| Summary: | Many non-specialist healthcare professionals can find the diagnosis of headache difficult, and both people with headache and their healthcare professionals can be concerned about possible serious underlying causes. This leads to variability in care and may mean that people with headaches are not always offered the most appropriate treatments. People with headache alone are unlikely to have a serious underlying disease. Comparisons between people with headache referred to secondary care and those treated in primary care show that they do not differ in terms of headache impact or disability. Many people with headache do not have an accurate diagnosis of headache type. GPs lack confidence in their ability to diagnose common headache disorders. They can feel under pressure to refer people for specialist opinion and investigation. Most common headache types can be diagnosed on clinical history and can be managed in primary care. If specialist advice is needed on headache diagnosis and management this can be provided by a neurologist with an interest in headache or a GP with a special interest (GPwSI) in headaches, or for young people under 18 years of age; a general hospital or community based paediatrician or paediatric neurologist. Within this guideline the term specialist is used to mean either a neurologist, GPwSI, paediatric neurologist or paediatrician with a special interest in headache. This guideline does not cover secondary headaches that require more specialist management, for example headaches that are due to an underlying infection (e.g. meningitis) and cervicogenic headache. Facial pain and occipital neuralgia are also beyond the remit of this guideline
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