Headache clinics

What is a headache clinic?

This page explains the role of headache clinics in the management of migraine in adults, how to be referred, and what to expect when visiting a headache clinic.

For a list of specialist migraine and headache health services in the UK that are known to The Migraine Trust please scroll down to the map below.

A headache clinic specialises in the diagnosis and treatment of migraine and head pain. The clinics are often linked to a hospital neurology department and are directed by a consultant neurologist or doctor with a particular interest and expertise in migraine. They are usually staffed by multi-disciplinary teams.

A headache clinic will be able to confirm if your attacks are migraine, review your current treatment and suggest ways to manage your condition.

In addition to their own expertise on migraine types and treatments, clinic staff will often also be able to call upon the services of other experts.

We use the general term ‘headache clinics’ to group together different types of NHS headache services including:

• dedicated headache clinics
• children’s headache clinics attached to Departments of Neurology or Paediatrics
• neurology departments with an interest in migraine and headache
• GPs with a Special Interest in headache and migraine (GPwSI).

There is a growing number of new community-based services involving GPs with a special interest in migraine and headache. These are sometimes called ‘intermediate care’.

Does everyone with migraine need to attend a clinic?

Most people with migraine who ask for a doctor’s advice are cared for solely by their GP. Not everyone needs to see a specialist for migraine.

If you do not respond well to several treatments via your GP or if your migraine attacks are not being well managed, further investigation may be needed. The reasons your GP may refer you on to a specialist clinic include:

• doubt over the diagnosis of migraine
• the possibility that yours is a rarer form of migraine
• the presence of other headaches besides migraine that may complicate your diagnosis
• the treatment is not working well for you
• your migraine attacks or headaches are getting worse/more frequent
• your own request for the referral.

How can I be referred to a headache clinic?

All NHS headache clinics require a letter of referral from a medical practitioner before they accept a new patient. This is most likely to be from your GP but could be from a hospital doctor or other healthcare professional within the NHS.

Do the clinics have long waiting lists?

The number of new patients that a clinic can see depends very much on the number of staff they have and their opening times. The number of new patients that a clinic can see depends on the resources which have been allocated to it and most have a waiting list. For most people, the wait for the first appointment will take several months.

How should I prepare for my first visit?

Before you attend the headache clinic for your first appointment it is worthwhile to keep a diary of your attacks. Keeping a record of these can be very helpful in assisting the doctor to have a clear picture of what you are experiencing. This is also important because as there is no specific test to diagnose migraine, much will be based on your description.

Medication record

The doctor will need to know the names and doses of any medication you have tried before, including any supplements and complementary treatments (such as acupuncture, homeopathy).

What will happen on my first appointment?

Your first visit to a clinic is likely to last much longer than the time you would usually spend with your GP. The doctor at the clinic will need to take a detailed history about your condition, including your medicines (both prescription and over-the-counter drugs), any complementary or alternative remedies you are taking, when your migraine started and how often they occur. The doctor will also ask about the ways in which you have taken your drugs – whether they have been in tablet form or through inhalers, injections or suppositories.

You may have a physical examination. This may provide important clues for the doctor. An awkward posture or tenderness in the muscles at the back of the neck, for example, are important to note as they may be a contributory factor to your migraine. You may also be asked about your lifestyle (sleep, job, eating/drinking, living situation, hormones). During your first visit, do ask questions about your condition – this may save you unnecessary worries after your visit.

What treatment will I be offered?

The complex nature of migraine means that the treatments available are varied and differ from person to person. There is currently no cure for migraine.

Once the diagnosis of migraine has been confirmed, the clinic staff will be able to suggest ways in which you can manage the attacks. This may involve trying new medication, advice on lifestyle, suggestions on how to cope with your symptoms, and self-management of your migraine to help minimise its impact on your everyday life.

By analysing their lifestyle in detail, many people find ways to reduce the number of attacks and manage their condition effectively. This process can be quite complicated, as people rarely have just one trigger that results in a migraine. In many cases, there is a build up of trigger factors, which may include weather changes, changes in sleep patterns, missing a meal, and hormonal changes in women. Sometimes the attacks are simply due to the variable cycle of migraine and not to any specific triggers.

Certain treatments that can only be offered in a clinic or by a specialist include Botox, CGRP monoclonal antibodies, gepants for preventive treatment and GON block injections.

Follow up visits

It is not always possible to make a diagnosis of migraine during your first appointment. A diagnosis may only be reached after a series of visits and involve keeping of a detailed migraine diary. If it’s concluded that you do not have migraine, you may be referred to a centre that deals with your type of headache. After a few visits to a clinic, many people find that they do not need to return, as they can manage their own condition. You can of course be referred back again if the need arises.

After your visit the clinic will write to your GP to tell them about any treatment that has been suggested and keep them informed of any progress you make.

How can I find out about local clinics?

Below you will find a map of the NHS specialist migraine and headache health services in the UK that are known to The Migraine Trust.

This map is for reference only. The location points on the map may not be the exact locations for the hospitals. To access the ‘search bar’ function, to enable you to search by area, please expand the map on either your computer or phone. The blue markers indicate adult headache clinics. The red markers indicate child headache clinic.

There may be other NHS headache clinics not included on this map that your GP is aware of. If your area does not have a clinic, your GP may refer you to one in an area close by or to a general neurology department. Some clinics also take national referrals.

Our NHS headache clinics list is for information only. It shows where some NHS clinics are located that your GP may be able to refer you to. It is the policy of The Migraine Trust to include only NHS clinics in this list of migraine and headache health services. The Migraine Trust does not recommend any particular products or treatments for migraine, nor refer enquirers to specific health professionals, organisations or products.

If you have any questions or would like to make us aware of an NHS service not included on the map, please reach out to The Migraine Trust helpline.

Unless stated, all Headache Clinics provide the standard secondary care treatments, including Botox, CGRP mAbs and gepants.

(Details correct as of February 2025)

Some people may also consider seeing a private neurologist for assessment and treatment. There are many private clinics available. We do not list private clinics as we are unable to prioritise or recommend one clinic over another. We are also not able to verify the specialists, procedures or treatments for each clinic. We would recommend that if you are considering private treatment that you research the clinic and check the specialist’s medical credentials. You can speak with your healthcare team for guidance.

Do you run a headache clinic?

Health professionals can submit details of NHS headache services here.

About our information

This information has been written by The Migraine Trust Information and Support Services team. It has been reviewed by our panel of expert health professionals and people affected by migraine.

Our information has been awarded the PIF TICK quality mark for trustworthy health information.

If you have feedback on our information, please get in touch at: feedback@migrainetrust.org

References for our information are available on request.