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Headaches

Topic Overview

Headaches are one of the most common pain-related health problems in both children and adults. You may have a headache along with another minor health problem such as a sore throat, cold, or sinus problem.

Types of headaches

The most common types of headaches usually are not serious but may occur again and again.

  • Tension headaches are the most common type of headache and are often caused by stress and emotional strain. Most adults have tension headaches from time to time, and everyone may have different areas of pain.
  • Cluster headaches
  • Migraine headaches. Approximately one-third of people who have migraine headaches first began having them as teenagers.

Common causes of headaches

Common causes of headaches include:

  • Alcohol, caffeine, or other drug use or withdrawal.
  • Changes in the levels of chemicals in the body (neurotransmitters).
  • Coughing or sneezing.
  • Dehydration.
  • Dental problems or procedures, such as pain from grinding the teeth or from a root canal.
  • Eating or drinking cold foods and fluids.
  • Emotional stress.
  • Exposure to smoke or fumes from chemicals, including carbon monoxide.
  • Eyestrain.
  • Fever.
  • High altitude. Lower oxygen levels at high altitudes can cause headaches.
  • High blood pressure (hypertension).
  • Infection in the sinuses, such as sinusitis or an abscess.
  • Medical procedures, such as the aftereffects of a lumbar puncture (spinal tap).
  • Medicines. Many medicines can cause headaches.
  • Muscle strain in the neck, upper back, or shoulder muscles.
  • Upper respiratory infections.
  • Premenstrual syndrome (PMS).

Headaches with other serious symptoms

Although rare, a headache may be a symptom of a serious illness. Other symptoms, such as vomiting, dizziness, or changes in vision, may also be present. The following serious illnesses or injuries can cause headaches.

  • A head injury:
    • Injury to the brain (concussion)
    • Fracture of the skull
    • Bleeding in or around the brain
  • Brain tumor, which causes swelling within the brain
  • Infection in the brain (encephalitis) or of the membrane surrounding the brain and spinal cord (meningitis)
  • Stroke, a problem that occurs when a blood vessel (artery) that supplies blood to the brain bursts or is blocked by a blood clot
  • A rupture of a blood vessel with bleeding in or around the brain (aneurysm)

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a headache problem?
Yes
Headache problem
No
Headache problem
How old are you?
3 years or younger
3 years or younger
4 to 11 years
4 to 11 years
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female
Did the symptoms start after a head injury?
Yes
Symptoms began after a head injury
No
Symptoms began after a head injury
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Do you have a severe headache that started suddenly and is the worst headache of your life?
This probably would not be like any headache you have had before.
Yes
Sudden, severe headache
No
Sudden, severe headache
Has there been a decrease in how alert or aware you are?
Yes
Decreased level of consciousness
No
Decreased level of consciousness
Have you had any new neurological symptoms?
Yes
Neurological symptoms
No
Neurological symptoms
Do you have these symptoms right now?
Yes
Neurological symptoms now present
No
Neurological symptoms now present
Have you had the symptoms for 1 week or less?
Yes
Neurological symptoms for 1 week or less
No
Neurological symptoms for 1 week or less
Do you have a headache right now?
Yes
Has a headache now
No
Has a headache now
Have you vomited?
Yes
Vomiting
No
Vomiting
Do you think you may be dehydrated?
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Are you having trouble drinking enough to replace the fluids you've lost?
Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids.
Yes
Unable to maintain fluid intake
No
Able to maintain fluid intake
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Is home treatment helping with the pain?
Yes
Home treatment is helping
No
Home treatment is not working
How long have you had the headache?
Less than 1 hour
Headache for less than 1 hour
1 hour to less than 12 hours
Headache for 1 hour to less than 12 hours
12 to 24 hours
Headache for 12 to 24 hours
More than 24 hours
Headache for more than 24 hours
Do you have symptoms of a serious illness?
Yes
Symptoms of serious illness
No
Symptoms of serious illness
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are your headaches caused or made worse by exercise, sex, having a bowel movement, coughing, or bending your head forward?
Yes
Headache is caused or made worse by activity
No
Headache is caused or made worse by activity
Do you think that a medicine may be causing your headaches?
Think about whether the headaches started after you began using a new medicine or a higher dose of a medicine.
Yes
Headache may be caused by medicine
No
Headache may be caused by medicine
Have you noticed a change in the usual pattern of your headaches?
Yes
Usual headache pattern has changed
No
Usual headache pattern has changed
Do your headaches ever keep you from doing your daily activities, such as school or work?
Yes
Headaches interfere with daily activities
No
Headaches interfere with daily activities
Has your headache lasted or kept coming back for more than 2 weeks, despite home treatment?
Yes
Headache has continued or recurred for more than 2 weeks despite home treatment
No
Headache has continued or recurred for more than 2 weeks despite home treatment

