It’s easy to feel isolated when you have a severe headache. For one thing, the extreme pain can seem to cut you off from the world, especially if your headache makes you sensitive to lights and sounds, or causes visual disturbances (such as an aura).
Beyond that, the most prominent symptom of severe headaches—pain—is “invisible.” Other people can’t actually see what you’re going through the way they could a broken leg, for example.
With that in mind, describing your headache to someone else can be tricky.
Talking about your headache might be tough (and, honestly, the last thing you feel like doing while dealing with one), but bridging that gap is important, especially when it comes to communicating with your doctor.
According to migraine expert and Cove Medical Director Dr. Sara Crystal, using the right words to describe your headache to a physician can help you get a diagnosis and find treatment that works.
There are many types of headaches and migraines, and the way you describe what you feel can signal to your doctor what’s ailing you. For example, “Throbbing and pulsating are common descriptions of migraine headaches and make up some of the diagnostic criteria,” says Dr. Crystal, while “band-like or vise-like pain suggests a tension-type headache.”
So, how should you describe your headache to help your doctor get you a diagnosis? Know that a physician will likely ask you several questions to learn more about your condition.
Using words to describe the acute pain is probably the toughest part of the equation. Your doctor can use these clues to get at the type of headache you might have. For example, a tension headache might feel more like “squeezing” or “tightness,” while migraines often feel like a “throbbing pain” or “pounding sensation" and are often associated with nausea, as well as light and sound sensitivity.
Here are some common words physicians hear to describe common headache types:
Last one sound unfamiliar? According to migraine expert and Cove medical advisor Dr. Philip Bain, indomethacin-sensitive headaches are not nearly as common as other headache types. They occur on just one side of the head and last seconds to minutes, but recur multiple times per day. Notably, they can be treated with the anti-inflammatory indomethacin.
The doctor can likely assume that headache pain is in your head, but let them know where exactly. Does the pain center around the base of your neck, or around your eyes? Or perhaps on one half of your head? Tension headaches tend to be bilateral, or on both sides, but Dr. Crystal notes that “migraine in adults is usually unilateral,” or focused on just one side of your head. That being said, a constant pain on one side of your head could be another type of headache, she adds.
Also, make sure to tell your doctor if the pain moves around or migrates as the headache develops.
Does the pain come on suddenly or start as a dull ache that crescendos into severe pain? This information can help the doctor figure out if you have a migraine (which might develop over several hours), or another common headache, such as a sudden cluster headache (which can peak in just 5-10 minutes).
Migraines can last from 4-72 hours, so be sure to let your doctor know if your headaches fall somewhere in that window. If they last longer than 72 hours, your headaches could be classified as Status migrainosis, or an unusually long-lasting migraine, which is sometimes triggered by medication overuse (need-to-know information for your doctor!).
Shorter headaches could be tension headaches, which can be as short as 30 minutes (though they can last up to 7 days), according to the International Headache Society.
Cluster headaches are also short-lived, lasting up to 3 hours, though the National Headache Foundation reports they’re not anywhere near as common as migraines or tension headaches (and mostly affect men).
Whatever bucket your headaches fall into, make sure you have a general sense of how long your headaches last so you can get closer to a diagnosis.
Your doctor will want to know how often your headaches are disrupting your life, and that information can help them pinpoint your specific medical condition. If you get short (30 to 120 minutes) very severe headaches several times a day, for example, you could be suffering from cluster headaches.
Also, if you get migraines more than 15 times per month, you could be considered a chronic migraine sufferer. Since your body’s pain tolerance and over- or under-medicating can affect your likelihood to end up with chronic migraines, it’s important to tell your doctor how often you’re struggling with headaches.
In other words, what else is happening in your life when headaches strike?
Believe it or not, doctors understand and can treat specific types of headaches triggered by specific things going on in your life, like sex, exercise, and menstruation. So, any patterns or correlations you’ve noticed between your lifestyle and your headaches could be relevant.
