Headaches are one of the most common medical conditions that people experience, affecting nearly everyone at some point in their lives.  Many medical professionals - including dentists, chiropractors, dietitians and therapists - are involved, to some extent, in headache treatment of one kind or another.  This can make choosing the right provider overwhelming, and many patients aren't sure who they should see for headache treatment.  Let me share a few suggestions.

Understanding the nature of your headaches

No two brains are exactly alike, and specific, unique, characteristics help differentiate the kind of headache you have, and which factors are contributing to your headache. There are over 150 different headache disorders - many with subtypes, each of these really do need to be treated differently and uniquely.  Understanding which type of headache disorder you may have ultimately determines how to best treat your headaches, and what kind of specialty (or generalist) care you might need. 

Headache Frequency

One major determining factor for which kind of provider to see is how often you experience headache attacks.  If you experience headaches less frequently than a few times per month, it’s worth discussing with your primary care physician first.  They know the best initial treatments, and what to look out to make sure your headache isn’t the sign of something more concerning.  If their initial treatments haven’t been very helpful, or you are experiencing more than one headache once a week, you will likely need to be evaluated by a neurologist - a specialist in all kinds of brain disorders, who has additional training in headache disorders.

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Many people with chronic headache disorders seek out sub-specialty care with a fellowship-trained, board-certified headache specialist like me.  We are doctors that spent additional years after completing our neurology training, to learn about and treat the most complicated and difficult-to-treat headaches.  There are rare headache disorders that we are more likely to see and be familiar with, and we are also trained in performing procedures - including nerve blocks and Botox injections.  We may also offer IV medications when headaches are the most severe.  

Other Professionals That Can Help

Headaches can be triggered by many factors, and your doctor may recommend seeing other professionals as part of a comprehensive treatment plan.  Neck and shoulder pain is a common issue that may be contributing to your headaches, or your headaches might actually be causing the neck and shoulder pain.  Physical therapists (and even chiropractors at times) can be helpful in resolving these issues by giving you stretching and strengthening exercises.  Jaw issues can worsen with your headaches, and can even contribute to headache pain.  Your doctor may recommend a night guard or other dental treatment to improve this pain as well. 

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Additionally, you may be aware that many migraine stereotypes involve food triggers.  The truth is, that although there are some foods that are more likely to trigger migraine attacks (MSG or other fake flavorings, fake sweeteners, and alcohol), there really isn’t one “migraine diet” that helps resolve everyone’s headaches.  However, your doctor might recommend seeing a nutritionist or dietician to review what specific food triggers you might have.  

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Stress is the universal trigger - although most people have really unique triggers, everyone’s migraine worsens with stress.  It’s important to consider what works for you to relieve the impact of the stress in your life.  It might be a guided kind of meditation called biofeedback, it might be mindfulness, it might be psychotherapy or even acupuncture.  Your doctor might recommend any one of these therapies (or others) and refer you to one of these professionals.  

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In summary, there are many specialists (and general practitioners) available to help you, and they all contribute to a comprehensive treatment plan. Your doctor will help determine which steps you need to take and who else to include in your treatment plan.

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We understand that the waiting time to see the right specialist can be as long as 3-4 months. If you want to get started by having an initial consultation with a board-certified neurologist specializing in headache care, you can do so right away, from the comfort of your own home, via the Neura Health app.

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