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
HomeTreatment
RelatedInformation
WhereToGo

Neurological symptoms—which may be signs of a problem with the nervous system—can affect many body functions. Symptoms may include:

  • Numbness, weakness, or lack of movement in your face, arm, or leg, especially on only one side of your body.
  • Trouble seeing in one or both eyes.
  • Trouble speaking.
  • Confusion or trouble understanding simple statements.
  • Problems with balance or coordination (for example, falling down or dropping things).
  • Seizures.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
  • You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Many prescription and nonprescription medicines and supplements can cause headaches. A few examples are:

  • Medicines that contain hormones, such as birth control pills and hormone therapy for menopause.
  • Medicines for erection problems.
  • Caffeine (because of caffeine withdrawal).
  • Some heart and blood pressure medicines.
  • Vitamins.

Severe dehydration means:

  • Your mouth and eyes may be extremely dry.
  • You may pass little or no urine for 12 or more hours.
  • You may not feel alert or be able to think clearly.
  • You may be too weak or dizzy to stand.
  • You may pass out.

Moderate dehydration means:

  • You may be a lot more thirsty than usual.
  • Your mouth and eyes may be drier than usual.
  • You may pass little or no urine for 8 or more hours.
  • You may feel dizzy when you stand or sit up.

Mild dehydration means:

  • You may be more thirsty than usual.
  • You may pass less urine than usual.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it's hard for you to function).
  • Shaking chills.

Here are some examples of possible changes in your usual pattern of headaches:

  • Headaches are worse than usual.
  • You get headaches more often.
  • The pain is in a different area.
  • The pain feels different.
  • The medicines you usually take for headaches no longer seem to work.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.
HomeTreatment
RelatedInformation
WhereToGo

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
HomeTreatment
RelatedInformation
WhereToGo

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
HomeTreatment
RelatedInformation
WhereToGo

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Pregnancy-Related Problems
Head Injury, Age 4 and Older
Head Injury, Age 3 and Younger

Home Treatment

Most of the time headaches get better or go away with home treatment and do not require a visit to a doctor. Home treatment for headaches can often help reduce the severity of pain and the length of time the pain is present. Home treatment may also relieve other symptoms, such as fever, nausea or vomiting, anxiety, or muscle aches. Start home treatment as soon as you can. Be sure to review the home treatment information for any other symptoms you may have.

If your doctor has prescribed a specific treatment for your headaches, begin treatment as soon as a headache starts. Be sure to follow his or her instructions when taking any prescription medicine for your headache.

For mild pain without other symptoms, try the following:

  • Rest in a quiet, dark room.
  • Place a cool compress on your forehead.
  • Do not smoke, drink alcohol, or use illegal drugs.
Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Reduce headaches

You may be able to reduce the frequency and severity of your headaches by trying:

  • Relaxation exercises. These exercises can help take away tension and stress that cause headaches or make them worse.
  • Heat, such as hot water bottles, heating pads, or hot baths, to relax tense muscles. Be careful not to burn yourself.
  • Ice, such as an ice pack applied to the back of the neck or the temples.
  • Massage therapy, biofeedback, and other complementary medicine treatments can reduce muscle tension, especially in your neck and shoulder muscles. Muscle tension can cause headaches or make them worse.

Headaches in children

When your child has headaches:

  • Talk to your child. Let him or her know you care. Extra attention and quiet time may be all that is needed to relieve the pain.
  • If your child's doctor has prescribed a specific treatment for his or her headaches, begin treatment as soon as your child complains of the pain.
  • Let your child rest quietly in a darkened room with a cool compress on his or her forehead.
  • If your child's headache pain is mild, encourage him or her to go on with normal activities.
  • Let your child do his or her usual activities if he or she feels like it unless the headache pain is moderate to severe.
Medicine you can buy without a prescription for children

Try a nonprescription medicine to help treat your child's headache:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen to treat a fever. When you switch between two medicines, there is a chance your child will get too much medicine.
Safety tips for children

Be sure to follow these safety tips when you use a nonprescription medicine:

  • Carefully read and follow all labels on the medicine bottle and box.
  • Give, but do not exceed, the maximum recommended doses.
  • Do not give your child a medicine if he or she has had an allergic reaction to it in the past.
  • Do not give aspirin to anyone younger than age 20 unless directed to do so by your child's doctor.
  • Do not give naproxen (such as Aleve) to children younger than age 12 unless your child's doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain increases or other symptoms develop, such as fever, confusion, vision changes, or vomiting.
  • Symptoms become more severe or frequent.

