Headache ‘diary’ can help doctor

DEAR DOCTOR K: I’ve made an appointment to see a doctor because of my frequent headaches. What is likely to happen at the appointment?

DEAR READER: Your appointment is likely to begin with a series of questions about your headaches. If you think about your answers to these questions in advance of the visit, it will help both you and your doctor. For example:

• When did your headaches begin? At what age?

• Does anything seem to trigger the headaches: particular foods, particular odors, stress, particular times of the day or the week?

• How often do they occur?

• How long do they last?

• Where is the pain located when the headache starts? Does the pain travel to other parts of the head as the headache takes hold?

• How severe is the pain?

• Describe how the pain feels – sharp, dull, constant, throbbing?

• Do you notice any other symptoms before or during the headaches, particularly trouble with your vision or an upset stomach?

• Does anything ease the pain?

I’ve put an example of a headache diary on my website, AskDoctorK.com.

Your doctor will also want to know about any medications you currently take, and whether other family members have problem headaches.

The doctor will also perform a physical exam. This will include a blood pressure check and a careful look inside your eyes. Increased pressure in the head can be a sign of a brain tumor. This can cause swelling of the optic nerve, and the eye exam can reveal such swelling. Tension headaches can cause spasms in the neck and shoulder muscles and tender areas at the back of the head. Your doctor will check for these.

To exclude more serious causes, your doctor may perform a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan. These procedures let your doctor get a good look at your brain. But rest assured, the vast majority of headaches do not have serious causes.