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Q. My migraine has been getting worse of late. What should I do?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 19, 2017

Hello doctor,

I am a 22 year old female. I have always suffered from migraines. Recently, it seems like it has been getting worse. Last year, I gave birth to my son vaginally. Now, when I lay on my abdomen or even turn my head, I notice a heartbeat sound in my ear. My nurse practitioner thought it was coming from my neck and sent me for physiotherapy. And, she checked my ears, but there was no wax. Do I need physiotherapy? Should I get a referral and maybe go to a specialist? Should I be worried about a possible hearing loss?

Dr. Sadaf Mustafa

General Medicine Internal Medicine


Welcome to

  • Do you feel like the throbbing or pulsating sensation in your ear becomes worse with the headaches or it is present even with no migraine?
  • I would also like you to explain your headache in a bit of detail.
  1. What are the triggers?
  2. Are they one-sided or on both sides?
  3. Is there nausea or vomiting?
  4. Do you feel like they are about to come on?
  5. How many attacks do you get in a month?
  6. How many times in a week have you taken anti-inflammatory agents like Excedrin Migraine, Ibuprofen or other similar compounds to get relief?

If it is a true migraine headache, you will need a preventive and abortive treatment. Also, this would decide whether you need the physiotherapy or not.

For more information consult an internal medicine physician online -->

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Thank you doctor,

I do not see any flashes of light nor have any smell issues. I do not have any weakness on any side of my body, just face pain, cheek pain, and pain in the sinuses that does not get relieved with medicines like Sudafed. Headaches can last from anywhere between eight hours to three days.

Dr. Sadaf Mustafa

General Medicine Internal Medicine


Welcome back to

  • This information makes a lot of difference. Please let your doctor know that you should be seen by a neurologist. You have a migraine headache. Meanwhile, you should maintain a headache diary to make a note of triggers like stress, cheese, foods, travel, etc. that provoke it.
  • You would also need a medication like Topiramate to prevent these headaches and an abortive therapy with Sumatriptan, assuming that you are not pregnant and breastfeeding. There are other options available as well.
  • Exercise will relieve stress and will help a lot. Physiotherapy will help as well but will not fix the underlying issue. The pulsating feeling could be due to stress, too much caffeine, soda, wine, alcohol, hyperthyroidism or the use of stimulants, all of which should be tracked and avoided.

I hope it helps. Take care and let me know if you need further assistance.

For more information consult an internal medicine physician online -->

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