What to tell your doctor about migraines: what to say and what to ask
The Headache Pal team Updated 9 min read
Tell your doctor when your headaches started, how often they come, how long they last and how bad they are on a 0 to 10 scale. Add your other symptoms, likely triggers, every medicine you take (including over the counter) and how often, how the headaches affect work and life, and whether family members get them.
If you have an appointment about your headaches coming up, the most useful thing you can bring is a clear story. The Migraine Trust, a UK charity, says “there is currently no test to diagnose migraine,” so diagnosis depends on your doctor “taking your medical history.” If you have a sudden, extremely painful headache, skip ahead to when to get medical help now. Below is what to tell your doctor, short sentences you can say as they are, and the questions to ask before you leave.
How to prepare for a migraine appointment
Book an appointment just for your headaches if you can, so there is time for the details. When you sit down, say in one sentence what you want from the visit. For example: “I’d like to find out what these headaches are and get a plan for them.”
If you have kept a headache diary, bring it. NICE, which writes guidance for doctors in England and Wales, tells doctors to “consider using a headache diary to aid the diagnosis of primary headaches.” Our migraine diary guide explains what to record and for how long. If you have not, book anyway, start one today and bring what you have.
Use the checklist below to get your notes ready the night before.
What should you tell your doctor about your migraines?
The Migraine Trust, Cleveland Clinic, NINDS and the AMF list much the same things a doctor will want to know at a first visit. Cover these:
| Topic | What to tell your doctor |
|---|---|
| When it started | When you first had these headaches (days, months or years ago) and whether they have changed |
| How often | How many days a month you have a headache, and how many attacks a week |
| How long | How long a typical attack lasts, start to finish |
| How bad | A pain score from 0 to 10, and how your worst attack compared |
| Where and what it feels like | The location of the pain and the feeling, in your own words |
| Other symptoms | Anything that comes with the pain, such as nausea or vision changes |
| Triggers | What seems to bring attacks on, and what makes them worse |
| Effect on your life | Missed work or school, cancelled plans, time spent lying down in a dark room |
| Family | Whether anyone in your family gets similar headaches |
The NHS says migraine attacks “usually last between 4 hours and 3 days,” so give a real length rather than “a while.” For what makes a headache worse, The Migraine Trust gives “movement, stress, noise” as examples. If attacks seem to follow your periods, say so: the NHS lists regular migraine “before or during your period” as a reason to see a GP.
Mention your daily habits too. NINDS, a US research institute, suggests a headache journal include “the quality and length of the previous night’s sleep.” Also name any other health conditions, since NICE asks doctors to weigh “comorbidities” when they discuss treatment to prevent attacks. If you take the contraceptive pill, say so: The Migraine Trust says to see your doctor immediately if your headache patterns change while you are taking it.
Do not play down how much the headaches cost you. The Migraine Trust says “the doctor will only understand how disabling the condition is if you tell him or her.” Name real things: the shift you left early, the birthday you missed, the fog the day after. NICE also asks doctors to weigh “the impact of the headache on their quality of life.”
Family history counts. The NHS says you’re more likely to get migraine “if you have a close family member who has it,” and the AMF (American Migraine Foundation) suggests checking whether any relatives had migraine.
Tell your doctor about every medicine, including over the counter
Bring one written list. NICE says a headache diary should record “all prescribed and over the counter medications taken to relieve headaches.” Add supplements: NINDS says to talk with your doctor first if you are considering them for migraine.
For each medicine, write down:
- The name and the dose
- How many days a month you take it
- Whether it helped, and how much
- Any side effects
The AMF asks for everything you have tried, “including how you responded to each and any side effects you experienced.” Include the ones that did not work.
Medicine days matter. Taking some headache medicines too often can lead to more headaches, called medication overuse headache. NICE asks doctors to be alert to it when triptans, opioids, ergots or combination painkillers are taken on 10 days a month or more, or paracetamol, aspirin or an NSAID on 15 days a month or more, for 3 months or more. The NHS says to “try not to take painkillers for more than 2 days a week.” Cleveland Clinic says to tell your provider if you take over the counter pain medicine “more than two to three times a week.”
Give the real count, even if it feels high. Please don’t stop or change any medicine on your own before the visit; talk it through with your doctor or pharmacist.
How to describe a headache: sentences you can say
Plain, concrete sentences get more done in a short visit. Copy these and fill in your own details:
- “These headaches started [when]. Lately they come more often.”
- “In a normal month I have a headache on about [number] days.”
- “A bad attack lasts [how long]. At its worst the pain is [number] out of 10.”
- “The pain is [where], and it feels [how]. Light and noise make it worse.”
- “Before the pain starts, my eyesight goes strange for a while.”
- “I take [medicine] on about [number] days a month. It helps a little, but the headache often comes back.”
- “Last month I missed [number] days of work because of headaches.”
- “My mum gets headaches like these too.”
- “What worries me most is [your worry].”
The AMF’s advice is to “communicate openly and honestly with your doctor.” If you are scared it might be something serious, say so. Then your doctor can answer the real question.
If you get more than one kind of headache, describe each one separately. Your doctor needs to tell them apart; our guide to migraine vs headache explains the main differences.
