Headaches & Migraines
Headache & Migraine Care at UVM Health
A headache is pain anywhere in the head. Most people experience occasional headaches, and most headaches don’t need medical attention. However, some headaches, such as migraines, can interfere with daily activities. Others can signal a serious health condition.
At University of Vermont Health, our neurologists have decades of experience treating all types of headaches, including migraines, tension headaches, cluster headaches, vascular headaches and facial pain. You receive advanced, comprehensive care, delivered with compassion.
Why Choose UVM Health?
As one of the region’s leading providers of headache and migraine care, we offer:
- Comprehensive diagnosis and treatment plans: Your care team listens to you carefully and conducts advanced tests to understand the source of your headaches. You work with your neurologist and your other providers to develop a customized treatment plan.
- Internationally known specialists in headache and migraine care: Our board-certified neurologists have completed additional training in headache and migraine diagnosis and treatment. Decades of experience inform their approach to care.
- Academic focus: Our physician-leaders are active researchers, many of whom are training the next generation of experts. You can feel confident that your care is backed by the latest evidence-based practices.
Types of Headaches
Headaches may affect one or more areas of your head. You may feel like something is squeezing your head or experience sharp, dull or throbbing pain.
Headaches can come on quickly or gradually and last from a few minutes to multiple days.
Most headaches are not dangerous, but new persistent or severe headaches or a worsening of your typical headache pattern should be evaluated as they could signal a serious underlying condition.
Experts have classified more than 150 types of headaches, usually by their symptom or cause. The most common headache types include:
Primary headaches are headaches without an underlying disease or condition. While painful, they usually aren't dangerous. Our experts treat all types of primary headaches, including:
- Cluster headaches: These recurring, debilitating headaches are short in duration but occur multiple times a day for a period of days or weeks. You may experience a watery eye or nasal congestion on the painful side of your head.
- Migraine headaches: These recurring, throbbing headaches can last from a few hours to a few days and are usually on one side of your head. Migraines are a genetic condition that can be triggered by hormones, stress, certain food and drink and lack of sleep. Symptoms can include nausea, vomiting and sensitivity to light and sound. Some people experience a migraine aura before their other symptoms. Auras usually cause temporary vision problems or tingling on one side of the body.
- New daily persistent headache (NDPH): This headache doesn't go away, despite common treatments. Your pain can be moderate to severe, and the constant pain can disrupt everyday life.
- Tension headaches: These are the most common type of headaches, usually caused by stress or tight muscles. You may feel dull pain on both sides of the head or squeezing pain around your whole head. You may also experience pain at the back of your head and neck.
Secondary headaches result from other conditions, lifestyle factors or environmental triggers. These headaches can sometimes signal a serious, underlying condition.
There are numerous causes of secondary headaches, including:
- An injury, such as a concussion or car accident
- Environmental exposures to allergens and irritants
- Hormonal changes such as pregnancy or menopause
- Illnesses such as viral or bacterial infections
- Other health conditions that impact structures of the head or neck
- Pain medication overuse
- Stress or changes in routine
Lifestyle changes may improve both primary and secondary headaches. This can include reducing or eliminating alcohol and caffeine, drinking 68 ounces of water daily and establishing a good routine for sleep and meals. Getting moderate exercise for at least 150 minutes a week and reducing stress may also improve headaches.
Contact your doctor or go to your hospital's emergency department right away if you or a family member have:
- Sudden or severe headache
- Headache combined with:
- Confusion or difficulty understanding people talking to you
- Difficulty seeing, talking or walking
- Fever greater than 102°F
- Nausea or vomiting (if not clearly due to the flu or a hangover)
- Numbness, weakness or paralysis on one side of your body
- Unexplained neck pain
- New headaches for people older than 50 and younger than six
Diagnosing Headaches & Migraines
Gathering information about your headaches is essential to determining their type and cause. Your doctor meets with you in person or by video to ask about your medical history, lifestyle and family history.
Your doctor may ask you to maintain a headache diary to record:
- When a headache started and its intensity
- Potential food triggers, including caffeine or alcohol
- Stress
- Changes in routine, particularly sleep, meals or exercise
- What, if any, medication you took to treat it
- If the medication worked
At an in-person appointment, your doctor completes a thorough physical examination and may order:
- Blood and urine tests: Abnormalities in your blood or urine can signal certain underlying health conditions.
- Eye examination: An ophthalmologist or optometrist may detect eye conditions contributing to headaches.
- Computed tomography (CT) scan: X-rays and advanced computers create 3D pictures of cross-sections of your neck and head.
- Magnetic resonance imaging (MRI): Magnets and a specialized computer work together to provide detailed images of your neck and head.
Headache & Migraine Treatment
Our headache experts work with you to develop a personalized treatment plan that meets your specific needs. Your headaches may need acute or preventive treatment that you receive at home or in a clinic. If your headaches are severe, you may need to receive care in one of our urgent care centers or hospitals.
Therapies include:
- Acute therapy, including trigger point injections, nerve blocks, and non-narcotic medications
- Preventive therapy, such as medications, Botox injections, physical therapy and acupuncture
- Mind-body approaches such as cognitive behavioral therapy, meditation and relaxation
- Lifestyle changes, including dietary modifications
For severe headaches, intensive inpatient treatments can include:
- Medications by mouth and infusion
- Medication injections, including nerve blocks and trigger point injections
- Stellate ganglion block, in which your doctor injects an anesthetic into a bundle of nerves in the neck (stellate ganglion)
Support Groups
Support groups connect people facing similar challenges. We can help you connect with support groups focused on cancer, dementia, bereavement, diabetes, mental health and more.
Patient Resources
- American Migraine Foundation: Patient support, advocacy and research for patients with migraine and other disabling diseases that cause severe head pain.
- UpToDate - Headache Treatment: Patient education about headache types and treatments.
Locations Near You
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89 South Williams Street
Burlington, VT 05401-3405
111 Colchester Avenue
Main Campus, East Pavilion, Level 5
Burlington, VT 05401-1473
15 Degrandpre Way
Plattsburgh, NY 12901
111 Colchester Avenue
Main Campus, East Pavilion, Level 4
Burlington, VT 05401-1473
1 South Prospect Street
Arnold, Level 2
Burlington, VT 05401-5505
130 Fisher Road
MOB-A Suite 1-6
Berlin, VT 05602-9000
