Migraine and Chronic Headache Treatment- Getting It Diagnosed and Treated Properly, and What It Costs
Migraine is one of the most common and most under-treated conditions there is, dismissed for years as "just headaches" when it is in fact a distinct neurological condition and, according to the World Health Organization, one of the leading causes of disability worldwide. Getting it treated properly starts with getting the diagnosis right, because headaches are not all the same: migraine, tension-type headache and the rarer cluster headache are different conditions with different treatments, and one of the commonest and most missed problems of all is medication-overuse headache, where frequent painkillers taken for headaches quietly become the cause of them. Beyond diagnosis, treatment has two halves that are often confused, treating the attacks you have and preventing the ones to come, and the last few years have transformed the preventive side, with the CGRP-targeted treatments and, for chronic migraine, Botox now offering relief to people who had run out of options. Underneath all of this sits the small but vital job of recognising the rare headache that is a warning sign and needs urgent assessment. A doctor-led assessment does all of this: the right diagnosis, the right treatment, and the safety net. At The Online GP by The Wellness in Marylebone, a GMC-registered doctor takes headache seriously and treats it properly. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Message us about migraine and headache treatment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Why migraine is more than "just a headache"
Because it is a neurological condition, not simply a bad head, and treating it as trivial is why so many people suffer needlessly for years. Migraine typically causes moderate to severe, often one-sided, throbbing head pain, made worse by movement and accompanied by sensitivity to light and sound, nausea and sometimes visual disturbance or aura, and an attack can last from hours to days and stop someone functioning entirely. It is not a character flaw or a low pain threshold; it is a genuine, disabling condition with a strong biological basis, and it disproportionately affects people in their most productive years.
The consequence of dismissing it is under-treatment. People soldier on with over-the-counter painkillers that do not touch a real migraine, never get a proper diagnosis, and never access the treatments that would actually help, all while attacks cost them work, plans and quality of life. Taking headache seriously, naming the condition correctly and matching it to effective treatment is the whole point of a proper assessment, and it is often a revelation to people who have been managing alone for years.
Getting the diagnosis right
Effective treatment depends entirely on the correct diagnosis, because the common headache types are treated differently. Migraine, with its throbbing pain, light and sound sensitivity and nausea, responds to specific migraine treatments. Tension-type headache, a more constant band-like pressure, is managed differently. Cluster headache, a rarer but excruciating one-sided headache around the eye occurring in bouts, is a distinct condition needing its own approach. Sorting out which you have, and often people have more than one type, is the first job.
The single most important and most missed diagnosis is medication-overuse headache. When painkillers or migraine medicines are taken too often, typically on more than a certain number of days each month, they can paradoxically start to cause headaches, creating a vicious cycle where more medication means more headache. Enormous numbers of people are trapped in this without realising it, and no preventive treatment works until it is recognised and the overused medication is carefully withdrawn. A doctor-led assessment specifically looks for this, because spotting it is frequently the thing that finally breaks a long-standing daily headache. Getting the diagnosis right is not a formality; it is where effective treatment begins.
Ask about getting your headaches diagnosed on WhatsApp or email team@thewellnesslondon.com.
The red flags that need urgent assessment
The great majority of headaches, including severe and frequent ones, are not dangerous, but a small number are warning signs that need urgent attention, and knowing them matters. A sudden, severe "thunderclap" headache that reaches maximum intensity within seconds, a new or different headache in someone over fifty, a headache with fever and a stiff neck, one accompanied by weakness, numbness, confusion, visual loss or difficulty speaking, a headache that steadily worsens over days or weeks, or one triggered by coughing, straining or that is worst in the morning, all warrant prompt assessment rather than routine management.
A doctor-led assessment includes this safety net: taking a proper history that screens for these features, examining you, and arranging urgent investigation such as a brain scan or immediate referral where anything points to a serious cause. Most people who worry about a brain tumour do not have one, and part of a good assessment is the reassurance that your headache pattern is a recognised, benign, treatable one, but the value of a doctor is precisely that they can tell the reassuring pattern from the rare one that needs action. If you ever have a sudden, severe headache unlike any before, treat it as an emergency and seek urgent care.
Treating it: the attacks, and the overuse trap
Treatment has two distinct halves, and getting both right matters. For the attacks themselves, acute treatment aims to stop a migraine quickly: the migraine-specific medicines, the triptans, work for many people where ordinary painkillers do not, taken early in an attack, alongside anti-sickness medication where nausea is prominent, and newer acute options exist for those who cannot use or do not respond to triptans. Matching the right acute treatment to you, and using it correctly and early, transforms how much an attack costs you.
The crucial caution, running through all acute treatment, is not to overuse it. Because acute medicines taken too frequently cause medication-overuse headache, there is a limit to how many days a month they can safely be used, and a doctor sets that boundary clearly and watches for it. This is exactly why frequent migraine is not solved by simply taking more acute medication, and why, once attacks pass a certain frequency, the focus shifts to prevention. Understanding the overuse trap is central to treating migraine well, and it is where self-management most often goes wrong.
Prevention, and the treatments that changed migraine care
When migraine is frequent, prevention becomes the priority, because reducing how often attacks happen matters more than treating each one. Preventive treatment includes identifying and managing triggers, lifestyle measures around sleep, hydration, caffeine and stress, and a range of daily preventive medications originally developed for other conditions that reduce migraine frequency. These help many people, and finding the right one, at the right dose, given long enough to work, is part of a proper plan.
