When to see a doctor for headaches and migraine

Call 911 or go to the emergency room

Mayo Clinic lists these as reasons to see your healthcare professional right away or go to the emergency room, because they could be caused by a more serious medical issue: an abrupt, very bad headache like a thunderclap; a headache with fever, stiff neck, confusion, seizures, double vision, or numbness or weakness in any part of the body, which could be a sign of a stroke; a headache after a head injury; a chronic headache that is worse after coughing, exertion, straining or sudden movement; and new headache pain after age 50.

The NHS adds to its emergency list problems speaking or remembering things, loss of vision or blurred vision, feeling drowsy, weakness on one side of the face or body, a rash that does not fade when a glass is rolled over it, and a head injury within the last 3 months. It says not to drive yourself to the hospital; ask someone to drive you or call the emergency number. The NHS number is 999. In the US, call 911.

Get seen soon

The NHS says to ask for an urgent appointment or call NHS 111 in the UK if a migraine attack has lasted longer than 72 hours, if aura symptoms last longer than 1 hour at a time, or if you are pregnant or have just had a baby. In the US, our suggestion is to call your doctor or an after-hours nurse line the same day for these.

For headaches in general, the NHS lists these as urgent: a headache with vision or eye problems, a headache triggered or made worse by coughing, sneezing, bending down or exercising (Mayo Clinic puts a chronic headache that gets worse after coughing or exertion in its right-away group), a headache with vomiting, and a headache with jaw pain when eating or a sore, tender scalp. For children, it adds a headache that is getting worse or wakes them at night.

Mayo Clinic says that if you have a history of headaches, see your healthcare professional if the pattern changes or your headaches suddenly feel different.

Book a regular visit for migraine

Mayo Clinic notes that migraines are often not diagnosed or treated, and says to keep a record of your attacks and how you treated them if you regularly have symptoms, then make an appointment. The NHS says to see a GP if attacks are severe, getting worse or lasting longer than usual, if you have them more than once a week, if migraine is hard to control, or if you regularly get it before or during your period.

For ordinary headaches, the NHS says to see a GP if you have tried treating one yourself and it is not getting better or is getting worse, or if you regularly get headaches. Migraine cannot be cured, the NHS says, but treatment can help manage attacks and prevent them, and you may need to try a combination before finding one that works.

What to bring and what the doctor will ask

The NINDS says a doctor will review your health history and do physical and neurological exams, and may ask when headaches start, how long they last, what they feel like, what triggers them and whether other symptoms such as nausea or vision changes come with them. Imaging such as MRI or CT is not usually used to diagnose migraine, but a doctor might order it to rule out another condition.

It suggests a headache journal and lists what to write after each headache: the time of day, intensity and length, sensitivity to light, smells or sound, activity right before, medicines taken, last night’s sleep, stress, weather or routine changes, food and drink in the previous 24 hours and other health conditions, plus period days and family history. Our suggestion: also bring a list of every medicine you take, including over-the-counter ones.