Headaches
Topic OverviewHeadaches 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 headachesThe 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 headachesCommon 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 symptomsAlthough 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 SymptomsDo you have a 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 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 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? Moderate Moderate 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 Yes Symptoms of serious illness No Symptoms of serious illness Do you think you may have a 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 TreatmentYou 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.
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 NowBased 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.
Seek Care TodayBased 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.
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.
Call 911 NowBased 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 TreatmentMost 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 headachesYou may be able to reduce the frequency and severity of your
headaches by trying: Headaches in childrenWhen 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 treatmentCall 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.
PreventionPrevent headachesYou 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 AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. Questions to prepare for your appointmentYou 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?
Other Places To Get HelpOrganizationAmerican Headache Society: ACHE www.achenet.org CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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