Keeping a Headache Diary
Record details about your headaches in a diary to pinpoint headache triggers and help your doctor make a diagnosis. Here’s how to keep your headache diary.
A headache diary can be a helpful tool for you and your doctor to pinpoint the cause of headaches. Sometimes called a “headache log” or “headache journal,” your headache diary can help identify:
- How often you have headaches
- How long they last
- Headache severity
- Associated symptoms
- Efficacy of treatments
Your headache diary can also show how headaches affect your life. Your doctor will use the information you record to help diagnose the type of headache you’re having and to see if treatment is working. A headache diary could be useful for most types of headaches, including tension, migraine and cluster headaches.
How do I create a headache diary?
There’s no “one-size-fits-all” for a headache diary. You can make one yourself by using a notebook with lined paper. If you know how, create a journal on your home computer or even with a handheld device that contains a word processing program. To give yourself plenty of room to work with, use one page of your notebook for each day. On the top of the page, create headings labeled:
- Time. Note the time of day or night the headache started as well as the approximate time the pain stopped.
- Headache details. Here’s where you specify:
- Location. Where on your head or face is the pain.
- Description of the pain. You might want to use words like “throbbing, pounding, splitting or stabbing.” Feel free to use your own words.
- Severity. Use a scale of 1 to 5, with 5 being the worst pain. Also write “disabling” if the pain prevents you from carrying out your usual activities.
- Associated symptoms. Were you nauseous? Did you feel sensitive to light? Any tears or sweating?
- Preceding symptoms. Think of how you felt or what you experienced minutes to one hour before the headache. This applies mostly to migraine headaches, which may have an “aura.” An aura often includes temporary changes in vision, such as the appearance of flashing lights or zigzag lines.
- Triggers. What seemed to bring on the headache? Include anything you ate or drank, skipping meals, odors, bright light, change in temperature, physical activities, stress, sleep deprivation or changes in sleep pattern or menstrual period.
- Medications. Record medication you took to relieve (or prevent) a headache. Include over-the-counter medications you take on your own, such as acetaminophen (Tylenol), plus drugs your doctor may prescribe. Specify the dosage as well.
- Relief. Did the medication help? Here you can also use a scale from 0 to 5, with 0 meaning no relief at all and 5 meaning complete relief.
How long do I need to keep a headache diary?
The American Headache Society suggests keeping a headache diary for a month before your office visit to gather useful information. Your doctor may also want you to continue the headache diary after your visit to see if treatment is helping.
How do I use my headache diary?
- Before your doctor visit. Leading up to your doctor visit, you’ll be collecting important information on your headaches. For example, you’ll know about triggers. Some common migraine triggers include foods containing the preservative MSG, chocolate or red wine. You can try to avoid anything that triggers your headaches.
- Your doctor visit and beyond. During your visit, your doctor will review your headache diary and use the information you’ve recorded to help diagnose your kind of headache. Over the weeks following your visit after starting medication, hopefully you will see for yourself fewer and fewer entries in your diary, a sure sign that treatment is helping. You may also notice that your pain severity scores are lower. Seeing more 1’s and 2’s instead of 3’s and 4’s is also a sign that your treatment is working.
When should I call my doctor?
Make an appointment to discuss your headaches if they are having an impact on your life. Also call your doctor if your headache pattern has changed or starts after age 50. Also see your doctor if headaches are frequent or if you are regularly taking over-the-counter pain medication to relive them.
Seek emergency medical care right away if you have a headache that:
- Follows a head injury
- Does not respond to treatment
- Starts during exercise
- Is accompanied by a fever, stiff neck, rash or new vision changes
- Is new and you have a history of cancer or HIV (the virus that causes AIDS)
Call 9-1-1 for:
- A sudden, very severe headache (the worst you’ve ever had)
- Headache linked to neurological symptoms, such as problems with vision, weakness, numbness, trouble speaking or walking, confusion, passing out or having a seizure