A patient guide to persistent headaches and migraines — what to expect from your GP or neurologist appointment, and how to get the right treatment in the UK.
Most headaches are managed by your GP, but if over-the-counter painkillers are not helping, or your headaches are getting worse, more frequent, or changing in character, it is worth pushing for a specialist referral. On the NHS, you may be referred to a neurologist or a dedicated headache clinic.
Before you go, keep a headache diary for at least two weeks. Note when each headache starts and ends, where the pain is, how severe it is (1-10), any triggers you notice (stress, certain foods, poor sleep, hormonal changes), and what you took for it. Apps like Migraine Buddy can make this easier. This diary is genuinely one of the most useful things you can bring.
Also write down everything you have already tried — medications, lifestyle changes, anything. Specialists see a lot of patients and your appointment may be short, so having this prepared saves precious time.
Your doctor will ask detailed questions about your headaches: their pattern, location, associated symptoms (like nausea, sensitivity to light or sound, visual disturbances), and family history. They will check your blood pressure and may do a brief neurological exam.
In most cases, headaches are diagnosed based on your history rather than scans. However, if your headaches are sudden and severe, or if there are any unusual features, your doctor may arrange a CT or MRI scan to rule out other causes. This is precautionary and does not mean they suspect something serious.
For migraines, your doctor might discuss acute treatments (triptans, anti-sickness medication) and preventive options if you are having four or more migraine days a month. Preventive treatments range from daily tablets (like propranolol, amitriptyline, or topiramate) to newer options like CGRP inhibitors, which are becoming more available on the NHS.
Finding the right treatment for persistent headaches often takes some trial and adjustment — try not to be discouraged if the first thing you try does not work perfectly. Most preventive medications need 8-12 weeks at the right dose before you can fairly judge them.
Watch out for medication overuse headache, which can happen if you take painkillers (including triptans) on more than 10-15 days per month. It is a very common and fixable problem, but it can feel counterintuitive — the treatment is to reduce the painkillers.
The Migraine Trust and the National Migraine Centre (which offers affordable private consultations) are excellent UK resources. Many people also benefit from identifying and managing triggers — regular sleep, meals, hydration, and stress management can make a real difference alongside medication.
Print this list or save it on your phone. It is easy to forget what you wanted to ask once you are in the room.
NuCover can help you find the right consultant — through the NHS, private insurance, or self-pay. Tell us what you are experiencing and we will point you in the right direction.
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