Headaches

Headaches 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 headaches

The 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. See an illustration of possible areas of pain from a tension headache.
• Cluster headaches
• Migraine headaches. Approximately one-third of people who have migraine headaches first began having them as teenagers.

Common causes of headaches

Common 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.

Headaches with other serious symptoms

Although rare, a headache may be a sign 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
  • 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)

Headaches and other health conditions

Other health conditions that can cause or contribute to headaches include:

• Fibromyalgia, a condition that causes widespread muscle and soft tissue pain and tenderness.
• Glaucoma, an eye disease that damages the nerves at the back of the eye.
• High blood pressure (hypertension).
• High blood sugar (hyperglycemia) or low blood sugar (hypoglycemia).
• Inflammatory problems, such as arthritis, lupus, or giant cell arteritis.
• Kidney disease, which causes wastes to build up in the blood.
• Low calcium levels in the blood (hypocalcemia) or overactivity of the gland that helps control the release of calcium into the blood (hyperparathyroidism).
• Lyme disease, a bacterial infection spread by certain types of ticks.
• Mental health problems, such as anxiety or depression.
• Problems with pregnancy, such as high blood pressure or preeclampsia.
• Sleep problems, such as insomnia or sleep apnea.
• Thyroid problems, such as hyperthyroidism or hypothyroidism.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

• Sudden, severe pain and is the worst headache you have ever had
• Confusion or change in behavior
• Change in level of consciousness
• Sudden loss of function in one part or all of one side of your body
• Sudden vision change, such as dimness, blurring, double vision, or loss of vision in one or both eyes (unless this is routine with your migraine headaches)
• Sudden, persistent difficulty speaking or difficulty understanding speech
• Seizure. (Protect the victim from harm during the seizure.)
• Severe dehydration
• A severe headache that starts during strenuous physical or sexual activity (exertional headache)

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• A headache develops after a head injury: Go to the topic:
  • Head Injury, Age 4 and Older.
  • Head Injury, Age 3 and Younger.
• A seizure: Go to the topic Seizures.
• A fever: Go to the topic:
  • Fever, Age 4 and Older.
  • Fever, Age 3 and Younger.
• Facial pain: Go to the topic Facial Problems, Noninjury.
• A headache and you are pregnant: Go to the topic Pregnancy-Related Problems.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Most 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.

You may be able to reduce the frequency and severity of your headaches by trying:

• Relaxation exercises. These exercises can help take away tension and stress that cause headaches or make them worse. For more information, see the topic Stress Management.
• Heat, such as hot water bottles, heating pads, or hot baths, to relax tense muscles. Be careful not to burn yourself.
• Ice, such as an ice pack applied to the back or the neck or the temples.
• Massage therapy and biofeedback, which can reduce muscle tension, especially in your neck and shoulder muscles. This muscle tension can cause headaches or make them worse. For more information, see the topic Complementary Medicine.

When 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.
• Do not allow your child to avoid chores or other activities unless his or her headache pain is moderate to severe.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Pain increases or lasts for longer than 12 hours despite the use of home treatment.
• New symptoms develop.
• Symptoms become more severe or frequent.

You 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 exercises you can do during your breaks. For more information, see the topic Neck Problems and Injuries.
  • 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 check ups 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, 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.

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.

Prevent head injuries to prevent headaches.

• Wear your seat belt when in a motor vehicle. Use child car seats.
• Do not use alcohol or other drugs before participating in sports or when operating a motor vehicle or other equipment.
• Wear a helmet and other protective clothing whenever you are biking, motorcycling, skating, kayaking, horseback riding, or rock climbing.
• Wear a hard hat if you work in an industrial area.
• Do not dive into shallow or unfamiliar water. Prevent falls in your home by removing hazards that might cause a fall.
• Do not keep firearms in your home. If you must keep firearms, lock them up and store them unloaded and uncocked. Lock ammunition in a separate area.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You 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?

Organization

• Allergic Rhinitis
• Carbon Monoxide (CO)
• Cluster Headaches
• Complementary Medicine
• Fever Seizures
• Fever, Age 3 and Younger
• Fever, Age 4 and Older
• Head Injury, Age 3 and Younger
• Head Injury, Age 4 and Older
• Influenza
• Migraine Headaches
• Neck Problems and Injuries
• Pregnancy
• Premenstrual Syndrome (PMS)
• Seizures
• Sinusitis
• Stress Management
• Stroke
• Temporomandibular (TM) Disorders
• Tension Headaches
• Transient Ischemic Attack (TIA)

