Headache: symptoms, causes and when to seek help

Headaches can feel like pressure, throbbing or sharp pain, and the right care depends on the pattern and accompanying symptoms.

Pain may sit across the forehead, behind the eyes, at the temples, around the face, or at the back of the head and neck. It can arrive gradually or suddenly, remain in one place or spread, and may be accompanied by nausea, light sensitivity, a blocked nose, tiredness or disturbed sleep.

Seek emergency medical care for a sudden, severe headache that reaches its peak quickly, especially after a head injury. Urgent assessment is also needed when headache occurs with fainting, confusion, a seizure, weakness or numbness on one side, trouble speaking, loss of vision, a stiff neck, fever with a rash, or repeated vomiting.

A new headache during pregnancy or soon after giving birth, a headache that is steadily worsening, or one that begins after starting a new medicine deserves prompt clinical advice. Do not drive yourself if you have neurological symptoms or feel unsafe to travel.

A headache may be linked with muscle tension, a migraine pattern, illness, poor sleep, missed meals, dehydration, caffeine changes, stress, eye strain, sinus symptoms or a medicine effect. The causes below are listed alphabetically, not in order of likelihood.

Allergic rhinitis, altitude sickness, chronic sinusitis, cluster headache, common cold, jet lag, meningitis, migraine, obstructive sleep apnoea, sinusitis and tension headache can each include headache among their symptoms. A clinician considers the full pattern rather than the pain alone.

A clinician will ask when the pain began, how it behaves, what you were doing before it started, which medicines or supplements you use, and whether there are associated symptoms. They may check blood pressure, temperature, vision, the neck and a neurological examination.

Tests are not needed for every headache. Blood tests, eye assessment or imaging may be considered when the story or examination suggests another condition needs to be ruled out. Keeping a short headache diary can make triggers and treatment response easier to review.

Rest in a quiet, dark room, fluids, regular food and a cool compress may help some people while the cause is being clarified. A pharmacist or clinician can advise whether a pain reliever is suitable for you, particularly if you are pregnant, have kidney, liver, stomach or heart conditions, or take other medicines.

Targeted treatment may address migraine, nasal inflammation, sleep problems, infection, high blood pressure or muscle tension when these are identified. Avoid using pain medicine more often than advised, as frequent use can itself maintain a cycle of headaches. Do not stop prescribed blood pressure medicine without medical guidance.

A regular sleep schedule, meals at predictable times and adequate fluid intake can reduce avoidable strain. Build screen breaks into long tasks, adjust workstations so the shoulders are relaxed, and gradually manage caffeine changes rather than making abrupt swings.

Record the date, duration, symptoms, food or drink, sleep, stressors and medicines around each episode. This record can reveal personal patterns without assuming that any one trigger explains every headache.

Tell a clinician about fever, a new rash, neck stiffness, congestion, facial pain, visual symptoms, dizziness, jaw pain, sleep disruption, snoring, nausea, vomiting, weakness, numbness or changes in mood. The combination and timing of symptoms are often more informative than the intensity of pain alone.

If headaches recur or interfere with work, school, sleep or daily activities, arrange a routine appointment. Follow-up may focus on a headache plan, reviewing medicines, checking sleep and blood pressure, treating an identified condition, or referring you to a relevant specialist when the pattern calls for it.