When The Doctor Gets It Wrong (And Why It Matters)
Misdiagnosis of migraine is common, depriving patients of proper treatment and relief.
For upwards of 80 percent of people with migraine symptoms, their first doctor encounter goes something like this: The patient raises the issue of headaches. The doctor asks about their symptoms, family history, administers a checkup, and at last gives a diagnosis not of migraine but of… sinus infection.
If that sounds familiar, you are far from alone. Studies have found a whopping 8 out of 10 people with migraine are initially misdiagnosed with sinusitis. And that’s just one of the health disorders migraine is confused for! An inaccurate migraine diagnosis is one of the many reasons why people with migraine experience crucial delays in getting treatment, and also a reason why some 28 million Americans living with migraine have never received a migraine diagnosis at all.
Reasons For A Missed Migraine Diagnosis
Why do doctors get the diagnosis wrong so often? Let us count the ways:
Because migraine wears many disguises.
Migraine is a disorder that manifests in so many ways that at first glance it can resemble all manner of other conditions. For example:
- Head and face pressure is often misdiagnosed as sinusitis or allergies
- Vestibular problems can be confused with inner ear disorders
- Visual aura could send you to the optometrist’s chair
- Aura that affects speech is confused for stroke
- Abdominal migraine or nausea could send you to a gastroenterologist
Because your doctor didn’t get much headache training. Although headache is among the most common patient complaints, most doctors get very little headache training in medical school––averaging only three hours of training, according to one study. Knowing only the basics, a primary care physician, gynecologist, or even a neurologist is not going to catch onto the telltale migraine clues that may be right there in the nuanced details of your symptoms or medical history.
Because you developed other health conditions along the way. You may have started out with typical migraine symptoms, but since migraine predisposes you to other health problems, you may have developed conditions such as depression, obesity, or sleep disorders, which obscures your health picture and makes doctors connect the dots differently.
Because there are more than 200 headache types. Even if a doctor makes it into the headache ballpark, that’s no guarantee they’ll be able to give you a correct migraine diagnosis. They may not know that there’s a type of headache that makes your belly ache, another that makes you garble your words, another that causes droopiness on one side of your body, even one that makes your tongue hurt––some of the 200-plus headaches compiled by the International Headache Society in its symptom and diagnosis guidelines.
Consequences Of Misdiagnosis
When a doctor mistakes your migraine for something else altogether, it places major burdens on your body, time, and wallet––not to mention creating a burden on the healthcare system.
You’re treated for a problem you don’t have. This might include office visits to see unnecessary doctors and dentists, taking unnecessary medications and withstanding their side effects, and undergoing unneeded and sometimes frighteningly sophisticated medical tests like MRIs and CT scans or even unnecessary surgeries.
Your untreated migraine continues. The months or even years your migraine continues to go unrecognized means more time spent in pain (including, perhaps, emergency room trips that could have been avoided), and more time missing out on healthy living.
Your headaches may get worse. The longer migraine continues untreated, the more likely it will increase in severity or frequency or become chronic, all of which makes it harder to treat. The more migraines you have, the more your brain rewires itself to be even more efficient at having migraines. More time spent in pain may also mean taking too much medication, putting you at risk for developing rebound headache (“medication overuse headache”).
Misdiagnosis of migraine is shockingly common. If after getting medical treatment you find your headache isn’t improving, do yourself a favor and ask your doctor to take a second look. Or get a second opinion from another provider. You may thank yourself later for having invested the effort in your own health.