When to Worry About a Headache

When you get a particularly bad headache, you can immediately think the worst. As someone who gets headaches often, I’ll admit that I’ve panicked, Googled my symptoms, and quickly diagnosed myself with a life-altering condition, when in reality I probably just needed to drink more water. Because while headaches can be uncomfortable (and even a little scary, depending on how badly you get them), they usually aren’t cause for concern. In fact, headaches are often triggered by everyday things like hormone fluctuations or dehydration — not some underlying condition.

Still, there may be times when you might feel unsure about whether the pain you’re experiencing is normal. POPSUGAR spoke with a neurologist about the most common types of headaches and when to worry that your headaches might point to something more serious.

Most Common Types of Headaches

Thomas Berk, MD, medical director of Neura Health, notes that tension headaches are the ones people experience most often. The pain associated with tension headaches is mild to moderate and often described as feeling like a tight band around the head. Tension headaches are typically caused by dehydration, muscle tension, and stress, according to Dr. Berk.

He adds that migraine headaches are also common, occurring in approximately one in six American adults. While migraines often run in families, most migraine sufferers can identify specific triggers that cause their headaches, including hormonal changes, sleep disruptions, and excessive stress. Migraines are much more painful than tension headaches, and typically consist of an intense throbbing pain on one side of the head, accompanied by symptoms like nausea, vomiting, and sensitivity to light. If you’ve never had a migraine before, it can feel incredibly scary and disorienting.

Another type of headache is the cluster headache — attacks that can occur over lengthy periods of time, typically spanning four to six weeks. Dr. Berk explains that cluster headaches are usually one-sided and can last for 15 minutes to three hours at a time. Symptoms of cluster headaches can include tearing of the eye, eyelid drooping, sinus congestion or a runny nose, and flushing of the face. The piercing or burning pain associated with cluster headaches can be excruciating. However, “most people who experience cluster headaches do not have another underlying condition,” Dr. Berk says. “Rarely, cluster headaches can occur due to a pituitary tumor.”

While both migraine and cluster headaches can be frightening, they are not an emergency and can typically be treated at home or during a routine checkup with your primary-care physician or a neurologist. If your headaches are active to your life, it’s especially important that you discuss treatments with a doctor. “There are so many options for people with headaches. These can vary from supplements to relaxation techniques to medications and injections,” Dr. Berk says.

When to Worry About a Headache

While most headaches are not linked to an underlying condition, strokes, brain infections, brain tumors, and traumatic brain injuries, all share similar headache-like symptoms. Because of this, specialists like Dr. Berk use a mnemonic device to help differentiate common headaches from ones that could be a sign of something more serious. SNOOP, established by The American Headache Society, is used to identify headaches that could be a cause for concern. If you’re experiencing any of the red flags below, Dr. Berk recommends seeking medical attention right away.

  • Systemic symptoms: Have you been sick, or do you have other medical conditions, such as cancer or HIV? A headache that occurs with systemic symptoms could indicate that your condition is worsening.
  • Nurological symptoms: Are you also experiencing numbness, tingling, weakness, loss of vision, trouble speaking, or other neurological issues you haven’t had before? A headache that’s paired with these symptoms can be a sign of a medical emergency, such as a stroke.
  • Onset: Did the headache within seconds, like a thunderclap? This rapid onset is typically associated with a stroke or brain bleed.
  • Older: Are you experiencing new, frequent headaches after age 50? Older people are more likely to have giant cell arteritis, a blood-vessel disease that affects the arteries in the head, according to the American College of Rheumatology.
  • Pregnancy, position change, prior headaches: Is this a new headache in pregnancy? Does it improve or worsen when you’re standing versus lying down? Is this different from any previous headaches? If you’ve experienced headaches in the past, and the ones you’re experiencing now are much more severe, you should seek care.

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