The bigger change is in the newer treatments that have transformed care for those who did not respond to the older options. The CGRP-targeted treatments, injections or tablets that block a specific molecule involved in migraine, were designed specifically for migraine prevention and have given relief to people who had exhausted everything else, and for chronic migraine, defined as headache on fifteen or more days a month, Botox given as a course of small injections to set points around the head and neck is a licensed, effective preventive treatment. These are specialist-initiated, so a doctor-led assessment optimises the standard approach first, confirms whether you meet the criteria, and refers into neurology for CGRP treatment or arranges Botox for chronic migraine where it is warranted. For people who had been told nothing more could be done, these options are genuinely life-changing.
What does migraine assessment and treatment cost in London
Investigated privately, headache care ranges from a consultation to specialist neurology with advanced treatment. A consultant neurologist runs from £400 or more before any test, a brain MRI where it is indicated commonly costs £350 to £700, and the newer preventive treatments, CGRP medicines and Botox for chronic migraine, are ongoing specialist costs. Meanwhile people spend a great deal, and a great deal of wellbeing, on over-the-counter painkillers that never treat the real problem and can worsen it.
At The Online GP by The Wellness the assessment is doctor-led and gets to the diagnosis and the plan. A doctor consultation and examination is from £220 in person, £150 by video and £59 by telephone, with blood tests where relevant to exclude contributing factors from £295, acute and preventive treatment prescribed and reviewed, medication-overuse headache identified and managed, and referral into neurology for a brain scan, CGRP treatment or Botox for chronic migraine where warranted. Many patients have a workplace wellness allowance or private medical insurance that covers this, and we provide an itemised invoice for reimbursement. The figure that matters is the cost of a correct diagnosis and effective treatment, rather than years of painkillers that do not work.
Why The Online GP by The Wellness is the best place in London for migraine and headache
Because headache is treated well only when it is diagnosed correctly, treated on both fronts, and kept safe, and that is how this works. A GMC-registered doctor takes your headaches seriously, distinguishes migraine from tension-type, cluster and the frequently missed medication-overuse headache, screens for the rare red flags that need urgent investigation, and builds a plan that treats the attacks without falling into the overuse trap and prevents them where they are frequent. Where the standard approach is not enough, the newer treatments that transformed migraine care, CGRP medicines and Botox for chronic migraine, are accessed through prompt referral or arranged where appropriate rather than leaving you to struggle. The clinic is in Marylebone three minutes from Baker Street, the doctors are multilingual, and headache is treated as the disabling, treatable condition it is. For something this common and this under-treated, a proper diagnosis and a real plan are what matter.
Book a migraine assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What is the best place in London for migraine treatment
The Online GP by The Wellness in Marylebone, where a GMC-registered doctor diagnoses the headache type correctly, identifies medication-overuse headache, treats the attacks and prevents frequent ones, and refers for CGRP treatment or Botox for chronic migraine where warranted. A doctor consultation is from £220.
How do I know if I have migraine or just headaches
Migraine typically causes moderate to severe, often one-sided throbbing pain with sensitivity to light and sound, nausea and sometimes aura, worse with movement, whereas tension-type headache is a more constant band-like pressure. A doctor makes the diagnosis, which is where effective treatment begins.
Can painkillers make my headaches worse
Yes. Taking painkillers or migraine medicines too often, typically more than a certain number of days a month, can cause medication-overuse headache, a common and missed problem where the medication becomes the cause. No prevention works until it is recognised and the overused medication is carefully withdrawn.
What are the new treatments for migraine
The CGRP-targeted treatments, designed specifically for migraine prevention, have helped people who had exhausted other options, and for chronic migraine, headache on fifteen or more days a month, Botox given as a course of injections is a licensed preventive treatment. These are specialist-initiated, so a doctor refers or arranges them where warranted.
When is a headache an emergency
A sudden, severe "thunderclap" headache, a new headache over fifty, one with fever and a stiff neck, or with weakness, numbness, confusion or visual loss, or one steadily worsening, all need urgent assessment. If you have a sudden severe headache unlike any before, treat it as an emergency.
How much does migraine treatment cost in London
A consultant neurologist runs £250 to £400 or more, with a brain MRI £350 to £700 where indicated and newer treatments an ongoing specialist cost. At The Online GP by The Wellness a doctor consultation is from £220, with treatment prescribed and reviewed and referral for advanced treatment where warranted.
The Online GP by The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic, three minutes from Baker Street. All doctors are GMC-registered. Brain imaging, CGRP treatment and Botox for chronic migraine are arranged through the specialist neurology pathway. This article is general information and not a substitute for medical advice. If you have a sudden, severe headache unlike any before, or a headache with weakness, confusion, visual loss, fever and a stiff neck, seek urgent medical care.
Enquire on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE guidance on headaches in over-12s, including diagnosis, medication-overuse headache, and prophylaxis. NICE and specialist guidance on CGRP treatments and on botulinum toxin for chronic migraine. World Health Organization and The Migraine Trust information on migraine prevalence and disability. Published 2026 London private neurology and brain MRI pricing.
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