NEW YORK (MainStreet) — Kerrie Smyres knows about headaches.  She has chronic migraines and headaches daily. No wonder she writes about them. 

Scott Noren, an oral and maxillofacial surgeon also suffers from frequent headaches.

Both have found relief with lifestyle changes. Smyres has modified her diet and takes a digestive enzyme when she eats. Noren has improved his posture during surgery and weight lifting. He’s also gone for massages and taken anti-inflammatory drugs when the pain has been severe.

Smyres and Noren are not alone in having to frequently deal with headaches. Some 12 million Americans a year visit their doctors complaining of headaches. Lost productivity and costs add up to an estimated $31 billion annually.

A new decade-long study by researchers from Beth Israel Deaconess Medical Center (BIDMC) of more than 9,000 doctor visits for headaches has found that doctors have been increasingly ordering advanced imaging tests and giving headache patients referrals to specialists, despite practice guidelines suggesting lifestyle modifications. CT scans and MRIs jumped from 6.7 % to 13.9% of visits for headaches between 1999 and 2010, the years the study examined.

Yet neither advanced imaging tests or referrals to specialists are considered to be of value for treating routine headaches, according to the researchers whose work was published online in the Journal of General Internal Medicine. The study also found counseling by the doctor decreased from 23.5% to 18.5%.

The results of the study suggest that some of the cost could be reduced by ordering fewer tests and counseling patients on the causes of headaches and on lifestyle changes, such as reducing stress and making dietary changes to avoid food triggers.

The data excluded doctor visits for headaches with serious underlying causes.

John N. Mafi, a fellow in the division of general medicine and primary care at BIDMC, said that the trend in ordering tests, prescribing medications and giving referrals is reflective of the overall trend in medicine to spend less time connecting with patients. He believes that one solution could be doctors and patients communicating electronically and wants doctors to promote this solution along with reimbursement by health insurance carriers.

While that strategy may save on costs associated with tests, it may increase costs for patients, which would, of course, be another headache for patients to endure.

—Written by S.Z. Berg for MainStreet