8 Times to Worry About a Headache
When do you need to see your doctor immediately, and when is it OK to wait?
A very important skill a doctor must possess is the ability to read minds. We have to figure out what people are saying when they aren’t saying it. For example, when a person comes to the office saying, “I’m having ,” they usually are really asking, “am I having a ?”
When Should You Worry About a Headache?
Today’s article will cover another example of this: headaches. When someone comes to the office with a headache, they are often worried of something more serious: brain tumors, aneurisms, or other scary things. It’s my job to not only figure out what’s causing the headache, but to reassure people that they are not about to die from something terrible. This is another installment of my “” series giving you advice as to when it’s OK to stay home, and when you should run to the doctor.
8 Times to Worry About a Headache
- Sudden onset of a severe headache, especially one that awakens you from sleep
- Onset of regular headaches starting after age 50
- Severe headache in the morning that is accompanied by vomiting
- Any significant change to a person’s normal pattern of headache
- Pain you’d call severe headache or “the worst headache ever”
- Headache accompanied by confusion or other changes in mental status
- Headache associated with red eyes
- Headache following a head injury–especially if the headache gets worse over time
As I said last week in my “” article, the first step in figuring out what’s going on is the story of the symptom. Here are the questions you should ask yourself to determine whether you should worry.
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How bad is the headache?
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When did it start?
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Does it come and go or is it constant?
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When does it happen?
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Are there any other significant symptoms happening along with the headache?
The Headaches You Don’t Need to Worry About
Of the less serious headaches, there are three types that I see the most:
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Migraine headaches
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Sinus headaches
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Tension headaches
I’ll cover each of them in more detail below so that you can recognize these different types of not-so-serious headaches.
What Are the Symptoms of Migraines?
You can recognize a migraine headache because migraines are episodic. They come and go. When you have one, the pain makes you miserable, but between headaches you feel completely normal. These episodes last anywhere from an hour to two days, and have some very distinctive features:
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They often happen on one side of the head (but not always)
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They are frequently described as being “throbbing”
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They make a person sensitive to light and sound–you just want to lie in a dark, quiet room.
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There is pain with movement
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The pain is sometimes accompanied by nausea and vomiting.
What is an Aura Migraine?
Sometimes migraines are preceded by an “aura,” which is a visual symptom where the person sees flashing lights, squiggly lines, or other visual disturbances. Auras usually last between 10 and 30 minutes. I can personally vouch for how miserable migraines are.
What Are the Symptoms of a Sinus Headache?
Sinus headaches are sometimes obvious, with nasal congestion and pressure and pain on the front of the face or the forehead. With these symptoms, there isn’t much doubt. But there are times when the nasal symptoms are not present. The clues to me that a person has sinus headaches are as follows:
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Symptoms last for days, weeks, and even months
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Headache is usually less painful than other headaches
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Pain is located on the forehead, under the eyes, or behind the eyes
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Headache pain occurs regularly in the fall and spring
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Pain is accompanied by a sore throat or cough, especially in the morning.
What Are Symptoms of a Tension Headache?
Muscle tension headaches usually start at the base of the neck and spread to the rest of the head. I find that the majority of people with tension headaches are not getting a good night’s sleep. That lack of sleep means their body never has a chance to relax, and so they wake up with tight muscles which get worse over the course of the day. A person with a tension headache may also have soreness of the jaw from clenching their teeth.
What Serious Medical Conditions Cause Headaches?
So what are the possible bad things that could cause headaches and when should you worry?
- Brain tumors: Though brain tumors can cause headache, they often do not.
- Aneurisms: Aneurisms, which are areas of blood vessels that blow up like a balloon, can leak and cause a sudden severe headache. A ruptured aneurism causes profound weakness to parts of the body, and so headaches are rarely the main concern.
- Infections: Certain infections, such as influenza, meningitis, and Rocky Mountain spotted fever can also cause bad headaches (along with other symptoms).
When to Worry About Headaches
What are the symptoms that should make you worry?
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Sudden onset of a severe headache, especially one that awakens you from sleep
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Onset of regular headaches starting after age 50
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Severe headache in the morning that is accompanied by vomiting
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Any significant change to a person’s normal pattern of headache
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Pain you’d call severe headache or “the worst headache ever”
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Headache accompanied by confusion or other changes in mental status
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Headache associated with red eyes
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Headache following a head injury–especially if the headache gets worse over time
All of these are signs to get your headache checked promptly.
As I have said in the past, if you have any concern, talk to your doctor. It is your doctor’s job to reassure you of the less-serious problems and possibly find solutions. There are good treatments for migraines, sinus, and tension headaches. There is no need to suffer.
If you have topics that you want me to cover, send them to housecalldoctor@quickanddirtytips.com, or you can submit them to me on twitter (@housecalldoc) or my Facebook page.
Let me once again remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.
Catch you next time! Stay Healthy!
Headache image from Shutterstock
