Ask Dr. Clary: When Does Headache Pain Need Medical Treatment?
Learn the headache pain symptoms that should be medically evaluated.
When you have a headache, the pain can be all-encompassing. And that kind of discomfort doesn’t discriminate. Headache pain can affect a range of people, from teenagers to those past retirement age. Summit spine specialist Dr. Andrew Clary explains when to seek medical evaluation for headache pain, and discusses treatment options.
Headache pain is very common
“Most people suffer from headaches at one time or another,” says Dr. Clary. “Some headache pain goes away quickly. Migraines, on the other hand, can last for days and really limit function. The origin of headache pain can vary. Some pain starts in your neck and moves up into your head. Other patients report pain that stars in the back of the head and goes into the forehead. When it comes to seeking medical treatment, I need to consider all factors from symptoms to timeline.”
Dr. Clary’s guidelines for seeking medical treatment
- “If you have experienced migraines for an extended period of time—three weeks or more—seek medical help,” says Dr. Clary. “Many patients come in to see me only after suffering for years, and that’s unfortunate. People frequently think that migraines are simply something they must accept. They believe nothing can be done to help them, and that’s just not true.”
- “If you’ve tried medications or therapies with your primary care doctor, and you are still having pain, we may be able to help” Dr. Clary advises. “Our team of pain specialists can offer specialized treatments to help.”
- “If headache pain is very debilitating, that’s another compelling reason to get a medical evaluation,” notes Dr. Clary. “You may have a migraine, but intense pain could also signal a more serious problem.”
Pain location is a clue to the origin of the problem
The origin of headache pain can be helpful in evaluating the underlying cause of the problem. “When debilitating pain starts in the neck and moves into the head, that tells me that the problem may be spine related,” explains Dr. Clary. “On the other hand, pain originating in the back of the head or in the face causes me to suspect migraines. This is particularly true when the pain is accompanied by blurry vision, other vision issues, or nausea symptoms.”
If headache sufferers come in, what can they expect?
“First and foremost, I want to make sure this is not a medical emergency,” says Dr. Clary. “As a general rule, if someone is 50 years old or older and is seeking treatment for a new headache that is either getting worse or has evolved over recent weeks, they should call their primary care physician or go to the emergency room. They may need imaging to rule out potentially serious problems.
“When you call Summit for a headache consult, we want you to know exactly what to expect,” explains Dr. Clary. “First, we’ll have a conversation about what you’re experiencing and I’ll take a history. I want to know about any treatments you’ve tried in the past. Usually, by the time I see migraine patients, they’ve been on several different types of medication. I want to know what works and what doesn’t work.”
Considering treatments for headache pain
“When I have a clear picture of what’s going on, I’m going to talk with you about available treatment opportunities,” Dr. Clary continues. “These might include therapies, medications, natural treatments, or simple injections. This conversation involves me, my patient, and my team. Our first step when considering treatment options is education. I’ll discuss the risks and benefits of each choice. It’s important for me to understand what you want and identify the treatment that’s the best fit for your lifestyle and needs. Usually, I suggest trying the least aggressive treatment first.
Every patient is unique, and response to pain treatment can vary. “I’m here to support my patients,” says Dr. Clary. “For some patients with refractory or unremitting pain, relief from injections can have fewer side effects and longer duration of benefit than traditional nonprocedural therapies. We will have a plan to follow up right away after treatment to prove you’re happy. We are happy to walk you through these next steps, and we are committed to finding the treatment that works for you.”
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