Skip to content
How It Works
Explore
Resources Ask a Question
Who It's For
Patients
Decode results, prep for appointments, weigh options.
Caregivers & advocates
Carry the research load for someone you love.
Providers & clinicians
Resources for patients in your practice.
Log In Ask a Question
PubMed This is a summary of 15 peer-reviewed journal articles Updated
Neurology

Building Your Care Team: Preparing for Success

At a Glance

To get the best migraine care, seek a board-certified headache specialist and bring a real-time headache diary to your visits. Being prepared with your treatment history and disability scores helps you partner with your doctor to access modern treatments and workplace accommodations.

Navigating the medical system with migraine can be a long and frustrating journey. Many patients find themselves undergoing unnecessary tests or cycling through ineffective treatments before they ever see a specialist [1]. Taking an active, informed role in your care is the most effective way to shorten this journey and ensure you receive modern, evidence-based treatment [2].

Finding the Right Expert

While many doctors treat headaches, a Headache Specialist is a neurologist or physician who has undergone additional training and certification specifically in headache medicine [3][4].

  • Vetting Your Doctor: When choosing a specialist, look for board certification from organizations like the United Council for Neurologic Subspecialties (UCNS).
  • Ask About 2024 Guidelines: A knowledgeable specialist should be familiar with the 2024 American Headache Society (AHS) updates, which state that CGRP-targeted therapies (like mAbs and gepants) are now considered first-line options [5][6]. If a doctor insists you must “fail” several older drugs first, they may not be following the most recent standards of care.

The Power of Prospective Tracking

The single most important piece of evidence you can bring to your appointment is a prospective headache diary. “Prospective” means you record your symptoms in real-time as they happen, rather than trying to remember them weeks later [7][8].

  • Why Memory Fails: Research shows that “retrospective recall” (remembering back) often significantly underestimates how many headache days you actually have [9][10].
  • How to Track: You can use dedicated smartphone apps (like Migraine Buddy) or a simple notebook. Your diary should include:
    • Frequency: Every day you have even a mild headache [11].
    • Medication Use: Every time you take a pill for pain (this helps identify Medication-Overuse Headache) [12][13].
    • Disability: Use a tool like the MIDAS (Migraine Disability Assessment) scale to track how many days migraine kept you from work, chores, or social events [14][15].

Preparing for Your First Visit

A first consultation is often brief. To make the most of it, bring a “Migraine Portfolio” that includes physical copies of the following:

  1. Your Prospective Diary: At least one month of daily tracking [11].
  2. Treatment History: A list of every medication you have tried for migraine, the dosage, how long you took it, and exactly why you stopped (e.g., “didn’t work” or “caused dry mouth”) [1].
  3. Imaging Reports: If you have had an MRI or CT scan of your brain, bring the written report from the radiologist, even if the results were normal [1].

Protecting Your Livelihood

Because migraine is a leading cause of disability, it can significantly impact your ability to work or attend school. During your visit, discuss whether your condition qualifies you for workplace accommodations (like modified lighting, flexible scheduling, or a quiet workspace) or protection under the Family and Medical Leave Act (FMLA). Having your specialist provide written documentation is a crucial step in protecting your career while managing your health.

By arriving with your data organized and your questions ready, you move from being a “reporter of pain” to a “partner in treatment.” This collaborative approach is associated with lower long-term healthcare costs and better control over your condition [2][8].

Common questions in this guide

How do I find the right doctor for my migraines?
Look for a neurologist or physician who is board-certified in headache medicine by an organization like the United Council for Neurologic Subspecialties (UCNS). These specialists have advanced training specifically in managing headache disorders.
Why is it important to keep a daily headache diary?
Tracking your symptoms in real-time is much more accurate than trying to remember them weeks later. A prospective diary helps your doctor see your true headache frequency, identify triggers, and spot potential medication-overuse issues.
Do I have to try older migraine medications before getting newer treatments?
Not necessarily. The 2024 American Headache Society guidelines state that newer CGRP-targeted therapies can be used as first-line options, meaning you may not need to 'fail' older, less effective medications first.
How can I protect my job if migraines cause me to miss work?
You can discuss workplace accommodations and the Family and Medical Leave Act (FMLA) with your headache specialist. Having your doctor provide written documentation about how migraine impacts you can help protect your career while you manage your health.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Are you board-certified in Headache Medicine, and how does your practice incorporate the 2024 AHS updates regarding CGRP-targeted therapies?
  2. 2.Based on my prospective diary, do I qualify for first-line preventive treatment without having to try older 'step-therapy' medications?
  3. 3.How often do you recommend we re-evaluate my treatment plan using my MIDAS (Migraine Disability Assessment) scores?
  4. 4.Do you have a preferred electronic diary app that you can review directly in my patient portal?
  5. 5.Could you provide documentation supporting workplace accommodations or FMLA for my condition?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (15)
  1. 1

    Migraine patients' journey until a tertiary headache center: an observational study.

