Migraine is more than just a headache. For some people, migraine attacks are occasional and manageable with a primary care physician or general neurologist. For others, headaches become frequent, disabling, difficult to control, or increasingly complicated to treat.
If migraine is interfering with your work, family life, sleep, or ability to function, or if you feel like you have tried treatment after treatment without getting adequate relief, it may be time to consider evaluation by a physician who specializes in migraine care.
If you are experiencing headaches regularly, particularly if you are having headaches on 15 or more days per month, you may have chronic migraine or another chronic headache disorder.
Even if you have not reached that threshold, increasing headache frequency is worth discussing with a physician. Frequent headaches can become more difficult to manage over time, and early intervention may help prevent the pattern from becoming more established.
You do not have to spend every day in bed with a migraine for it to deserve speciality care.
Consider seeking additional evaluation if migraines are causing you to:
• Miss work or family activities
• Cancel plans or avoid things you enjoy
• Spend significant portions of the day recovering from an attack
• Worry about when the next migraine will occur
• Plan your life around your headaches
The goal of migraine treatment is not simply to make headaches slightly less painful. It is to help you function and live your life more normally.
If you are taking medication for migraine but still having frequent or disabling attacks, it may be time to reassess your treatment plan.
This can include situations where:
• Preventive medication is not reducing your migraine frequency enough
• Acute medication does not reliably stop attacks
• You experience significant medication side effects
• You are using acute medications frequently
• You have tried several treatments without meaningful improvement
Migraine treatment has changed substantially in recent years. Depending on your history, treatment may include preventive and acute medications, CGRP-targeted therapies, Botox for chronic migraine, nerve blocks, or combinations of treatments.
Sometimes the problem is not that treatment cannot work, it is that the overall treatment strategy needs to be reconsidered.
If you have accumulated a long list of medications that you have tried without adequate relief, a specialist evaluation can help organize your treatment history and identify what options remain.
A medication that did not work several years ago does not necessarily mean that effective treatment is unavailable today, particularly as newer migraine therapies have become available.
Some people experience migraine attacks that last for many hours or even days. Others feel as though they are almost constantly recovering from one headache before another begins.
If headaches are becoming prolonged, nearly continuous, or increasingly difficult to control, it is worth discussing this with a physician rather than simply continuing to manage each episode independently.
Long waits for neurology and headache specialty appointments can be frustrating when headaches are already affecting your ability to function.
You do not necessarily have to wait until your symptoms become unbearable before seeking additional help. A physician experienced in migraine management can review your history, previous treatments, and current symptoms to determine whether specialty migraine care may be appropriate.
Not necessarily.
Neurologists receive extensive training in headache disorders, but migraine care is not limited to neurology practices. Physicians in other specialties may also develop focused expertise in migraine and headache management.
The most important question is whether the clinician has the experience and resources to provide comprehensive migraine evaluation and treatment appropriate to your situation.
At Center for Complex Pain Care, migraine care is physician-led and focused on patients whose headaches are frequent, complex, disabling, or difficult to manage
Most migraine attacks are not emergencies. However, a new or unusually severe headache should not automatically be assumed to be migraine.
Seek urgent medical evaluation for a headache that is sudden and extremely severe, follows a significant injury, occurs with new neurological symptoms such as weakness or difficulty speaking, or is accompanied by other concerning symptoms.
If headaches are becoming more frequent, interfering with your life, or remaining poorly controlled despite treatment, a migraine specialist evaluation may help clarify what is happening and what options are available.
Center for Complex Pain Care provides physician-led evaluation and treatment for chronic migraine and complex headache disorders in Norfolk and the Hampton Roads region.
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