Should you see a GP or a neurologist?
For most people the GP is the right place to start. The Migraine Trust says “many people with migraine are successfully treated by their GP.”
The NHS says to see a GP if:
- your attacks are severe or getting worse, or lasting longer than usual
- you have migraine attacks more than once a week
- you find it difficult to control your migraine
- you regularly get migraine before or during your period
The Migraine Trust says you may be referred to a neurology department or headache clinic if there is doubt about the diagnosis, your attacks are getting worse, or you have not responded to the treatments your GP can prescribe. In the US, Cleveland Clinic says your primary care provider “may refer you to a headache specialist or a neurologist.”
What about a brain scan? NINDS says imaging tests such as an MRI or CT scan “aren’t usually used to diagnose migraine,” and NICE tells doctors not to refer people diagnosed with migraine for brain scans “solely for reassurance.” The Migraine Trust adds that tests can rule out other causes but “cannot be used to diagnose migraine.” If you are worried, say so and ask what your doctor thinks.
Questions to ask your doctor
The AMF puts it simply: “Remember, it’s okay to ask questions.” Write yours down and ask the one that matters most first.
These come from the AMF and Cleveland Clinic:
- What type of migraine do I have?
- Are my migraines considered chronic?
- What can I expect from my treatment plan?
- How can I prevent migraines?
- What side effects can occur with this medication?
- Can non-medication treatments and supplements help?
A few more we suggest, for your GP or a neurologist or headache specialist:
- “Do I need any tests, and why or why not?”
- “What should I do during an attack, and is there a plan to make attacks less frequent?”
- “How many days a month can I safely take my medicine?”
- “How will we know if the treatment is working?”
- “When should I come back, and who do I contact if things get worse?”
If time runs out, ask how to send a follow-up question, or book another appointment.
When to get medical help now
Some headaches cannot wait for an appointment. The NHS says to call 999 or go to A&E if you or a child has a headache and:
- it started suddenly and is extremely painful
- you have had a seizure (fit)
- you have numbness or weakness in the body or face
- you have had a head injury within the last 3 months
- you find it difficult to speak, balance, walk or remember things
- you are drowsy or confused
- you have loss of vision
- you have a rash that does not fade when a glass is rolled over it
- you have a very high temperature, a stiff neck, or bright lights are bothering you
The NHS says not to drive yourself to A&E. Ask someone to drive you or call 999 for an ambulance, and bring any medicines you take with you.
The NHS says to ask for an urgent GP appointment or contact NHS 111 if:
- you or a child has a headache and vision or eye problems
- you or a child has a headache triggered or made worse by coughing, sneezing, bending down or exercising
- you or a child has a headache and is being sick (vomiting)
- a child has a headache that’s getting worse or wakes them at night
- you have a headache and jaw pain when eating or a sore or tender scalp
- you or a child has any other symptoms you’re worried about
For migraine, the NHS adds an attack that has lasted longer than 72 hours, aura symptoms that last longer than 1 hour at a time, and being pregnant or having just had a baby.
In the US, Cleveland Clinic says to call 911 or go to an emergency department for the worst headache of your life (thunderclap headache), new neurological symptoms you have never had before, or a headache after a head injury.
At a routine visit, also tell your doctor about any big change in your usual headaches. The Migraine Trust says “any change in the pattern of your headaches should be checked with your doctor.”
How Headache Pal can help
A notebook works fine for everything above. If you’d rather use your phone, Headache Pal lets you log a headache in seconds, with a daily “No headache” check-in so good days count too, and shows your logs on a calendar. Pro adds a doctor report PDF of the last 30 days, made in Insights, that you can share before or during the visit. The app is iPhone only and is not medical advice: it keeps the record, and your doctor makes sense of it.
Common questions
How do I describe a headache to a doctor?
Use plain facts: when the headaches started, how many days a month you get them, how long an attack lasts, and a pain score from 0 to 10. Say where it hurts, what it feels like and what comes with it, such as nausea or vision changes. Then say how it affects your work and home life.
Should I see a GP or a neurologist for migraines?
Start with your GP. The Migraine Trust says many people with migraine are successfully treated by their GP. You may be referred to a neurologist or headache clinic if there is doubt about the diagnosis, your attacks are getting worse, or the treatments your GP can prescribe have not helped.
Do I need a brain scan for migraines?
Often not. NINDS, a US research institute, says imaging tests "aren't usually used to diagnose migraine." NICE, which writes guidance for doctors in England and Wales, says not to refer people diagnosed with migraine for brain scans solely for reassurance. If something worries you, ask why a scan is or is not needed. A sudden, extremely painful headache needs urgent care.
What medicines should I tell my doctor about?
All of them. NICE says a headache diary should record all prescribed and over the counter medicines taken for headaches. Mention supplements too. For each one, give the name, the dose, how many days a month you take it, whether it helped and any side effects. Talk to your doctor or pharmacist before changing anything.
What should I bring to a migraine appointment?
Bring your headache diary or notes, a list of every medicine with doses, your headache days and medicine days added up, a short account of your worst recent attack, and your questions written down. If you have not kept a diary, bring what you remember and start one now. Our migraine diary guide explains what to record.
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