A migraine is a complex neurological condition characterized by episodes of moderate-to-severe head pain. This pain is often throbbing or pulsating and typically affects one side of the head. The attack commonly involves debilitating symptoms such as severe nausea, vomiting, and extreme sensitivity to light and sound. When an acute attack becomes unmanageable at home, the decision to seek professional help should be guided by symptom severity and the presence of alarming indicators suggesting a more serious health crisis.
When Urgent Care Is Appropriate for Migraines
Urgent care provides an appropriate level of treatment when a migraine attack is severe but does not present with life-threatening symptoms. This is the right choice when the pain level is debilitating, often rated 7 to 10 out of 10, making it impossible to function normally. An urgent care visit is warranted if your usual at-home abortive medications have failed to relieve the pain. You should also consider urgent care if the migraine attack has persisted for an unusually long duration, such as more than 24 to 72 hours, and shows no signs of improvement. Severe, persistent nausea and vomiting that prevent you from keeping down food or fluids are a clear reason to seek help due to the risk of dehydration.
Warning Signs That Require the Emergency Room
Certain symptoms accompanying a migraine indicate a medical emergency requiring immediate evaluation in an emergency room. The most alarming sign is the “thunderclap headache,” which is pain that reaches its maximal intensity within sixty seconds, potentially signaling a condition like a subarachnoid hemorrhage. Any new or sudden-onset neurological symptoms, especially those you have not experienced before, should prompt an immediate trip to the ER. These include sudden weakness or numbness on one side of the body, difficulty speaking, slurred speech (mimicking a stroke), vision loss that does not quickly resolve, confusion, or a severe change in mental status. Additionally, a high fever or a stiff neck could point toward a serious infection such as meningitis, and you must bypass urgent care if the headache followed a recent head injury, seizure, or loss of consciousness.
What to Expect During an Urgent Care Visit
Upon arrival at urgent care for a severe migraine, the initial steps involve triage to assess your overall condition and rule out any immediate threats. A provider will conduct a focused neurological exam, checking your vitals, reflexes, and cognitive status to ensure your symptoms are consistent with a typical, severe migraine and not an ER-level emergency. Once a serious condition is ruled out, treatment focuses on rapidly stopping the acute attack, often using intravenous (IV) or intramuscular injections. This typically includes a non-steroidal anti-inflammatory drug (NSAID) like Ketorolac to reduce inflammation and pain, alongside an anti-nausea medication such as Zofran or metoclopramide, and IV fluids may be administered to correct dehydration. The goal of urgent care is to stabilize the acute migraine, offering relief so you can return home, but it does not provide long-term preventative care.