This Neurologist Knows What It’s Like to Live with Migraine: What She’s Doing About It

A neurologist with migraine shares what she’s learned from personal experience, plus what she’s doing to help people with migraine gain critical access to care.

Dr. Sara Crystal is many things — a neurologist, a headache specialist, and a person who experiences migraine.

As both a migraine expert and someone living with the condition she treats, Crystal has a unique perspective on migraine.

Here’s how Crystal’s experience with migraine has informed her work as a neurologist, how she’s helping to expand access to migraine care, and her advice for finding a migraine healthcare professional.

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Dr. Sara Crystal’s migraine journey

Crystal is a specialist at the New York Headache Center, a migraine and headache treatment clinic, and the Medical Director at Cove, a telehealth migraine treatment company.

She started her career as a physical therapist, which set her on a path to neurology.

“Working with people with stroke sparked my interest in learning more about the brain and how it recovers after injury, and I decided to go to medical school,” she says.

She particularly loved her neuroanatomy class and neurology rotations.

“What could be more interesting than the brain?” she says.

Like millions of other people, including her patients, Crystal experiences migraine.

She first started experiencing headaches around age 13. She remembers going through testing but to no avail. At the time, she wasn’t diagnosed with migraine, and she was never prescribed medication for her pain.

It wasn’t until years later that she got her diagnosis, thanks to her time in medical training.

“As a medical student rotating in a Family Medicine clinic, my preceptor said my headaches were probably migraine,” Crystal recounts.

Her preceptor, a practicing doctor who helps train medical students, offered her a sample of migraine medication to try (triptan in this case), which worked wonders for her.

Coincidence, a stroke of luck, or neurological destiny — either way, getting this initial, informal diagnosis and trying migraine medication was life changing.

What it’s like to have migraine as a neurologist

Crystal’s perspective as a healthcare professional and someone with lived experience with migraine allows her to see things from both sides in a way not every doctor can.

“Living with migraine really helps me to be empathetic. Patients know that I get it,” says Crystal. “Even though every person with migraine has a different experience, it is comforting to patients to know that I will take their pain seriously and do everything I can to help.”

This is a relief for many migraineurs. Not everyone with migraine gets a diagnosis or finds the help they need — like Crystal during her teenage years.

The WHO estimated in 2016 that 60% of people living with migraine worldwide were undiagnosed. In the United States and the UK, even among those diagnosed, only 50% had seen a doctor for migraine or headache in the past year. The majority relied solely on over-the-counter medication for treatment.

It’s different with Crystal. Her professional expertise and personal experience make her particularly well-suited to helping people with migraine who are searching for treatment.

Patient reviews seem to point to this.

“One patient recently wrote: ‘She is the first doctor who is trying to get to the bottom of how to help me feel better,’” Crystal shares.

For another patient, Crystal helped create a treatment plan in just a few days, finally offering relief to someone who had been trying to find help for years.

Remembering her own path to diagnosis and treatment, Crystal notes that she wishes she knew sooner that there are so many medications to help manage migraine and treat symptoms, including for kids and teens.

That’s also part of what Crystal enjoys about neurology and migraine care: the wealth of treatment methods available to patients makes it particularly rewarding.

She adds, “Seeing people improve over time is so gratifying.”

How telehealth is filling a gap in migraine care

Crystal is helping to expand access to healthcare through telehealth. Here’s what that means.

What is telehealth?

Telehealth or telemedicine is remote healthcare provided through telecommunications systems like video conferences, apps, or the phone.

Telehealth has been steadily expanding into various medical fields, including migraine care.

That’s good news for people with migraine, partly because the United States has a shortage of headache specialists. That shortage affects certain states and certain demographics more than others.

Data from the United Council for Neurologic Subspecialities (UCNS), which certifies neurologists in different sub-fields, helps illustrate this shortage.

Some states have very few UCNS-certified migraine and headache specialists. According to the UCNS directory, states like Idaho, Montana, and North Dakota have fewer than five headache specialists as of early 2024. Wyoming has none.

While other types of neurologic specialists and primary care physicians are capable of treating people with migraine, they’re not as well-versed in the condition as migraine and headache specialists.

How is telehealth helping people with migraine?

Here’s where telehealth comes in.

Telehealth can offer virtual connection to headache specialists nationwide, providing easier access to quality care for people with migraine, including those with limited resources and those living in areas with few in-person options.

“I loved the idea of being able to help people living with migraine all over the country, especially those who would otherwise lack access to care,” says Crystal, who is UCNS-certified.

People from marginalized groups, including BIPOC (Black, Indigenous, and People of Color) and low-income communities, often have a harder time accessing healthcare, whether migraine care or general health services. Yet research shows that people from these same communities have high rates of migraine.

Crystal emphasizes that healthcare disparities restrict access to care. She says telehealth companies can provide specialized migraine care to people otherwise excluded, helping to bridge the gap by providing equitable care to people of color.

Studies like this 2022 systematic review have found that headache telehealth consultations are similar in quality to traditional in-person consultations when it comes to treatment efficacy and safety. Telehealth can also be more convenient and less expensive than in-person visits.

“Migraine is an ideal condition to treat via telehealth, as the diagnosis is made based on history and headache features, with imaging indicated only when red flags are present,” says Crystal.

A neurologist’s advice for finding migraine care

For those seeking a healthcare professional specializing in migraine, Crystal jokes: “Find a provider who also has migraine!”

While it isn’t necessary to find a professional with migraine, Crystal says that “it is important to find a professional who understands that migraine is disabling and is willing to work with you to help you find relief.”

She also stresses the importance of never giving up hope that you’ll find relief — a trap she knows all too well as a person with migraine herself.

“I have seen many patients over the years who have tried many treatments before they come to me and are so discouraged,” she says. “Just hearing that there are other options and that we will work together gives them hope.”

From her personal experience with migraine, Crystal also has a few words of wisdom for the loved ones of people with migraine.

“We desperately want to be present, but it isn’t always possible. Thank you for your patience and compassion and believing that we’re suffering from something that isn’t apparent from the outside,” she says.

The takeaway

Neurologist and headache specialist Sara Crystal knows what it’s like to navigate the world and the healthcare space while living with migraine.

Not only does she treat people with migraine, but she’s also working to expand migraine care by connecting people to specialists they couldn’t otherwise access.

Crystal’s unique perspective allows her to empathize with and support her patients even more, whether in person or through telehealth.