Time to Find a Migraine Specialist? Why Your Family Doctor May Not Be Enough

Your family doctor knows a lot about primary care, but they might not be as familiar with the particulars of migraine. Here’s how a migraine specialist can help fill in the gaps and expand your care.

Migraine is a complex condition, and the medical community is constantly learning more about it.

In fact, like with other complex conditions, an entire field of medicine is dedicated specifically to migraine: headache medicine, practiced by neurologists or migraine and headache specialists.

Your family doctor or primary care physician belongs to a different specialty field. While these doctors are certainly capable of helping you with migraine, there are some limits to what they can do.

Let’s take a look at what a migraine specialist is, why a specialist is most prepared to treat migraine, plus how to find one.

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What is a migraine specialist?

Migraine and headache specialists are doctors who are experts in headache medicine, or the diagnosis and treatment of migraine and other headache disorders.

Many migraine and headache specialists train as neurologists first, although other types of physicians can also become certified in headache medicine.

Neurologists specialize in conditions that affect the brain and nervous system, including migraine.

The path to becoming a migraine and headache specialist typically looks like this:

• 8 years of undergraduate and medical school
• 1 year at an internal medicine internship
• at least 3 years in a neurology residency program
• board certification
• at least 1 year in a headache medicine fellowship

After a minimum of 13 years of medical and migraine training, aspiring migraine and headache specialists make things official by obtaining certification in headache medicine. From there, some certifying bodies also require yearly recertification.

As experts, migraine and headache specialists have extensive, in-depth knowledge about diagnosing, treating, and managing migraine.

They’re up to date on:

• migraine classification
• symptoms
• the latest treatments
• new and developing research

This makes them well-positioned to provide comprehensive migraine care.

Why should you see a migraine specialist?

Your family doctor or primary care physician (PCP) knows what migraine is, and they’re likely able to help with treatment in most cases. However, migraine and headache specialists know the ins and outs of migraine care, which means they may be able to provide the most comprehensive care.

At the cutting-edge

A migraine specialist is an expert in all things headache and migraine. They constantly monitor research to see what’s developing, what’s new, and what’s changed in order to give you the very best and most comprehensive migraine care.

Specialized treatment

Migraine and headache specialists may be the most well-positioned to help you get to the bottom of your unique case, diagnose your specific type of migraine, and develop an effective treatment plan tailored to your individual needs.

For instance, headache specialists usually receive referrals for refractory migraine, cluster headaches, and other circumstances when people can’t have usual migraine therapy.

Access to clinical trials

Your migraine specialist may also be participating in research trials and could potentially help you consider enrolling in a trial to try a newly developed therapy.

PCPs have a wealth of advanced knowledge, and they’re extremely capable of caring for your overall health and well-being. They can offer migraine solutions that work for most people.

That said, some cases may require a level of personalized care that a specialist is better equipped to provide.

Signs it’s time to seek a specialist

Signs it’s time to see a neurologist or migraine specialist include:

• Your migraine attacks suddenly become more severe.
• Your pain and attacks make it impossible to function day-to-day.
• You’ve developed sudden symptoms, like Visual disturbances and aura.
• The treatment plan you developed with your PCP is no longer providing effective relief.

Keep in mind, however, that a migraine specialist doesn’t replace other doctors, and it’s important to continue talking with your PCP about migraine. In fact, informing your various healthcare professionals about all the different aspects of your health can help you build a more robust migraine care team.

How to find a migraine specialist

If you’ve decided to expand your migraine care but aren’t sure how to find a specialist, try starting with your PCP. They may be able to refer you.

For those based in the United States, here are two tools to help you find a certified migraine and headache specialist by state:

• National Headache Foundation online search tool
• United Council for Neurologic Subspecialties online search tool (be sure to select “Headache Medicine” as the subspeciality)

If you’re planning an in-person visit, prep for what to expect at your first appointment.

If finding a local specialist proves difficult, many offer telehealth or virtual care over video or phone. According to research like this 2022 systematic review, headache telehealth consultations provide treatment that’s just as effective and safe as in-person consultations.

In other words, for people with migraine who otherwise lack medical access, telehealth can be a great way to receive quality, specialized migraine care.

Common migraine treatments

Migraine treatments fall into two categories:

• Preventive medications: Also called “prophylactic” medications, these aim to reduce the frequency and severity of migraine attacks.
• Acute medications: Also called “abortive” medications, these aim to relieve migraine symptoms as they occur.

Preventive migraine medications include:

• beta-blockers, which aim to reduce blood vessel dilation, calm the nervous system, and restore balance to neurotransmitter levels, among other things
• certain antidepressants, which aim to restore balance to neurotransmitter levels
• CGRP (calcitonin gene-related peptide) receptor agonists, a newer treatment that aims to block CGRP, a protein that may cause inflammation, pain, and worsen headaches
• topiramate or other anticonvulsants, which aim to restore balance to nerve activity

Acute migraine medications include:

• over-the-counter pain relievers (NSAIDs)
• anti-nausea medication
• triptans, which aim to relieve pain by reducing the dilation of blood vessels in the brain

A specialist will know all about these options, including newer ones like CGRP treatment. Sometimes, migraine specialists treat certain types of migraine with infusion therapy or other Interventional treatments, like intranasal oxygen.

Whatever type of healthcare professional you see, you and your doctors are a team. Together, you and your migraine care team can work toward finding the right treatment course to help you manage attacks and get symptom relief.

The takeaway

A migraine specialist is an expert in migraine and headache medicine.

Out of all the different types of doctors, including your family doctor, a migraine specialist is likely the most well-suited to give you the specific and specialized care you need.

Consider talking with your family doctor about finding a specialist and expanding your migraine care team. Connecting with a specialist could be the next step on your path to relief.