migraine specialist. This could be an internal medicine doctor, family practice doctor, neurologist or other specialist who has completed additional training and holds special certification in headache treatment. Most see a large number of headache patients, and some might even work in a clinic specializing in headache treatment. 

Neurologists are trained in diagnosing and treating disorders and diseases of the brain, spinal cord, nerves and muscles. They can address headaches that stem from problems in these areas of the body.

Ophthalmologists specialize in the medical and surgical treatment of the eyes. Migraine sufferers, in particular, have symptoms that impact eyesight, including vision changes, loss of vision and light sensitivity. Ophthalmologists can help determine if the problems are caused by an eye disorder or by migraines.

Otolaryngologists, also known as ENTs, specialize in ear, nose and throat problems. Often, sinus problems can cause headaches.

Allergists focus on diseases and conditions that cause allergic reactions, asthma, or immune system problems. Some migraine symptoms are similar to those experienced by people with allergies, such as head pain, puffy eyelid and hives.

Obstetrician/gynecologists specialize in disorders and diseases in women, focusing on female reproductive systems, pregnancy and childbirth. Women have migraines far more often than men, thanks to fluctuating hormones.

Pain management specialists come from a variety of medical backgrounds, including anesthesiology and neurology. They can help you find ways to reduce headache pain.

Neuromuscular dentists can treat misalignment in the jaw and neck region. A neuromuscular dentist may be able to find out if there are other underlying causes for your headache in the surrounding tissues, muscles, teeth, joints and nerves.

Start with your primary care doctor. If she can’t figure out what’s wrong, or thinks you need additional help, she’ll likely refer you to a specialist.

Psychiatrists can be helpful if the headaches are linked to depression or anxiety. They can examine you, both physically and emotionally, and prescribe medications to help ease the root cause of your headache.

Psychologists are not medical doctors (they usually have a PhD), but they specialize in the human mind and behaviors. They can help you find ways to avoid or better cope with situations that affect your mental well-being, which sometimes lead to headaches.

Preparing for Your Appointment

Once you’ve chosen a doctor, it’s a good idea to prep for your appointment. To get the most out of your visit, the American Headache Society offers these tips:  

• Keep a "headache diary": Track your headaches in an organized way by recording the date and time, length, severity, symptoms and triggers. Note what medication you took and how effective it was. Take the diary to all your doctor appointments. “An accurate headache diary can help your doctor decide what type of headache you have, such as episodic versus migraine. And knowing your symptoms can help to tailor treatment options,” explains neurologist Richard Kim, MD, of Premier Health Clinical Neuroscience Institute.
• Have reasonable expectations about treatment. Give it time to work. Be prepared to modify the treatment, as necessary. “It may take up to four to six weeks before you start seeing improvement from a preventive medication. An adequate medication trial could take up to two to six months. It’s important not to give up on a medication too soon, as it may just not have had enough time to work yet,” Dr. Kim says.
• Be honest about the medications you take, how often you take them, and other medical conditions you have. Tell your doctor about all your current therapies, including prescription, over-the-counter, natural remedies and illicit drug use.
• Ask for detailed instructions for taking your medications.
• Follow up with your doctor regularly. Seeing her on a regular basis helps you develop a relationship that can improve the treatment process. 
• Schedule a follow-up appointment when you finish each doctor visit. Make sure the time between visits will be long enough to evaluate the effectiveness of your treatment.

Source: American Headache Society; migraine.com; healthline.com