Headaches: When Should I See a Doctor?

Nagging, mild pain to outright debilitating – headache symptoms range the gamut, leaving most people wondering: When should I see my doctor?

“If not diagnosed properly, it can be a disaster,” Set Shahbabian MD, a neurological surgeon at the TriHealth Orthopedic and Spine Institute, explains. Fortunately, a majority of headaches – while chronic and, not to mention, a nuisance – aren’t serious, but it’s still important to monitor symptoms.

Common Types of Headaches

#1: Tension Headaches

The most common type of headache, a tension headache, is often caused by tight muscles in your shoulders, neck, scalp and jaw. It may be related to stress, depression, anxiety, a head injury or holding your head and neck in an abnormal position.

Treating a tension headache typically involves relieving pain when the attack occurs and preventing the recurrence of attacks with over-the-counter pain relievers, like acetaminophenaspirin or ibuprofen. These medicines, however, should not be used more than twice a week because overuse could lead to rebound headaches.

If you experience tension headaches twice or more a month, you should meet with your doctor to discuss preventive measures.

#2: Migraines

A migraine headache involves severe pain and usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea. The pain may be throbbing, pounding or pulsating and tends to begin on one side of your head (it may spread to both sides).

Migraines may also be triggered by foods like:

  • Chocolate
  • Certain cheeses
  • Monosodium glutamate (MSG, a flavor enhancer)

Also, caffeine withdrawal, lack of sleep and alcohol could also ignite a tension headache. 

“Headaches can also be cyclical or seasonal,” Dr. Shahbabian says. Certain weather triggers include changes in humidity, temperature, storms, dry conditions or dusty environments. Pay attention to these triggers so if you do have chronic headaches, you can tell your doctor at your next appointment. 

For migraines, try to alleviate symptoms when the headache occurs with over-the-counter pain relief medicines, like: 

How to Tell if Your Headache is an Emergency

If your headache persists for several hours without resolving itself, you should schedule an appointment with your doctor.

On the other hand, if your headache is accompanied by symptoms like weakness, dizziness, bad vision, nausea, fainting, a seizure, a change of mental state or numbness or weakness on one side of the body, you could have a neurological issue going on, like a stroke, so you should call 911.

“A sudden blow up type of headache – that’s when you should be checked for an aneurysm. Most of these are not aneurysms, but you should still be checked,” Dr. Shahbabian points out. You should also seek immediate medical help if:

  • This is the first headache you have ever had in your life and it interferes with your daily activities.
  • Your headache comes on suddenly and is explosive or violent.
  • Your headache is "the worst ever," even if you regularly get headaches.
  • You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache.
  • Your headache gets worse over 24 hours.
  • Your headache occurs with a head injury.
  • Your headache is severe and just in one eye, with redness in that eye.
  • You just started getting headaches, especially if you are older than 50.
  • Your headaches are associated with vision problems, pain while chewing, or weight loss.
  • You have a history of cancer and develop a new headache.

Learn more about headaches in our Health Library.

Tags: Miscellaneous

Last Updated: November 23, 2014