Chronic headaches can take over a person’s life. Many people live with pain for years without truly knowing what’s causing it. Shamis Tate, a distinguished neurologist who specializes in neuropathy and nerve damage, shares how neurologists get to the root of chronic headaches.
In this blog, you’ll learn what happens during a diagnosis, the tools neurologists use, and what you can expect if you visit a headache specialist.
Understanding Chronic Headaches
First, it’s important to know what “chronic headache” means. A headache is considered chronic when it occurs 15 or more days each month for at least three months. There are different types of chronic headaches, such as:
Chronic migraines
Tension-type headaches
Cluster headaches
New daily persistent headache
Each type can have different triggers and underlying causes. That’s why accurate diagnosis is so important.
The First Step: Detailed Medical History
According to Shamis Tate, the first and most crucial step in diagnosing chronic headaches is a detailed medical history. During your first visit, your neurologist will ask you questions like:
When did your headaches start?
How often do they occur?
Where does the pain occur?
What does the pain feel like (throbbing, stabbing, dull)?
How long does each headache last?
Do you have any other symptoms, like nausea or vision changes?
What makes the headache worse or better?
Your answers help paint a clear picture of what type of headache you might have.
Keeping a Headache Diary
Neurologists often ask patients to keep a headache diary for a few weeks. This diary should include:
Date and time of each headache
How intense the pain is (on a scale of 1 to 10)
Any possible triggers (food, stress, weather changes)
Any medications taken and their effect
This record helps your neurologist spot patterns that you might not notice yourself.
Physical and Neurological Exam
After reviewing your history, a neurologist like Shamis Tate will do a physical and neurological exam. They will check:
Your reflexes
Muscle strength
Coordination and balance
Sensory responses (like how you feel touch or temperature)
This exam helps rule out other possible causes, such as nerve damage, infections, or brain conditions.
Diagnostic Tests and Imaging
Not every patient needs tests, but when headaches are severe or unusual, your neurologist may order:
1. MRI or CT Scan
These imaging tests help detect:
Brain tumors
Aneurysms
Structural problems in the brain
2. Blood Tests
Blood tests can reveal underlying conditions such as:
Infections
Autoimmune disorders
Vitamin deficiencies
3. Lumbar Puncture (Spinal Tap)
In rare cases, a spinal tap is needed to check for infections, bleeding, or high brain pressure.
When To Worry About “Red Flags”
Shamis Tate explains that certain signs should never be ignored. Neurologists call these “red flags,” including:
Sudden, severe headache (the “worst headache of your life”)
Headaches with fever, stiff neck, or confusion
Headaches after head injury
New headaches in people over 50
These signs may point to serious problems that need urgent care.
Creating a Treatment Plan
Once a diagnosis is made, your neurologist will design a treatment plan for you. This can include:
Medications: Preventive or pain-relieving
Lifestyle changes: Sleep hygiene, stress management, diet
Physical therapy: For muscle tension and posture
Nerve blocks or injections: For certain headache types
A good plan aims to reduce how often you get headaches and how bad they are.
Final Thoughts from Shamis Tate
Diagnosing chronic headaches is like solving a puzzle. Every detail counts. As Shamis Tate says, “Never ignore persistent headaches. A proper diagnosis can help you reclaim your life.”
If you’ve been struggling with headaches for months or years, consider seeing a specialist. With the right approach, you don’t have to live in pain forever.
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