Headache: when to worry and how we help by video

Headache is one of the most common symptoms. Most headaches are not dangerous: they come from tight muscles, stress, poor sleep, migraine or an infection such as a cold. What matters is recognizing the few signs that are an emergency, and getting help when headaches keep coming back or change.

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The causes table on this page sums them up:

• Tension headache: the most common. It feels like pressure or a band around the head and often goes with tight neck, shoulder or jaw muscles, or stress.
• Migraine: throbbing pain, often on one side, with nausea or vision changes.
• Sinus infection: pain and pressure in the forehead or face that gets worse when you bend forward.
• Cold, flu or fever: headaches come with many infections.
• Rebound headache: taking pain medicine more than 3 days a week on a regular basis can cause headaches that keep coming back.

A headache with fever, pain behind the eyes and bone pain can be dengue. In that case use acetaminophen, avoid aspirin and ibuprofen, and read our dengue warning signs guide.

High blood pressure usually causes no symptoms, so a headache is not a reliable way to tell whether you have it. If you have high blood pressure, check it at home and keep a log. See high blood pressure.

For a headache without warning signs:

• Rest in a quiet, dark room and drink water.
• Put a cool cloth on your forehead.
• Try relaxation techniques and stretch your neck and shoulders.
• Acetaminophen, aspirin or ibuprofen can help a tension headache; follow the label. If dengue is possible, use acetaminophen only.
• Keep a headache diary: when it starts, what you ate or drank, how you slept and what you were doing. Bring it to your visit.
• An ordinary headache rarely needs lab work. If the doctor suspects another cause, such as an infection or dengue, she gives you an order for a lab near you; if you need a different kind of test, she tells you which one and where to go.

For your safety, do not wait for a video visit: call 911 or go to the ER if a headache starts suddenly and explosively or is the worst you have ever had; comes with slurred speech, vision changes, weakness in an arm or leg, loss of balance or confusion; comes with fever, a stiff neck, nausea and vomiting; or comes with severe pain and redness in one eye.

Get medical care soon if this is your first severe headache and it stops you from doing your usual activities, if it gets worse over 24 hours, if it follows a blow to the head, if headaches are new after age 50, if they come with vision problems, pain when chewing or weight loss, or if you have a history of cancer. See when to go to the ER.