    Peres MFP, Swerts DB, de Oliveira AB, Silva-Neto RP

    The journal of headache and pain 2019; (20(1)):88 doi:10.1186/s10194-019-1039-3.

    PMID: 31416424
  2. 2

    Association of neurologist care with headache expenditures: A population-based, longitudinal analysis.

    Ney JP, Sico JJ, Klein BC, et al.

    Cephalalgia : an international journal of headache 2018; (38(12)):1876-1884 doi:10.1177/0333102418762572.

    PMID: 29504480
  3. 3

    Comment: Headache medicine as an emerging subspecialty-Irony and reality.

    Robbins MS

    Neurology 2017; (88(13)):e124 doi:10.1212/WNL.0000000000003774.

    PMID: 28348127
  4. 4

    Procedural Headache Medicine in Neurology Residency Training: A Survey of US Program Directors.

    Robbins MS, Robertson CE, Ailani J, et al.

    Headache 2016; (56(1)):79-85 doi:10.1111/head.12695.

    PMID: 26352267
  5. 5

    Calcitonin gene-related peptide-targeting therapies are a first-line option for the prevention of migraine: An American Headache Society position statement update.

    Charles AC, Digre KB, Goadsby PJ, et al.

    Headache 2024; (64(4)):333-341 doi:10.1111/head.14692.

    PMID: 38466028
  6. 6

    Comprehensive preventive treatments for episodic migraine: a systematic review of randomized clinical trials.

    Vélez-Jiménez MK, Martínez-Mayorga AP, Rodriguez-Leyva I, et al.

    Frontiers in neurology 2025; (16()):1611303 doi:10.3389/fneur.2025.1611303.

    PMID: 40901671
  7. 7

    Headache providers' perspectives of headache diaries in the era of increasing technology use: a qualitative study.

    Minen M, George A, Lebowitz N, et al.

    Frontiers in neurology 2023; (14()):1270555 doi:10.3389/fneur.2023.1270555.

    PMID: 38322798
  8. 8

    Practical Experience with the Use of Electronic Headache Diaries and Video Consultations in Migraine Care from a Longitudinal Cohort Study.

    van der Arend BWH, Holwerda LJ, Verhagen IE, et al.

    Telemedicine journal and e-health : the official journal of the American Telemedicine Association 2024; (30(11)):2696-2703 doi:10.1089/tmj.2024.0105.

    PMID: 39007201
  9. 9

    Comparing prospective headache diary and retrospective four-week headache questionnaire over 20 weeks: Secondary data analysis from a randomized controlled trial.

    Miller VE, Faurot KR, Palssson OS, et al.

    Cephalalgia : an international journal of headache 2020; (40(13)):1523-1531 doi:10.1177/0333102420949180.

    PMID: 32799667
  10. 10

    Determining the Evolution of Headache Among Regular Users of a Daily Electronic Diary via a Smartphone App: Observational Study.

    Raffaelli B, Mecklenburg J, Overeem LH, et al.

    JMIR mHealth and uHealth 2021; (9(7)):e26401 doi:10.2196/26401.

    PMID: 34255716
  11. 11

    [The headache questionnaire of the German Migraine and Headache Society (DMKG) : A new tool to improve headache care].

    Ruscheweyh R, Gaul C, Dresler T, et al.

    Schmerz (Berlin, Germany) 2025; (39(3)):169-176 doi:10.1007/s00482-025-00870-0.

    PMID: 39948245
  12. 12

    An investigation of the effects of connective tissue massage in women with migraine: A controlled clinical trial.

    Toprak Celenay S, Coban O, Mete O, Karahan N

    Journal of bodywork and movement therapies 2023; (33()):112-119 doi:10.1016/j.jbmt.2022.09.008.

    PMID: 36775505
  13. 13

    Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications.

    Park JW, Chu MK, Kim JM, et al.

    PloS one 2016; (11(2)):e0149577 doi:10.1371/journal.pone.0149577.

    PMID: 26901341
  14. 14

    A new neuromodulation method in chronic migraine; non-ınvasive pulsed radiofrequency, a single-blinded, randomised, controlled trial.

    Perdecioğlu GRG, Ateş MP, Yürük D, et al.

    Irish journal of medical science 2024; (193(3)):1487-1493 doi:10.1007/s11845-023-03598-x.

    PMID: 38147268
  15. 15

    Does Mindfulness-Based Cognitive Therapy for Migraine Reduce Migraine-Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial.

    Seng EK, Singer AB, Metts C, et al.

    Headache 2019; (59(9)):1448-1467 doi:10.1111/head.13657.

    PMID: 31557329

This page provides educational information about preparing for migraine consultations and finding specialists. It is not a substitute for professional medical advice or formal legal guidance regarding workplace accommodations.

Get notified when new evidence is published on migraine disorder.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.