Help! I have a migraine
6/12/2023 by Nathan Young, D.O.
Migraine is one of the most common and debilitating conditions we care for in primary care. Thousands of office visits per year are focused on evaluating and treating migraine headaches. Their impact on quality of life, function, work and leisure activities can be tremendous.
Suffering from a migraine is not like a broken bone that heals predictably over time but instead can be unpredictable, frequent and just as disabling. A migraine is a biological disease that probably has genetic underpinnings. Migraine patients face a lot of unnecessary stigmas. A migraine is not due to a lack of resiliency or ability to manage stress or emotion. The migraine patients we care for every day are very resilient and are usually trying to live busy, active lives.
Migraine headaches are typically experienced as throbbing, pounding headaches that are often worse on one side. Migraines are usually accompanied by sensitivity to light, sound, smell and motion, as well as nausea. The pain usually goes on for more than four hours and can last days.
Thankfully, there are many evidence-based treatments for migraine, and the list of options continues to grow. Most treatments can be provided by your primary care team, although some may require consultation with a neurologist.
In primary care, we are working hard to improve migraine care and make it more convenient and affordable for our patients.
All clinicians at Mayo Clinic may order the migraine e-learning module for their patients. This is a self-paced online learning module full of helpful content from Mayo headache experts. You will need access to the Mayo Clinic patient portal to access the module. If you do not have a portal account, you can sign up here. Ask your primary care team for an order.
Keep in mind that when you see your primary care clinician, they have access to telephone or electronic advice from neurologists in the Integrated Community Specialty (ICS) clinic where the full range of migraine treatments may be prescribed. Formal face-to-face consults are available in ICS as well as the headache subspecialty clinic.
If your condition leads to an ICS visit, we will develop an individualized migraine care plan. We have learned from patients that they want a plan as well as the ability to contact us via portal or telephone as they progress along the plan. The ICS team can help you follow your treatment plan until you are stable and satisfied. Your primary care team can then help continue with the long-term care plan.
Within ICS we have developed a way for you to use the Mayo app on your smartphone to assess and monitor your migraine. This approach is called the Migraine Interactive Care Plan. The data you share about your headaches goes into your chart and can replace other headache trackers you may be using. We don't actively monitor the data, but if you are not well, we can use your information to justify the next step in a care plan. You can also see and track your own progress with additional education that is delivered through the app. This helps ease communication with your care team. We hope to begin offering this interactive care plan in primary care in late 2023.
Nathan Young, D.O., is a community neurologist with a special interest in migraine care. He sees patients in the Integrated Community Specialties practice that supports Rochester-based primary care teams. He is also the chair of Community Neurology for the Mayo Clinic Health System.