Migraine, tension-type headache, cluster headache and headaches caused by another condition need different treatment plans. The aim of assessment is to identify the headache pattern, check for warning signs and choose treatment that reduces disability as well as pain. [1]

When should I seek urgent help?

Seek emergency assessment for a sudden extremely severe headache, new weakness, confusion, reduced consciousness or a concerning headache with fever. Headache after significant injury, or a major change in a usual headache pattern, needs prompt review. New symptoms should not automatically be attributed to an existing migraine diagnosis. [4]

What information helps the diagnosis?

Keep a diary of headache days, duration, associated symptoms, likely triggers and medicines taken. Record whether headaches affect work, sleep or normal activity. Assessment may consider migraine symptoms, autonomic symptoms such as eye watering, neck or nerve tenderness, and whether further investigation is needed. [1] [4]

Bring the names and frequency of all pain medicines, including over-the-counter products. Frequent use of acute headache medicines can contribute to medication-overuse headache; management depends on the medicine and should be planned with the clinician. [1]

Acute treatment and prevention

Acute treatment aims to manage an attack. Preventive treatment aims to reduce the frequency or burden of attacks when appropriate. The choice depends on the diagnosis, other health conditions, pregnancy considerations, previous response and patient preferences. Review both benefit and adverse effects. [1] [5]

Set practical goals such as fewer days lost to headache, improved sleep or less reliance on rescue medicine. Agree when to review the plan and what change would justify adjusting it.

Where do nerve procedures fit?

An occipital nerve block may be considered for selected headache disorders. It can produce temporary relief, but response varies and the procedure has risks including soreness, infection, bleeding and, with steroid, local skin or hair changes. [2]

Pulsed radiofrequency has been studied in selected patients with occipital neuralgia or migraine with nerve tenderness. Findings should not be generalised to every headache or used to promise permanent relief. Ask how a proposed occipital or other nerve procedure fits the specific diagnosis and the wider preventive plan. [3]

Questions to ask

Which headache diagnosis best fits my symptoms? Do any features need investigation? What should I take during an attack, when should I consider prevention, and what is the plan if treatment is ineffective?

Related information

Sources and evidence

Evidence sources checked: 10 November 2026. This information supports a clinical discussion; diagnosis and treatment depend on an individual assessment.