How long should I keep a headache diary before my appointment?

NICE recommends that, if a headache diary is used to help diagnose a primary headache, the person records for a minimum of 8 weeks. ICHD-3 says that at least one month of day-by-day records is generally needed to characterize frequent headache. If your appointment is sooner, bring what you have and ask your doctor how long to continue.

Facts checked on · Written by Alfonso Matos, the developer of MyGrain.

What the guidelines say about duration

NICE guideline CG150 says to consider using a headache diary to aid the diagnosis of primary headaches and, if one is used, to ask the person to record for a minimum of 8 weeks. For menstrual-related migraine, it says to diagnose using a headache diary for at least 2 menstrual cycles. ICHD-3 states, in its description of chronic migraine, that characterizing frequently recurring headache generally requires a diary recording pain and associated symptoms day by day for at least one month. These are minimums given for diagnosis; your own doctor may ask for something different.

What to record each day

NICE lists what the diary should include: the frequency, duration and severity of headaches, any associated symptoms, all prescribed and over-the-counter medications taken to relieve headaches, possible precipitants, and the relationship of headaches to menstruation. ICHD-3 also notes that if you have an aura, an aura diary after an initial consultation may clarify the diagnosis, and that people who use several drugs but cannot give an account of their names and quantities need diary follow-up.

Keep it going after the first visit

NICE also says to consider a headache diary to record the frequency, duration and severity of headaches, to monitor the effectiveness of headache interventions, and as a basis for discussion with the person about their headache disorder and its impact. So a diary is useful before the diagnosis and afterwards. ICHD-3 also asks for a diary day by day when headaches are frequent.

If the appointment is soon

If your appointment comes before then, bring what you have, with dates, durations, symptoms and medication, and tell your doctor how long it covers. In MyGrain you log each episode with its type, intensity, duration, symptoms and treatments, see the days on a calendar and take that record to your appointment. MyGrain does not diagnose; only a doctor can diagnose and decide how long you need to keep recording.

Frequently asked questions

Is 8 weeks a rule?

It is a NICE recommendation for when a headache diary is used to help diagnose a primary headache: ask the person to record for a minimum of 8 weeks. Your doctor may ask for a different period.

Do I have to record on days without a headache?

ICHD-3 refers to day-by-day records of pain and associated symptoms for frequent headache, so logging headache-free days gives a complete count of headache days.

What should I include besides the pain?

NICE lists associated symptoms, all prescribed and over-the-counter medications taken, possible precipitants and the relationship of headaches to menstruation.

Should I stop the diary once I have a diagnosis?

NICE says to consider a diary for all headache disorders to record frequency, duration and severity, to monitor the effectiveness of interventions and as a basis for discussion with your doctor.

Sources

NICE guideline and classification criteria, re-read on .

Medical disclaimer. MyGrain is a self-tracking diary, not a medical device. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or another qualified health professional with any question about a medical condition.
Download on theApp Store Get it onGoogle Play

More guides