Who Should You See About Your Migraines?
You’d think anyone who experiences a migraine would rush to the doctor to find out what’s going on. But that isn’t necessarily the case. Less than 40% of men with migraine symptoms have gotten them diagnosed by a doctor. That means they’re out there on their own trying to figure out the right way to deal with the pain, something experts wish they wouldn’t do. “When it comes to who you should see about a migraine, start by seeing anybody!” says Juliana VanderPluym, MD, assistant professor and consultant in the department of neurology within the division of headache at the Mayo Clinic Arizona. “A lot of people never talk to their doctor about headaches because they assume everybody gets them and they aren’t worth mentioning, but they are.”
Check in with your regular M.D.
Your primary care physician is a great place to start. More than 10% of people experience migraines, so your main doc is likely to have experience addressing them. “A primary care physician can help manage your migraines and give you appropriate medications,” says Nadia Hindiyeh, MD, a headache neurologist based in California. “Plus, it can be hard to find a headache specialist because there aren’t that many and they can have long wait times.”
Signs it’s time to see a neurologist
In some situations, your primary care physician is going to want you to see someone who focuses on migraines, which can be either a neurologist or a headache specialist (usually a neurologist with additional training and licensing). These scenarios include:
Your main doctor has run out of ideas. “Often a primary care physician will refer you to neurology when the headaches aren’t responding to first-line treatments like triptans, or if there are atypical features,” says Jennifer Robblee, MD, a neurologist who specializes in the treatment of headaches and migraines at Barrow Neurological Institute in Arizona.
You have chronic migraines. “A primary care physician might refer you to a specialist if you experience 15 or more headache days per month for three months,” says VanderPluym. In that situation, you won’t just need medication to help you in the moment, you’ll need preventive therapies that a neurologist or headache specialist can be more educated on.
Your migraines really impact your quality of life. “If you’re unable to work or take care of your kids because of how severe and intense your migraines are, you should see a specialist sooner rather than later,” says Lisa Cook, MD, a neurologist and headache specialist and co-founder of the Los Angeles Headache Center.
Your migraines are changing. “Whenever something is different from the typical pattern of your migraines—they go up in frequency, severity, or there are unusual symptoms like difficulty speaking or thinking or numbness on one side of your body—it should prompt you to see a neurologist or headache specialist,” says Cook.
Feeling overwhelmed by the options? Head to the provider directory of the American Migraine Foundation to find someone near you who can help.
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