Should I go to a Private Headache Clinic?

In almost every case "Should I go to a Private Headache Clinic?" should be answered with a resounding NO!

As 99% of headaches are one of 6 common causes, almost every case can be managed by your general practitioner or family physician.

The most common reasons for failing to achieve headache control relate to

• Lifestyle
• Inadequate doses of medication
• Incorrect timing in use of medications

Live a Headache-Friendly-Lifestyle Instead

Sometimes, despite living a very healthy lifestyle and enjoying proper sleep, you still have frequent headaches.

If a Headache Friendly Lifestyle Fails...

If the diagnosis is correct, it may be time to step up a gear and try some specific medication for your headache condition. This is particularly true if your diagnosis is migraine.

It is important that medication, if used, is built up to a sufficient dose and used for a sufficient length of time.

Timing of medication, especially in migraine, is very important.

For example - if you take the painkiller too late in a migraine attack they may not be fully effective. Anti-migraine medications work best if taken just as the pain is starting to build, not once you have full-blown attack.

If the diagnosis is not correct, one cause for severe headaches are one of the Strange Headaches.

However, these strange headaches are rare, and in most people difficult to control headaches are severe migraine or a cervicogenic headache (in my experience).

When is Specialist Advice Required?

Another common reason for seeking advice from a headache expert would be to try more powerful medications, of which a family physician or GP may have limited experience.

If your family doctor and you reach a dead-end in terms of diagnosis or treatment then consultation with a headache specialist (usually a neurologist) can be helpful. Even then, the longterm management will usually be overseen by the family physician or GP.

The other common reason for requesting a referral is to try and get a brain scan to "make sure there is nothing else going on".

Many clinics, including some private headache clinics, may offer a brain scanning service, but you should be wary of going for a scan without first talking to your own doctor about your symptoms.

If you have a Top 6 Headache (tension-type, migraine, cervicogenic, ice-pick, chronic tension-type, chronic migraine) then the probability of having a serious problem on your scan is already virtually zero.

It is probably more important to have a clinical headache diagnosis than to have a scan.

Spending money on a scan will not help you get a diagnosis, although knowing that the scan is normal can provide a period of reassurance.

Knowing the correct clinical headache diagnosis will assist in getting best information about your headaches and will help tailor medications to your own particular headache type.

So should I go to Private Headache Clinic?

In 1-2% of headache cases seen by a general practitioner advice from a neurologist can give further information to help you improve headache control.

However, in many parts of the world, with state insured health systems (like the HPSS in Northern Ireland and the NHS in the rest of the UK) headache advice can be obtained relatively easily, from a local hospital, without going to a private headache clinic.

Often that advice can be given to your GP by telephone or email and need not require you to pay for a face to face consultation!

Knowing the correct headache clinical diagnosis is more likely to put you on the right track to obtaining effective headache treatment.

A headache management plan, for the vast majority of headache complaints, is relatively easy for most general practitioners to provide. This includes which includes paying attention to lifestyle and using appropriate medications at high enough doses and at appropriate times.

Therefore, for almost everybody with headaches, the correct place to be is in the hands of your family physician. In a very small number of cases, specialist advice can be obtained on a non-urgent basis from local healthcare providers.

So don't pay for a private headache consultation if you have not paid attention to lifestyle and consulted your own family doctor first - he or she will have a lot to offer you.

Ultimately, the time you invest in attending your family doctor will spare you a lot of inconvenience and expense.

A general practioner can take into account all aspects of your health that might impact on headache intensity, and should be in a good position to judge when it is in your interest to seek further advice from a neurologist or headache expert.

At that stage, it is a matter of choice whether that advice is on a private or public healthcare basis.

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