Optimising primary headache management.

Despite the fact that headache is one of the commonest of medical complaints seen in practice, most headache patients continue to be suboptimally managed. Probably because recent advances in the field of headache are written about more in specialty journals, many physicians even today feel that nothing much can be done for their headache patients! And, since more than 90% of headaches seen in practice are primary headaches, we need to realize that there is enough evidence now to show that primary headaches are a potentially treatable biological problem. It is therefore important that we do not err in the diagnosis and choice of the right drug options. This article discusses some of the reasons for suboptimal management of primary headaches and suggests measures to avoid these 'Pitfalls'. Secondary headaches where there is an underlying cause identifiable on examination or investigation are outside the scope of this review.