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NEUROLOGY SERVICES

Diagnosis & Treatment

Headaches

Find a headache specialist

How are Headaches Diagnosed?

Diagnosis

Often headaches are diagnosed by a healthcare provider who completes a comprehensive medical evaluation, which includes asking about the details of your headaches and other medical conditions.

Your doctor may ask a series of questions to better understand your headache patterns and triggers to identify or rule out specific causes or types of headaches. Your physician may ask:

  • How long have you been having headaches?
  • What time of day do they begin?
  • How long does the headache last?
  • Where is the pain?
  • What type of pain is it? (i.e. throbbing, dull, stabbing, etc.)
  • Are you experiencing any other symptoms?
  • Do you have a family history of headaches?

After the initial consultation, your headache doctor may perform tests, including bloodwork and a brain scan if needed. Tests may depend upon your reported headaches symptoms. Diagnostic tests and methods may include:

  • CT scans. Imaging of the brain may be used to rule out a head injury, tumors, blood clots, or bleeding for severe headaches
  • MRI. This is the most common scan used for headaches to assess if there are any underlying causes or conditions separate from migraine or other genetic headache disorders
  • Eye exams. Certain eye disorders or eye problems may be an underlying cause of headaches
  • Spinal tap. The fluid that surrounds your spine and brain may be tested around the low back if you have a headache condition that is caused by high pressure or infection
  • Blood tests. Certain tests may be performed to look for infection or inflammation

How are Headaches Treated?

Treatments

Headaches may be treated in various ways, based on whether it’s a primary or secondary headache and symptom severity. Certain changes, such as lifestyle modifications or stress management, may help to relieve some headaches. At the same time, medications and alternative treatments may be suggested for those with chronic headaches or daily headaches.

The ColumbiaDoctors Neurology Headache and Facial Pain Center at NewYork-Presbyterian and neurology specialists at Weill Cornell provide the latest approaches and innovative techniques for treating all types of headaches.

Headache treatments may include:

  • Lifestyle Changes. Recommendations may include regular sleep and meals, establishing an exercise routine, stress management techniques, limiting the use of alcohol and tobacco, and avoiding individual headache triggers. It may be helpful to keep a headache diary to record any patterns or changes to identify potential triggers.
  • Stress Management. Headache disorders may be treated with stress management techniques such as relaxation exercises, yoga, massage, biofeedback, and acupuncture. Good nutrition, regular exercise, and healthy sleep habits can also help to reduce headaches caused by stress.
  • Medications. There are certain classes of medications and approaches to treating headache disorders, such as migraine. Your medication may be considered a rescue headache medication if it is being used to treat your symptoms. If the medication is intended to lower the frequency and severity of headache attacks, it is considered a preventive headache medication.
    • Anti-inflammatories, such as aspirin and ibuprofen, may be used to treat a migraine or headache
    • Antiemetics for headaches that are associated with nausea and vomiting
    • Triptans and gepants, classes of medications may be prescribed for severe headaches
    • Preventive treatments may include medications such as antidepressants, anti-blood pressure drugs, and antiseizure medications, as well as other treatments such as Botox injections, CGRP blocking pills, and monthly injections
  • Procedural therapies. If oral medications are ineffective, your doctor may recommend a procedural therapy such as a nerve block injection to help break a bad headache cycle
  • Neuromodulation strategies, using an electronic or magnetic device to stimulate the nerves in the brain or neck, may lessen headache symptoms and frequency
  • Alternative Treatments, such as herbal supplements, meditation, energy healing, guided imagery, CBT, and biofeedback, are all considered integrative headache treatments for severe headaches and migraine relief

FAQs

FAQs

There is no one way to get rid of a headache fast, as individualized treatment may be necessary to target your type of headache and specific set of symptoms. To ease initial headache symptoms, reduce your activity, turn off the lights, and apply an ice pack to your head to numb the pain. See your doctor or healthcare provider for more acute headache attack treatments.

Migraine commonly leads to headache attacks in the morning hours. In addition to poor sleep quality and sleep apnea, teeth grinding, depression, alcohol use, and certain medications may also cause you to wake up with a headache.

A postural or positional headache is a type of headache that may occur when standing up or sitting. It is important to see your doctor if you have a positional headache to rule out spinal injuries, leakage of spinal fluid, or associated health concerns, such as certain blood vessel conditions or postural orthostatic tachycardia syndrome.

A headache that occurs when you bend over, strain, cough, or shout may be primary or secondary, which could be more serious and require medical attention. This headache could occur from straining or overactivity but could also occur if you have developed a cerebrospinal fluid (CSF) leak.

Headaches that occur while lying down could be caused by poor sleep posture, teeth grinding, high blood pressure, or other factors. If a headache occurs each night at the same time during sleep, it may be from a condition called hypnic headache, which is considered a primary headache with no underlying cause.

Get Care

Trust NewYork-Presbyterian for Care to Address Your Headaches

At NewYork-Presbyterian we offer the latest treatments, innovative therapies, and state-of-the-art care from a team of headache and migraine specialists. Our neurologists, who provide comprehensive care for conditions of the brain and spine, diagnose and treat a wide range of headaches and migraine as well as associated symptoms. Understand the causes and symptoms of headaches and migraines to find the right treatment approach with the help of a highly experienced NewYork-Presbyterian doctor.