Headache (cont.)

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When should I seek medical care for a headache?

A patient should seek medical care if their headache is:

  • The "worst headache of your life." This is the wording often used in textbooks as a cue for medical practitioners to consider the diagnosis of a subarachnoid hemorrhage due to a ruptured cerebral aneurysm. The amount of pain will often be taken in context with the appearance of the patient and other associated signs and symptoms. Too often, patients are prompted to use this expression by a health care professional and do not routinely volunteer the phrase.
  • Different than their usual headaches
  • Starts suddenly or is aggravated by exertion, coughing, bending over, or sexual activity
  • Associated with persistent nausea and vomiting
  • Associated with fever or stiff neck. A stiff neck may be due to meningitis or blood from a ruptured aneurysm. However, most patients who complain of a stiff neck have muscle spasm and inflammation as the cause.
  • Associated with seizures
  • Associated with recent head trauma or a fall
  • Associated with changes in vision, speech, or behavior
  • Associated with weakness or change in sensation on one side of their body that may be a sign of stroke.
  • Not responding to treatment or is getting worse
  • Requires more than the recommended dose of over-the-counter medications for pain
  • Disabling and interfering with work and quality of life

How do you get rid of a headache? Are home remedies effective for headaches?

It is important to at least think that an unusual headache may need to be evaluated by a health care professional, but in most instances, primary tension headaches may be initially treated at home.

  • First steps include maximizing rest and staying well hydrated.
  • Recognizing and minimizing stressful situations may be of help, if that is one of the contributing causes of the headache.
  • If there has been a cold or runny nose recently, humidifying air may be helpful in allowing sinuses to drain.
  • Rubbing or massaging the temples or the muscles at the back of the neck may be soothing, as might warm compresses.
  • Over-the-counter pain medication may be helpful, in moderation.

Those with migraine headaches often have a treatment plan that will allow treatment at home. Prescription medications are available to abort or stop the headache. Other medications are available to treat the nausea and vomiting. Most patients with migraine headaches get much relief after resting in a dark room and falling asleep.

Patients who have secondary headaches most often need to seek medical care.


Beithon, J., et al. "Health Care Guideline Diagnosis and Treatment of Headache." 10th Edition. 2011.

Headache Classification Committee of the International Headache Society (IHS). "The International Classification of Headache Disorders, 3rd edition (beta version)." Cephalagia. 33:9 (2013): 629-808.

Olesen, J., et al. "The International Classification of Headache Disorders." 2nd Edition. International Headache Society (IHS). May 2005.

Steiner, T. J., et al. "Guidelines for All Healthcare Professionals in the Diagnosis and Management of Migraine, Tension-Type, Cluster and Medication-Overuse Headache." 3rd Edition. British Association for the Study of Headache. 18 Jan. 2007.

Previous contributing author and editor: Dennis Lee, MD and Harley I. Kornblum, MD, PhD

Medically Reviewed by a Doctor on 11/13/2015

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