Many neurologists diagnose and treat headache disorders like migraine. But some neurologists and physicians pursue advanced training and certification in headache medicine.
Headache disorders like migraine, tension-type headache, and cluster headache are neurological disorders. Neurologists regularly diagnose and treat these conditions. But some doctors (usually neurologists) pursue extra training to specialize in headache disorders.
Historically, headache disorders received little attention from the medical community. A
While awareness has improved since then, the improvements have been modest. According to the American Headache Society, there’s only 1 headache specialist for every 80,000 people in need.
Migraine attacks are one of the most common reasons people visit neurologists, so most neurologists have experience treating headache disorders. But if your current treatment isn’t working, it might be time to look for a headache specialist.
Ultimately, choosing the right healthcare professional for you can come down to accessibility, insurance coverage, and personal preference.
A neurologist is a medical doctor who specializes in conditions affecting your brain and nervous system, such as migraine, stroke, and Parkinson’s disease. A neurologist can help diagnose, manage, and treat a number of different conditions.
Conditions neurologists commonly treat include:
- Parkinson’s disease
- amyotrophic lateral sclerosis (ALS)
- migraine and headache disorders
- multiple sclerosis (MS)
- brain and spinal cord injuries
- Alzheimer’s disease and other forms of dementia
- tumors in your brain, spine, or nerves
Neurologists have at least 12 years of training. After medical school, neurologists complete a 1-year internship followed by 3 years of residency training specific to neurology. After passing an exam to become a board certified neurologist, most neurologists get additional training through fellowship programs in various subspecialties.
According to a 2015 survey of graduating neurology residents, only 2.8% cited headache medicine as their first choice of fellowship opportunities.
Neurologists work in private practices, in hospitals, and in a variety of other clinical settings.
Headache specialists are healthcare professionals who have advanced training, certification, or clinical experience in headache medicine.
Headache specialists diagnose and treat headache disorders
- episodic migraine
- chronic migraine
- tension-type headache
- cluster headache
- medication overuse headache
- persistent daily headache
Most headache specialists are neurologists who’ve completed fellowship training programs in headache medicine. But any licensed physician with several years of experience treating headache disorders can become a certified specialist.
Primary care doctors or healthcare professionals frequently see people with headache disorders. Some of these doctors might mention special interests in or experience with treating migraine and other headache disorders. If you’re looking for a new doctor, this might be something you want to consider.
Medical doctors aren’t the only healthcare professionals who can become headache specialists. Some certifications may be available to:
- clinical psychologists
- physician assistants
- nurse practitioners
Organizations that offer accreditation and certification in headache medicine include the:
- United Council for Neurologic Subspecialties (UCNS)
- American Academy of Pain Medicine
- National Headache Foundation
Benefits of seeing a headache specialist
Headache disorders are famously difficult to diagnose and treat. It can sometimes be very challenging to distinguish between different headache disorders, like chronic migraine and chronic tension-type headache. Headache specialists have more training in different headache types and more experience identifying the symptoms in people.
Headache specialists also:
- understand that not every treatment works for everyone and that it takes time to find the right one
- have more experience with new treatment options like nerve stimulation and preventive medications
- have a better understanding of what it’s like living with a headache disorder
- know how to work with the healthcare system to help get you the treatment you need
Neurologists help diagnose and treat primary headache disorders like migraine and tension-type headache. They also diagnose and treat many secondary headache disorders, which happen when there’s an underlying cause for your headaches. These can include disorders of the nerves or blood vessels in your head and neck, infections, and injuries.
A neurologist will perform a basic neurological exam and ask you about your symptom history. They may also order tests such as bloodwork or MRI scans.
Limitations of seeing a general neurologist
A general neurologist may not have specific training in headache medicine or in pain management. They may not have as much experience with newer treatment options as someone who specializes in headaches would. They also may have less experience providing interventional treatments like Botox injections.
General neurologists may also be unaccustomed to dealing with the insurance issues that can arise for people with headache disorders. This can include requirements to try certain (cheaper) medications before qualifying for other (more expensive) ones.
You might consider several factors when choosing a healthcare professional to treat your headache disorder:
- accessibility of specialists in your area
- cost of treatment and what your insurance covers
- the professional’s experience with headache pain management
- whether they offer telehealth services
You may want to see a headache specialist or neurologist for headache pain if:
- Your current healthcare professional isn’t helping.
- Your current medications don’t work or cause unwanted side effects.
- You’re pregnant or nursing and experiencing severe headache.
- You have a headache 15 or more days per month.
- You have new or suddenly worsened headache pain.
A primary care doctor can give you a specialist referral if necessary.
If you think it’s time to get help from a neurologist or headache specialist, you may want to consider these options:
- Ask friends or family for recommendations.
- Ask a family doctor or primary care healthcare professional for a referral.
- Call your insurance company to ask for a headache specialist who is covered by your policy.
- Use the Find a Doctor page of the American Migraine Foundation website.
- Search the UCNS website for a list of everyone with a headache medicine subspecialty.
- Neurologists treat all disorders of the brain and nervous system.
- Headache specialists are usually medical doctors with special training or certifications.
- You can find a headache specialist through online directories or personal referrals.
- You may want to visit a headache specialist if you have frequent or severe headaches.