8 Times to Worry About a Headache

When do you need to see your doctor immediately, and when is it OK to wait?

Rob Lamberts, MD
4-minute read
Episode #67

A very important skill a doctor must possess is the ability to read minds. We have to figure out what people are saying when they aren’t saying it. For example, when a person comes to the office saying, “I’m having chest pain,” they usually are really asking, “am I having a heart attack?”

When Should You Worry About a Headache?

Today’s article will cover another example of this: headaches. When someone comes to the office with a headache, they are often worried of something more serious: brain tumors, aneurisms, or other scary things. It’s my job to not only figure out what’s causing the headache, but to reassure people that they are not about to die from something terrible. This is another installment of my “when to worry” series giving you advice as to when it’s OK to stay home, and when you should run to the doctor.

8 Times to Worry About a Headache

  1. Sudden onset of a severe headache, especially one that awakens you from sleep          
  2. Onset of regular headaches starting after age 50
  3. Severe headache in the morning that is accompanied by vomiting
  4. Any significant change to a person’s normal pattern of headache
  5. Pain you’d call severe headache or “the worst headache ever”
  6. Headache accompanied by confusion or other changes in mental status
  7. Headache associated with red eyes
  8. Headache following a head injury--especially if the headache gets worse over time

As I said last week in my “mystery diagnosis” article, the first step in figuring out what’s going on is the story of the symptom. Here are the questions you should ask yourself to determine whether you should worry. 

  1. How bad is the headache? 

  2. When did it start? 

  3. Does it come and go or is it constant? 

  4. When does it happen?

  5. Are there any other significant symptoms happening along with the headache?

The Headaches You Don’t Need to Worry About

Of the less serious headaches, there are three types that I see the most:

  1. Migraine headaches

  2. Sinus headaches

  3. Tension headaches

I’ll cover each of them in more detail below so that you can recognize these different types of not-so-serious headaches. 