When to See a Doctor

See significance of a headache with a severe stiff neck or a fever if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you need information on how to take a temperature, see the topic Body Temperature.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Do you have a severe stiff neck?
Yes	Do you have a fever of 103°F (39.4°C) or higher?
Yes	Do you think you have a moderate fever but you are unable to measure your temperature?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache with loss of function if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you have loss of function symptoms that have not gone away, call 911 or other emergency services immediately. These symptoms can be a sign of a stroke.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Have you had any symptoms of loss of function, but all symptoms are now gone?
Yes	Have you had a history of headaches and new symptoms of loss of function have come on slowly?
Yes	Are you having trouble standing, walking, or changing position?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a change in level of consciousness if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Are you having trouble staying awake?
Yes	Is your headache so severe that you are having trouble standing, walking, or changing position?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See the significance of vision changes if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Have you had temporary change in your vision but your normal vision has returned?
Yes	Do you have severe sensitivity to light (photophobia)?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of headaches in children if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your child's symptoms.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Does your child have a headache with other symptoms of a serious illness?
Yes	Does your child have severe headache pain?
Yes	Does your child have a headache with nausea, vomiting, or vision problems, such as blurred vision or blind spots?

	Call your health professional today if you answer "Yes" to the following question.
Yes	Are you unable to relieve your child's moderate headache with home treatment?

	You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions.
Yes	Has your child's headache caused mild pain without other symptoms for 24 hours or longer?
Yes	Has your child's headache gradually gotten worse during the past 24 hours?
Yes	Does your child have recurrent headaches that have not gotten better for 24 hours or longer after being checked by a doctor?

	You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions.
Yes	Does your child have a headache without other symptoms every day?
Yes	Does your child have a headache two or more times per week?
Yes	Are you giving your child nonprescription pain medicine (such as acetaminophen or ibuprofen) for a headache more than once a week?
Yes	Does your child miss school because of his or her headaches?
Yes	Are you unable to find the cause of your child's headache?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache that awakened you from sleep if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to the following question.
Yes	Is your headache so severe that you cannot return to sleep?

	Call your health professional today if you answer "Yes" to the following question.
Yes	Were you awakened from sleep by a headache but were able to return to sleep?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache with nausea and vomiting if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to the following question.
Yes	Do you have a moderate to severe headache with nausea and vomiting?

	Call your health professional today if you answer "Yes" to the following question.
Yes	Do you have mild to moderate dehydration, and you are not able to drink enough to replace lost fluids?

	You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question.
Yes	Have you had a headache without other symptoms off and on for the past 48 hours?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache that is caused or made worse by activity if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to the following question.
Yes	Do you have a severe headache that is made worse by any type of activity?

	Call your health professional today if you answer "Yes" to any of the following questions.
Yes	Is your mild to moderate headache caused or made worse by exercise?
Yes	Is your mild to moderate headache caused or made worse by sexual activity?
Yes	Is your mild to moderate headache caused or made worse by straining to have a bowel movement?
Yes	Is your mild to moderate headache caused or made worse by coughing?
Yes	Is your mild to moderate headache caused or made worse by bending your head forward?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache caused by abuse if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to the following question.
Yes	Do you think your headache may be caused by abuse?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache that does not improve with medicine if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to the following question.
Yes	Have you had a severe headache for 1 hour or longer?

	Call your health professional today if you answer "Yes" to the following question.
Yes	Have you had a moderate headache for 12 hours or longer?

	You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question.
Yes	Have you had a mild headache for 24 hours or longer that has improved but not gone away?

	You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions.
Yes	Have your headaches prevented you from completing your daily activities, such as school or work?
Yes	Have persistent headaches caused you to limit your usual activities for 2 weeks or longer?
Yes	Have you used prescription or nonprescription medicine to control your headaches for 2 weeks or longer?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a headache that may be caused by medicine if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional today if you answer "Yes" to the following question.

Yes

Do you think your headache may be caused by a medicine? Note: If your answer is Yes: Call the doctor who prescribed the medicine to determine whether you should stop taking the medicine or take a different one. An appointment may not be necessary. If you are taking a medicine or using an alternative therapy not prescribed by a doctor (nonprescription), stop taking the medicine or using the alternative therapy. Call your doctor if you feel you need to continue taking the medicine or using the alternative therapy or if you need help to control your symptoms.

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of change in the pattern of your headaches if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you have a new and different headache, use the questions in the Check Your Symptoms section to determine if and when to see a doctor.

	You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions.
Yes	Are you having headaches more often?
Yes	Are your headaches more severe?
Yes	Are your headaches interfering with your school, work, or social activities?
Yes	Has the location of your headache pain changed?
Yes	Has the type of pain from your headaches changed?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.