Prevention

Prevent headaches

You may be able to prevent headaches by changing your daily routine. Identify possible causes of your headaches using a headache diary( What is a PDF document? ).

  • Eat regularly. Do not skip meals. Choose nutritious foods. Do not fill up on salty foods or carbonated beverages.
  • Keep a regular sleep schedule. Set a bedtime and time to get up, and stick to them, even on weekends. This will help your body get used to a regular sleep time. Avoid oversleeping.
  • Physical therapy may help you strengthen your neck muscles, improve your posture, and increase your mobility.
    • Exercise regularly. Walking, cycling, jogging, swimming, or even dancing or gardening are great ways to relieve stress. If you tend to hold tension in your neck and shoulders, walking may be especially helpful. The swinging motion of the arms seems to relax those muscles.
    • Practice a relaxation exercise once or twice a day for 10 to 20 minutes.
    • Try massage, which can reduce muscle tension, especially in your neck and shoulder muscles. Muscle tension can cause headaches or make them worse.
  • Practice good posture and body mechanics at home and at work:
    • Sit straight in your chair with your lower back supported. If you sit most of the day, take breaks once an hour to stretch your neck muscles. There are some specific neck exercises you can do during your breaks.
    • If you work at a computer, adjust your monitor so that the top of the screen is at eye level. Use a document holder to keep the copy at the same level as the screen.
    • If you frequently use the telephone, consider a headset or speakerphone. Do not cradle the handset between your shoulder and your ear.
  • Have frequent dental checkups and yearly eye examinations.

Headaches can often be prevented by avoiding things that may cause, or "trigger," the pain. Although these triggers may be different for different people, generally avoid:

  • Alcohol and caffeine (coffee, tea, or soda pop).
  • Sudden caffeine withdrawal.
  • Foods, such as very salty foods or foods that contain the preservative MSG.
  • Poor eating habits, including missing meals, extreme diets, and fasting.
  • Dehydration.
  • Changes in usual sleep patterns, not getting enough sleep, or oversleeping.
  • Stress, anxiety, or depression.
  • Medicines, such as heart medicines, blood pressure medicines, and hormones.
  • Poor posture and body mechanics.
  • Smoking cigarettes or cigars, or breathing secondhand smoke.
  • Glare from sunlight or artificial light.
  • Exposure to strong odors.
  • Strain in the muscles of the jaw from grinding or clenching teeth or chewing gum.
  • Herbal remedies, such as ginseng or St. John's wort.

To prevent a child's headache:

  • Make sure your child gets enough rest.
  • Offer frequent nutritious snacks and beverages during the day. Do not allow your child to fill up on salty foods or carbonated beverages.
  • Do not allow your child to skip meals.

Preparing For Your Appointment

To prepare for your appointment, see the topicMaking the Most of Your Appointment.

Questions to prepare for your appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions. When you go to your appointment, be sure to bring your headache diary( What is a PDF document? ).

  • What medicines do you take, either weekly or monthly, depending on the severity of your headaches? What is your response to the medicine? Make a list to help you remember your medicines and your response.
  • For a headache that started suddenly (acute):
    • When did the headache start?
    • What were you doing when the headache started?
  • For ongoing headaches (chronic):
    • When did your headache problems start?
    • How often do you have headaches?
    • How long do your headaches usually last?
    • Where is your headache pain located?
    • Describe your headache pain (stabbing, throbbing, dull, sharp), and how you would rate the pain?
    • How do your headaches usually begin or evolve?
    • Do you have other symptoms with your headaches?
    • Are your headaches related to your menstrual cycle?
    • What do you think causes your headaches?
    • What home treatments have you tried, and how well did they work?
    • What prescription medicines have you been given? Did they work?
    • What prescription or nonprescription medicines do you take?
    • Are you using an alternative or complementary medicine or treatment (including herbal remedies)?
    • Have you recently had a dental procedure, such as a filling or a root canal?
    • When was your last eye examination? Do you wear corrective lenses?
    • Do you have any health risks?

Credits

Current as ofSeptember 23, 2018

Author: Healthwise Staff
Medical Review: William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine

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