Same-day illness
Headaches & migraines
We work out what kind of headache you have and treat it accordingly. Most are tension headaches or migraines, and both respond far better to prevention than to treating each episode. If you are taking painkillers most weeks, that itself may be part of the problem.
Come in if you have
- Headaches several times a month, or affecting work or sleep
- You take over-the-counter painkillers for headaches most weeks
- Your usual headache pattern has changed
- Headaches with nausea, visual changes, or sensitivity to light and sound
- Headaches that wake you from sleep
What happens at your visit
- We take a careful history — the pattern matters far more than any test.
- We check blood pressure, and examine you neurologically where indicated.
- We identify which type of headache you have, because the treatments differ substantially.
- We focus on prevention, not just relief, and often ask you to keep a short diary.
The pattern is the diagnosis
Almost all headache diagnosis comes from the history, not from tests. How often, how long, where, what it feels like, what makes it worse, what comes with it — those answers identify the type, and the type determines the treatment.
That is why this appointment is mostly conversation. It is worth thinking about the pattern before you come, or jotting down the last few episodes.
The overuse trap
This one catches a lot of people. Using over-the-counter painkillers more than about two or three days a week can, over months, start causing headaches. You take more because the headaches are worse; the headaches are worse because you are taking more.
It is genuinely common and rarely self-diagnosed. Breaking the cycle works, but it is unpleasant for a couple of weeks and much easier with a plan and support than alone.
Prevention beats treatment
If you have frequent migraines, the aim is not a better painkiller — it is having fewer migraines. There are effective preventive options, and many people have never been offered them.
Alongside medication: sleep timing, meal timing, hydration, caffeine consistency and stress all measurably affect frequency. A short diary usually reveals a pattern within a few weeks.
Go to the ER for
A headache that reaches maximum intensity within seconds, headache with fever and a stiff neck, with weakness, numbness or difficulty speaking, with confusion, after a head injury, or one you would describe as the worst of your life.
Common questions
- Do I need a scan?
- Usually not. Most headaches are diagnosed from the history and examination, and scanning a typical headache pattern rarely finds anything. We will recommend imaging if there are specific features that warrant it, and explain why.
- What is medication overuse headache?
- Taking painkillers for headaches more than about two or three days a week can, over time, cause the headaches themselves. It is common, frustrating, and frequently missed — and it improves once the cycle is broken, though it gets worse before it gets better.
- How do I know if it is a migraine?
- Migraines are typically one-sided, throbbing, worsened by movement, and come with nausea or sensitivity to light and sound. Many people who describe "sinus headaches" or "stress headaches" actually have migraine, and they respond to quite different treatment.
- When is a headache an emergency?
- A sudden severe headache that peaks within seconds, headache with fever and a stiff neck, with weakness or numbness, with confusion, after a head injury, or the worst headache of your life. Call 911 for any of those.
This page explains how we care for this condition at our office. It is general information, not medical advice for your specific situation — please talk to us about your own care.
Ready to get this looked at?
Call us or send a request and we will get you in — often the same or next day.