Practical guide
Make a Headache Diary Useful at Your Next Visit
A simple record of timing, symptoms and medicines can give a clinician a clearer picture than memory alone.
Start with a record you can maintain
Recurring headaches can be difficult to describe weeks after they happen. A notebook, calendar or private digital document can provide a place to collect the details. The Migraine Trust recommends keeping the record simple so it is practical to continue. Choose a format you can bring to an appointment without searching across several apps. Ask your clinician whether a particular template or observation period would be useful for the questions you are trying to answer together.
Record the attack and its effects
Write the date, approximate start time, duration and severity. Note symptoms accompanying the pain, such as nausea or sensitivity to light and sound. Use the same severity scale consistently so entries are easier to compare. Include what the episode prevented you from doing, such as finishing a work shift or taking part in a planned activity. A short, factual description is more useful than trying to produce a perfect narrative while you feel unwell.
Include medicines and relevant context
Record which medicine you took, when you took it and any additional dose, along with whether it helped or caused unwanted effects. Note possible context such as changes in sleep, meals or menstrual timing when relevant. These observations can support discussion, but a diary alone cannot prove what caused an attack. Avoid making sweeping dietary restrictions or changing prescribed treatment on the strength of a single entry. Bring suspected patterns to the clinician for interpretation.
Use the diary to ask better questions
At the appointment, discuss how often headaches occur, how much they disrupt your life and whether the treatment plan is working. NHS guidance advises medical review when migraine attacks are severe, worsening or difficult to control. Frequent painkiller use also deserves discussion because it can contribute to further headaches. Tell the clinician about both prescription and nonprescription medicines. Ask which changes should prompt a call before your next scheduled visit and what information to keep recording.
Do not wait to document an emergency
A diary is a tool for ongoing care, not a reason to postpone urgent assessment. Seek emergency help for a headache that begins suddenly and is extremely painful, or headache with new weakness, difficulty speaking, confusion, seizure or sudden vision loss. In the United States, call 911 for emergency symptoms. A new or unusual pattern also needs clinical attention rather than an assumption that it is your usual migraine. Once urgent needs are addressed, the record can help support the longer conversation about care.
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