15 Signs Your Headache Could Be Something More Serious
Most headaches are nothing to be worried about, except when they are. Here, doctors give the scoop on your head pain: What it means and how to know if you need medical attention
There’s no one-size-fits-all headache
Sometimes a headache is just a headache, and the pain will subside with time and over-the-counter pain relievers. However, some headaches are more serious, prolonged, or keep recurring. These may require a targeted treatment plan, a prevention strategy, more in-depth treatment, or possibly even a trip to the emergency room. (Find out the foods that are the most likely to trigger a headache.)
According to Brian Grosberg, MD, director of the Hartford HealthCare Headache Center, there are over 300 different types and causes of headaches. “Taking a thorough headache history helps determine if there are ‘red flags’ or worrisome features that may be indicative that the headache is attributable to some underlying condition or cause,” he says.
Here are some things you should look for if you have headaches, or additional symptoms that could indicate a more serious problem.
Your head is throbbing
It’s estimated that around six percent of men and 18 percent of women suffer from migraines. If you happen to fall into that group, you know how painful and debilitating they can be. Though the first time you feel it coming on, you might worry something is terribly wrong, people with migraines often become experts at spotting the warning signs. Neurologist Isha Gupta, MD, explains, “Severe migraines can be described as intense throbbing or pounding sensations, with sensitivity to light or sound. Other types of severe headaches can be described as sharp stabbing pain in the face or around the eye. Some people have severe tension headache described as a band-like squeezing.” Though it’s important to talk to your doctor if you continuously experience migraine-like symptoms, they can be managed with medicine and therapy.
You have numbness or slurred speech
There are a some symptoms that, when combined with a severe headache, indicate the pain between your eyes or in the back of your head is potentially more dangerous. One possibility is a stroke.
Strokes are a reduction of blood flow to the brain, either due to a clot (the most common type) or bleeding in the brain. While strokes can cause a sudden severe headache, they also typically cause other symptoms like face drooping or numbness, weakness on one side of the body, slurred speech, and difficulty thinking.
If you suspect someone is having a stroke, you can ask them to smile to see if one side of their face is drooping. The American Stroke Association also recommends using the acronym FAST—which stands for Face drooping, Arm weakness, Speech, and Time to call 911—if you think someone is having a stroke. And time is of the essence—the faster the treatment with clot-dissolving drugs, the less likely someone is to have permanent brain damage, so strokes are considered a medical emergency.
Dr. Gupta explains that headaches “are sometimes associated with difficulty speaking, slurred speech, difficulty thinking or understanding other people, difficulty moving your arms or legs, numbness or tingling in the body, vision changes, or face drooping.” She says that if you notice any of those additional symptoms, it’s time to go to the emergency room, ASAP. Here are 13 surprising things that can trigger a headache.
You can’t concentrate
Have you had a head injury? Concussion occurs when you’ve suffered a a blow to your head or body, and the brain is injured by the movement it makes back and forth inside the skull. Concussion awareness is at an all-time high in schools and professional sports. You need to be every bit as cautious and concerned with your own noggin, says Dr. Gupta. Oftentimes, you won’t know you have a concussion until you experience post-trauma—you’re struggling to concentrate or have sudden memory loss. If this happens, you should seek medical attention and stay awake until you see a professional.
A headache is so bad it wakes you up
Dr. Gupta explains that if a headache is so severe that it wakes you up or is specifically really intense only in the mornings, tell your doctor as an onset of increasing morning headaches that wake you from sleep could be due to increased pressure from a mass or tumor. “The only way to completely rule out causes of a more serious headache is to see a doctor who will order either a CT scan or MRI of your brain and possibly blood vessels, based on your symptoms,” she explains. Here are 8 types of headaches–and how to get rid of them.
If your neck is stiff or you have a fever
Meningitis is an inflammation of the tough membrane that surrounds the brain and spinal cord, and it can be caused by viruses, bacteria, or other factors. Bacterial meningitis tends to be more serious than viral infections, but thankfully it is relatively rare. About 4,000 people get bacterial meningitis each year in the US. If you have a sudden severe headache coupled with a high fever and your neck becomes sore, Tania Dempsey, MD, recommends seeing a doctor immediately. While the majority of patients do recover from this illness, it needs to be treated promptly.
Your headache just won’t quit
A stubborn headache might cause you to double-up on pain meds, chug water, and close your eyes, but if the symptoms persist Dr. Dempsey says book an appointment ASAP. Especially if you already struggle with head pain, you not being able to move past the dull sensation may be extra cause for worry. “Someone with a history of headaches who notices a change in the pattern and location of the headache and a lack of response to headache treatments that worked in the past should know that the headache is severe and needs prompt attention,” she says. (Find out the unexpected reasons you’re waking up with a headache.)
It’s the worst headache of your life
If you normally suffer from headaches, this will feel worse. Sometimes called thunderclap headaches, the American Migraine Foundation, notes that these may develop to full force in less than one minute, last 5 minutes or longer, and have no obvious trigger. They may or may not have a serious underlying cause, but they do need to be checked out immediately. Emad Estemalik, MD, clinical assistant professor of medicine at The Cleveland Clinic Lerner College of Medicine, says that if this is the absolute worst headache of your life, you may want to head straight to the emergency room for evaluation.
You have visual changes
“A headache that is accompanied with visual changes, vision loss, weakness, numbness, or tingling should be checked out,” says Dr. Esternalik. According to the American Migraine Foundation about one-third of migraine sufferers experience aura, but for those who don’t, any changes in vision, spots, blurred vision, trouble focusing that accompanies a headache should be checked out by a doctor. Try these home remedies for headaches.
You are older than 50
“If the person is over the age of 50 and they are experiencing a new type of headache or a change in a preexisting type of headache that they experienced, it’s time to see a doctor” says Dr. Grosberg. (Find out these natural headache remedies.)
Changing your position affects the headache severity
Both Dr. Grosberg and Dr. Esternalik agree that headaches that worsen with laying down or sitting up, should be taken as a warning sign. According to The Cleveland Clinic, this could be a sign of something more serious such as a cerebral spinal fluid leak (although this is very rare).
You have an underlying condition
“If you have a history of fever, weight loss, rash, chills, and/or sweats accompanying the headaches, or secondary risk factors, such as a condition or medication that suppresses your immune system, it’s time to make an appointment,” says Dr. Grosberg. (Try these stretches to relieve your headache.)
The headache hits suddenly
Was this headache sudden? “If the headache come on all of a sudden, like you were being hit over the head with a baseball bat, where the pain reached maximal intensity within seconds up to a minute, see your doctor,” says Dr. Grosberg.
An activity preceded the headache
Coughing, bending down, straining, or sexual activity could all set off a headache, says Dr. Estemalik. This could relate back to an underlying cause. Learn more about the types of migraines.
Your medication isn’t working
If normal over-the-counter medications aren’t working, it may be time to see the doctor, says Grosberg. Also, if you use a prescription that has suddenly stopped working, you should also consult your doctor. There are many new options of medication including Zembrace, which can help get rid of a migraine in as quickly as 10 minutes. (Next, find out ways to stop a headache before it starts.)
- Brian Grosberg, MD, director of the Hartford HealthCare Headache Center
- Isha Gupta, MD, a neurologist
- Tania Dempsey, MD
- Emad Estemalik, MD, clinical assistant professor of medicine at The Cleveland Clinic Lerner College of Medicine
- American Migraine Foundation: “Understanding Migraine with Aura”
- The Cleveland Clinic: "Cerebrospinal Fluid (CSF) Leak”