health topics

When Should I Worry About a Headache?

Signs that a headache is something more serious include major changes in the pattern of your headaches, headaches that get steadily worse, an unusually severe headache (“the worst headache of your life”), head pain that increases with coughing or movement, headache after a blow to the head, headache that interferes with normal daily activities, and others.
Signs that a headache is something more serious include major changes in the pattern of your headaches, headaches that get steadily worse, an unusually severe headache (“the worst headache of your life”), head pain that increases with coughing or movement, headache after a blow to the head, headache that interferes with normal daily activities, and others.

There are several different types of headaches. The most common types of headaches are:

  • Tension headaches (most common form of headache) cause pressure or tightness on both sides of the head
  • Migraine headaches often affect one side of the head and feel like pounding or throbbing pain
  • Sinus headaches feature pain and pressure in the sinus area
  • Other types of headaches that occur less frequently include
    • Cluster headaches, which are short but painful headaches that can occur for weeks or months at a time
    • Chronic daily headaches
    • Medication overuse headaches
    • Exercise-induced headaches

Headaches can often be treated at home and will go away on their own. In some cases, for more severe or chronic headaches, prescription medicines may be needed. 

When a Headache Is Serious

Warning signs when you should worry about a headache include:

  • Major changes in the pattern of your headaches
  • Headaches that get steadily worse
  • An unusually severe headache (“the worst headache of your life”)
  • Head pain that increases with coughing or movement
  • Headache after a blow to the head
  • Headache that interferes with normal daily activities
  • Headache that comes on abruptly, especially if it wakes you up
  • Headaches that first develop after age 50
  • Changes in personality or mental function
  • Headache accompanied by fever, stiff neck, confusion, reduced alertness, problems with memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
  • Headache accompanied by a painful red eye
  • Headache accompanied by pain and tenderness near the temples
  • Headache in a patient with cancer or impaired immune systems

See a doctor if you have a headache and any of the symptoms or conditions above. 

What Causes Headaches?

When headaches are caused by an underlying medical condition, they are called secondary headaches and these may be headaches that you need to worry about. Secondary headaches could be a sign of:

How Are Headaches Diagnosed?

The underlying cause of headaches is diagnosed with a patient history and a physical examination. Tests used to diagnose the type or cause of the headache include: 

What Is the Treatment for Headaches?

Treatment for secondary headaches caused by underlying conditions depends on the condition. 

Treatment for tension and migraine headaches includes: 

  • Pain relievers
    • Acetaminophen (Tylenol)
    • Aspirin 
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
      • Ibuprofen (Advil, Motrin)
      • Naproxen (Aleve)
      • Ketoprofen (Orudis)
    • Analgesics containing caffeine often work best
  • Other medications
    • Triptans
    • Trigger point injections
  • Non-medical treatments
    • Heat
    • Ice
    • Massage
    • Rest
    • Biofeedback

In addition to the above, migraine headaches may also be treated with:

  • Antiemetics (anti-nausea medicines)
    • Chlorpromazine, prochlorperazine, droperidol, and diphenhydramine
  • Selective serotonin 1F receptor agonist
    • Lasmiditan (Reyvow)
  • Calcitonin-gene related peptide (CGRP) antagonists
    • Rimegepant (Nurtec)
    • Ubrogepant (Ubrelvy)
  • Ergotamine preparations
    • Ergotamine (Ergomar)
    • Dihydroergotamine (D.H.E. 45, Migranal)
  • Neuromodulation
    • Transcutaneous supraorbital nerve stimulation 
    • Remote electrical neuromodulation 
    • Transcranial magnetic stimulation (TMS) 
    • Noninvasive vagus nerve stimulation (nVNS) 
  • Peripheral nerve blocks
    • Occipital nerve blocks 
    • Sphenopalatine ganglion blocks

From WebMD Logo

Migraines and Headaches Resources
Featured Centers
References
https://www.health.harvard.edu/staying-healthy/causes-of-headaches

https://www.uptodate.com/contents/headaches-in-adults-the-basics?search=headache&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.uptodate.com/contents/evaluation-of-headache-in-adults?search=sinus%20headache&source=search_result&selectedTitle=2~89&usage_type=default&display_rank=2

https://www.ihateheadaches.org/what-diseases-cause-secondary-headaches

https://www.uptodate.com/contents/tension-type-headache-in-adults-acute-treatment?search=headache%20treatment%27&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults?search=headache%20treatment&source=search_result&selectedTitle=7~150&usage_type=default&display_rank=7

https://www.health.harvard.edu/pain/headache-when-to-worry-what-to-do