Dr. Bain states that certain health conditions and traumas, like head injuries or chronic illnesses such as HIV, can be causes of headaches.
For example, tension headaches can be triggered by stress, grinding your teeth, sleeping in a strange position, straining your eyes, and so on. Migraine triggers can include things like stress, diet, caffeine and alcohol (especially red wine), sleep, weather, and more.
Knowing if one of those things coincides with your headaches can help your doctor get a read on your condition.
If it’s tough to remember the context around your headaches, consider keeping tabs on them using a headache tracking tool. With a log to review, your doctor will get a clearer picture of what you’re going through, and you’ll likely learn more about your specific triggers and how to avoid them.
Some headaches could be passed down through your family. While cluster headaches may have a genetic cause, up to 90% of migraine sufferers have a family history of migraines.
Although there isn’t one specific “migraine gene,” researchers think at least 20 chromosomes might be related to migraines. And specific types of migraines can have a genetic component. Any background you can dig up about your family headache history can be useful to your doctor. (Just a note that your primary family members are most key here.)
In other words, what have you tried, and what has worked? Whether you’ve used home remedies or over-the-counter NSAIDS—or even lifestyle changes like sleeping or staying in a dark, quiet room—let your doctor know what you’ve tried, how it affected your headache (did it shorten it, dull the pain, have no effect at all, etc.?), and for how long it was effective.
Knowing how a headache responds to treatment can help your doctor figure out what kind of headache you’re dealing with, and also give you helpful next steps for further treatment.
Once you’ve given your doctor as much information as possible, including whether your headaches feel more like “throbbing” or “tightness,” for example, what should you expect next?
Unfortunately, says Dr. Crystal, there’s no blood test or scan for diagnosing your headaches. These tests are used to rule out other caues of headaches. Instead, your doctor will look at your personal history, she says.
You might have to go through a few tests, especially if your doctor thinks you might have a type of headache other than migraine. But, if your doctor does suspect migraine, she will use these criteria:
Migraine is diagnosed when a patient has had at least 5 episodes of headaches in their lifetime lasting between 4 and 72 hours and accompanied by at least two of these symptoms:
And at least one of the following:
Other factors might lead to a migraine diagnosis too, adds Dr. Crystal, like aura (or visual disturbances), motion sickness (especially if you had car sickness as a child), and the presence of common migraine triggers in your life.
The good news, says Dr. Crystal, is that you’ll likely leave your first visit with a diagnosis and a treatment plan.
“I like to divide the treatment plan in terms of transitional treatments (to break a headache cycle if needed),” she says, “preventives (including natural products and prescription medications), and acute treatment (or medications to take when you have a headache).”
The bottom line: the more information you share with your doctor, the more specific she can be with a treatment plan that helps you feel better faster.
Make sure to ask your doctor what you can do to start feeling better and control your headaches while you wait for prescribed treatments to start working. It's important to remember that preventative treatments can take six to eight weeks to start having a real impact on your headaches.
Your doctor may suggest making lifestyle changes, including “stress reduction, good sleep hygiene, identifying and avoiding triggers, adding aerobic exercise, and possibly adding supplements,” says Dr. Crystal.
Some natural headache treatments might give you some relief, so make sure to ask your doctor if any alternative migraine treatments or common home remedies for headaches (such as supplements, caffeine, or ginger) are worth a try.
“Migraines didn’t begin overnight, and they likely won’t be fixed overnight either,” says Dr. Crystal, and the same holds true for other types of headaches. But, by communicating with your doctor, you can get an effective treatment plan that helps you handle your headaches and start to feel better.
Do you tend to get throbbing headaches, but aren’t sure if they’re migraines or something else? Learn more here about migraine symptoms and other headache types, so you can get prepared to talk through them with your doctor.
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
Photo by Ehimetalor Unuabona on Unsplash