Headache & Migraine Evaluation in Loxahatchee, West Palm Beach & Belle Glade, FL

What it involves

A headache evaluation starts with a conversation. Your provider asks what the pain feels like, where it is, how long it lasts, what comes with it, and what seems to set it off, then examines you and decides whether anything more is needed. Most of the work is sorting out which kind of headache you have, because the kinds are managed differently.

Who this is for

• Adults with headaches that keep coming back or that have recently changed
• Patients who suspect migraine because of throbbing pain, nausea, or sensitivity to light and sound
• Patients who cannot tell whether their headaches are tension, sinus, or something else
• Patients who take pain relievers often for headaches and want a plan

What to expect

• Questions about the pain, its timing, and what you were doing and eating beforehand
• A physical exam, including a check of your blood pressure
• A review of any headache diary and of the medicines you have been taking for the pain
• A plan, and clear guidance on which symptoms mean calling back or going to the emergency room

Four kinds of headache people mix up

MedlinePlus says the most common type is the tension headache, caused by tight muscles in the shoulders, neck, scalp, and jaw and often tied to stress, too little sleep, skipped meals, or alcohol. The other common kinds behave differently: Pressure behind the eyes or cheeks together with nasal congestion can come from the sinuses, and the sinus infection or cold guide describes how a provider tells that apart from other headaches.

• Tension headache: a band or pressure feeling, linked to muscle tightness and stress
• Migraine: a recurring headache with moderate to severe throbbing or pulsing pain, often on one side
• Cluster headache: a distinct type that MedlinePlus lists separately
• Sinus headache: listed as its own type, and easy to confuse with migraine or tension headache

The four phases of a migraine

MedlinePlus describes four phases and notes that you may not go through all of them each time. Knowing them helps you describe an episode accurately:

• Prodrome, up to a day before: food cravings, mood changes, yawning, fluid retention
• Aura, in some people: flashing or bright lights, zig-zag lines, or a feeling of being touched
• Headache: throbbing pain that builds, with sensitivity to light, noise, and smells, and sometimes nausea
• Postdrome: exhaustion, weakness, and confusion that can last up to a day

Common triggers

MedlinePlus says triggers vary from person to person. The list includes stress and anxiety, hormonal changes in women, bright or flashing lights, loud noises, strong smells, too much or too little sleep, sudden changes in weather, overexertion, tobacco, skipped meals, and caffeine or caffeine withdrawal. Some people also react to foods such as alcohol, chocolate, aged cheeses, or processed meats, especially in combination with other triggers. Taking migraine medicine too often is itself listed as a trigger, which is one reason to talk about how often you reach for it. Congestion from allergies can bring headaches along with it for some people, and the seasonal allergies guide explains how allergies are confirmed and treated.

A headache diary that actually helps

• The date, the time it started, and how long it lasted
• Where it hurt, and whether it was throbbing, pressing, or stabbing
• What came with it: nausea, light or sound sensitivity, visual changes
• What you had eaten, drunk, and slept the day before, and your stress level
• What you took for it, how much, and whether it helped

Headaches that should not wait

MedlinePlus says not every headache needs a doctor, but sudden, severe headaches should be reported to your provider. It advises getting medical help right away for a headache after a blow to the head, or one that comes with a stiff neck, fever, confusion, loss of consciousness, or pain in the eye or ear. Those belong in an emergency room, not on a waiting list. Likewise, a severe headache together with a very high blood pressure reading is a reason for emergency care, as the blood pressure categories explain. Headache with dizziness, vision changes, or weakness deserves prompt attention, and the dizziness evaluation guide lists the signs MedlinePlus says need 911 or an emergency room. A stiff neck together with fever and headache is an emergency, and the neck pain evaluation explains why and which neck symptoms can wait for a visit. A headache that comes with eye redness, light sensitivity, or eye pain is addressed in the pink eye guide, which lists the symptoms that should prompt a visit.

Why this is a primary care question

Headaches overlap with sleep, stress, blood pressure, medicines, and sinus problems, so the first step is often a general look at all of them. Patients with a cough, fever, or congestion alongside the headache can be seen through the same-day sick visit pathway, and those with a long list of conditions are followed through ongoing chronic care, so the headache is not treated as an isolated problem.

Sources

• MedlinePlus — Headache
• MedlinePlus — Migraine