Frequently Asked Questions

What is an aura?

An aura is a neurological symptom that is associated with a migraine headache either immediately preceding or during a migraine attack. It can last from 5-60 minutes. The most common aura is visual-seeing flashing lights, zigzag lines or losing part of your vision. However auras can also be sensory-such as a pins/needles feeling in the hand or face, motor-with weakness of a hand or arm or involve speech such as confusing or slurring words.

What is a trigger?

A trigger is something that predictably leads to a headache. Common triggers include stress or relaxation after stress, changes in weather, missing a meal, under or over sleeping, menstrual periods, certain types of foods like chocolate or soft cheeses. It is helpful to try to identify triggers by using a headache diary. Often times, there will be triggers that you can control and ones you can’t. However, by eliminating the controllable triggers, headache frequency can drop dramatically.

When should I see a doctor for my headaches and/or migraines?

You should seek medical attention if your headaches are moderate or severe in nature and are not responsive to over the counter pain relievers, or if you have headaches occurring more frequently than three times per month. You should seek immediate medical attention if you have a new onset of severe headaches, continuous headache over several days or a headache accompanied by other neurological symptoms, such as change in vision, numbness, and difficulty with speech or weakness.

What is a cluster headache? What causes it, and how can I treat it?

Cluster headaches are one-sided headaches with stabbing pain through the eye accompanied by eyelid drooping, eye tearing and/or nasal stuffiness/runniness that usually last from 15 minutes to three hours. Headaches typically come in "clusters" of attacks that can happen a few times a day for several weeks in a row. In between clusters the person does not experience any headaches at all. These in-between periods can range from months to years. A cluster headache is thought to come from a part of the brain that is in charge of circadian rhythms called the hypothalamus. Exactly how it creates the pain is unclear. Steroids can be helpful to decrease the frequency of the headaches and preventive medicine should be introduced into the regime. Additionally, oxygen or injectable sumatriptan can help stop an attack.

How can I treat my throbbing sinus headache?

Sinus headache usually refers to pain that is felt over the forehead and cheeks that is associated with nasal congestion or runny nose. However, if the pain is the primary complaint, most often this type of headache is actually a migraine. Only in the setting of an active infection where the primary symptoms are fever, cough and bloody thick nasal discharge, can headache be attributed to sinus infection. Chronic sinusitis is never a cause of headaches. There is a widespread misconception that pain over the forehead and cheeks is related to the sinuses. Migraines not only cause pain over the forehead and face, but can cause nasal stuffiness, eye tearing and runny nose. People who have frequent headaches involving the front of their head/face should not only be evaluated by an ear, nose and throat specialist but should also see a neurologist about the possibility of migraine.

What is a rebound headache?

Rebound headaches or “medication overuse headaches,” can occur when patients use rescue medications frequently. Medications such as ibuprofen, acetaminophen, butalbital containing products or narcotcis used more often than two times a week can actually cause more headaches. Caffeine especially in high quantities can also lead to more headaches. Even if you are using the mediction for a reason other than headache it can cause rebound headaches. The way to treat a rebound headache is to stop or at least significantly limit the overused medication, being careful to not just substitute in another medication. If you find that you are having headaches frequently enough you may need to consider a preventive medication which is safe to use every day.

Are there non-medication therapies for headaches?

Meditation, biofeedback and even acupuncture can be helpful non-medication therapies. Other useful treatments include:

  • Resting in cool dark room with an ice pack
  • Eating small, frequent meals throughout the day
  • Staying hydrated
  • Getting an adequate amount of sleep at night and maintaining a regular sleep schedule
  • Frequent exercise.

What medications can I take to stop my headache?

Abortive medications are those that you use when you get a migraine attack to stop the attack in its tracks. Examples of abortive medications include acetaminophen, ibuprofen and triptans. An effective abortive medication should take the headache away within two hours. Care should be taken not to overuse abortive medications.

How do I know if this headache is it a tension headache or migraine?

Tension headaches are everything that migraines are not-they are mild, can be both sides of the head and often feel like a band around the head or a pressure. While those with tension headache can have light sensitivity, sound sensitivity, nausea or vomiting at most only one of these is present and it is not a prominent part of the headache syndrome. They usually don't require treatment or are easily treated with over the counter pain relievers. Common triggers for TTH include stress, poor posture and depression.

My headache has lasted for hours and I am sensitive to light, what does this mean?

You likely have had a migraine. Migraines are moderate to severe headaches that are usually one sided, throbbing and associated with light/sound sensitivity and or nausea/vomiting. They are often worsened by routine activity (climbing the stairs) and improved with sleep. Other common symptoms of migraine include neck pain or stiffness, dizziness, fogginess and nasal congestion/eye tearing. They last anywhere from 4-72 hours. Migraine is a genetic condition that often it runs in families. A migraine can be treated with rest in a cool dark place, but often requires additional medication such as caffeine, ibuprofen, acetaminophen, a triptan and sometimes an anti-nausea medication.

Can children get migraines?

Absolutely about 5-10 percent of children get migraines. And more than 50 percent of those with migraine start having migraines before the age of 18. Migraines in children tend to be bilateral, shorter in duration (30 min-1 hour) and be very responsive to sleep. There are also certain things that children have that can be predictive or seen along with migraines such as recurrent stomach aches or vomiting, motion sickness, recurrent limb pain or dizziness.

What are preventative medications for headaches and migraines?

These are medicines that are taken every day to try to reduce the frequency of migraines, reduce the severity of migraines and/or make headaches easier to treat. Often times if you are having headaches more than six days out of a month preventive medications should be considered. There are no medications that were specifically designed for migraine prevention so those prescribed all have another use including antidepressants, antiseizure medicines and blood pressure medicines.

Contact Us

Tel: 212-241-7076
Fax: 646-537-8513

Center for Headache and Pain Medicine
The Mount Sinai Hospital
Faculty Practice Associates
5 East 98th Street, 7th Floor
Box 1139
New York, NY 10029

For billing questions, please call 212-987-3100