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When To Worry About Headaches

Headaches are one of the most common health complaints. Luckily most aren't serious and are easily treated. In many cases, you can treat your headaches at home with over-the-counter painkillers and lifestyle changes, such as reducing alcohol intake, smoking cessation, getting enough sleep and drinking enough fluids. However, it's a good idea to see your doctor if your headaches aren't relieved by over-the-counter medications, or if they're so painful or frequent that they affect your daily activities or are causing you to miss work/school.

Scientists don't fully understand what causes most headaches. They do however know that the brain tissue and the skull are never responsible since they don't have nerves that register pain!

Headaches usually do not indicate a serious problem. However, once in a while it can be a symptom of a condition such as a stroke, meningitis, or a brain tumour. A headache is more likely to be serious if:

- it occurs suddenly and is very severe – especially if they wake you up

- it doesn't go away and gets worse over time

- it is accompanied by pain and tenderness near the temples

- it occurs after a head injury

- you notice changes in personality or mental function

- it is triggered suddenly by coughing, laughing, sneezing, changes in posture, or physical exertion

- you have symptoms suggesting a problem with your brain or nervous system, including weakness, slurred speech, confusion, memory loss, and drowsiness

- you have additional symptoms, such as fever, a stiff neck, a rash, jaw pain while chewing, vision problems, a sore scalp, or severe pain and redness in one of your eyes

- your headaches are different from other headaches you’ve had, especially if you are age 50 or older

- you have been diagnosed with cancer or have an impaired immune system

Many people who have headaches want a CT scan or an MRI to find out if their headaches are caused by a serious problem. I have asked many of my patients why they want a CT or an MRI, and what I gather from their response is that they want the test because they equate it to an x-ray of sorts for the brain. Most of the time these tests are not needed, because imaging tests like CT or MRI rarely help.

A doctor can diagnose most headaches during an office visit. Your doctor will ask you questions about your health and your symptoms, and will perform a neurological exam, which includes a test of your reflexes. If your medical history and neurological exam are normal, usually imaging tests will not show a serious problem.

One of the best ways to help your doctor diagnose the type of headache you are experiencing is by keeping a headache diary. Make note of frequency, intensity, time of day, duration, changes in weather, what you ate/drank that day, your stress level, physical activity, and anything else you think might be a trigger. Logically speaking, if you can establish what triggers your headaches, you can work on avoiding the trigger. And hopefully, avoiding the triggers can help stop the headaches.

If you're concerned that your headache might be serious, you should seek immediate medical advice. If your headaches are severe or happen often, there are medications which your doctor can prescribe to help lower the pain level and/or reduce how frequently you get them. At the same time, I must warn you about falling into the trap of overusing medications, and getting addicted to them, or developing serious side effects.

I can imagine how challenging it can be for someone to carry on with their life while struggling with pain from headaches. Getting diagnosed with a specific condition presenting as headaches can be a long and tiresome journey. At in4MED, we can make this stressful time easier by providing you with information about your condition, connecting you to local support systems and being there for you as your trusted health advocates. As always, feel free to connect with me or leave a comment.


Healthcare Consultant, in4MED


The complete headache chart


Choosing Wisely Canada

Guideline for primary care management of headache in adults

The author of this blog post is a Physician with over 10 years of experience working in the healthcare system as a clinician, researcher and educator. She is passionate about healthcare for older adults and strives to be a resourceful inspiration to caregivers.

*No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified healthcare professional.

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