Almost everyone has experienced a headache. It can feel like the pain is focused on one side of your face or head, or your whole head can hurt. This pain usually will go away on its own or with the aid of an over-the-counter pain reliever. But if you have headache pain that is chronic (every day or most of the time) or have sudden and excruciating headache pain, you should seek medical help.
A sudden, severe headache with no known cause is one of the symptoms of a stroke or bleeding into or around the brain. If you have a headache like this, call 911 immediately.
Headaches vary greatly in terms of pain location, pain intensity and how frequently they occur. They may be caused by a number of conditions, including disorders of the neck, eyes, brain, jaw or teeth. Muscle tension, exposure to certain foods, medications, dehydration or changing levels of hormones can be contributing factors (sometimes called headache triggers).
When the headache itself is the main medical problem, it’s called a primary headache. Headaches due to an underlying medical condition are classified as secondary headaches. An example of a secondary headache would be a headache due to an infection or tumor.
Types of primary headaches include:
- Migraines, characterized by head pain plus other symptoms such as nausea and vomiting, lightheadedness, sensitivity to light (photophobia) and other visual symptoms
- Tension headaches, the most common type of headache, which often have stress and muscle tension as factors
- Cluster headaches, which usually occur in a series that may last weeks or months and may return every year or two
Diagnosis and next steps
Fortunately, most headaches are not signs of a more serious condition. However, you should see a doctor if any one of the following statements is true:
- You have three or more headaches per week.
- You must take a pain reliever every day or almost every day.
- You need more than recommended doses of over-the-counter medications to relieve headache symptoms.
- You have a stiff neck and/or fever in addition to a headache.
- Your headache is accompanied by shortness of breath, fever and/or unexpected symptoms that affect your eyes, ears, nose or throat.
- You are dizzy, unsteady or have slurred speech.
- You experience confusion or drowsiness.
- Your headaches begin and persist after a head injury.
- Your headache is triggered by exertion, coughing, bending, or sexual activity.
- Your headache keeps getting worse and won’t go away.
- Your headaches have changed in character.
- You have persistent or severe vomiting along with your headache.
- You have your “first and/or worst” headache.
- Your headaches begin after you reach the age of 50.
For many types of headache, treatment may include medications (preventive, rescue or abortive), diet changes, lifestyle changes, biofeedback, or physical or exercise therapy. If your current treatment doesn’t relieve your headaches, your doctor may refer you to Lehigh Valley Health Network’s (LVHN) Headache Center, part of LVHN’s Neuroscience Center.