National Institute for Health and Clinical Excellence (NICE)
Printable version E-mail this to a friend

New standard could improve diagnosis and management of headaches

A new quality standard could help healthcare professionals improve the diagnosis and management of the most common types of headache disorders.

Headaches are among the most common complaints seen by GPs and neurologists, with an estimated 25 million days lost from work or school due to migraine each year.

They tend to be categorised under two forms - primary headaches, which may be tension-type headaches or migraine attacks; or secondary headaches caused by underlying disorders such as neck injury or stroke.

The most common forms of headaches healthcare professionals can expect to see are caused either by primary headaches, or by medication overuse headache, which is where a person experiences a headache through using too many over-the-counter medicines.

NICE's quality standard on headaches contains five statements that together aim to improve the diagnosis and management of headache disorders in people aged 12 or older.

The standard says that people diagnosed with primary headache disorder should have their headache type classified as part of their diagnosis. This will allow them to receive appropriate treatment and prevention for their headaches.

Since some people might have more than one headache disorder, and consequently more than one classification, accurate classification and treatment may reduce referrals for unnecessary investigations and improve quality of life.

The quality standard also recommends that people with a primary headache disorder are given information on the risk of medication overuse headache, in order to help prevent the occurrence of these secondary headaches.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "It is important for people to understand that different headaches require different treatments, and so a correct diagnosis is vital.

"People may not know that overusing some types of medication for treating tension-type headaches or migraines can actually make things worse, causing further pain. This standard aims to raise the bar in the care and support for people with headache and migraine."

Sam Chong, Consultant Neurologist at King's College London, and member of the committee which developed the quality standard, said: "Headaches and migraine can be debilitating and distressing for those affected. Effective management of headaches depends on making a correct diagnosis and agreeing an appropriate treatment plan.

"Medication overuse headaches are a common problem; I hope this quality standard will go some way in raising awareness of this, and ensure that people with headache and migraine are getting the right treatment."

Joanna Hamilton-Colclough, Director of Migraine Action, added: "We believe the standard is essential as part of the continuing process of recognising the huge impact of headache, both on individuals and wider society, and ensuring that those affected are informed about and have access to the most appropriate treatments based on current evidence, no matter where in England they are treated."


Facing the Future...find out more