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Here’s when to worry about a headache

When you have an intense headache, it might feel like someone is taking a hammer to your temples, or your head is in a vise.

If you suffer from headaches, you know how painful and intense they can be. Often, an over-the-counter pain reliever is enough to dull the pain; however, sometimes you need a more structured care plan.

"There are actually hundreds of different types of headaches, all caused by different issues with different treatments," said Uzzal Roy, MD, a neurologist at Geisinger Community Medical Center. "When you understand the type of headache you get, you can treat it more effectively when it comes on."

Here are some common types of headaches.

  • Tension headache: Tension or stress headaches are the most common headaches experienced by kids and adults, with noticeable pressure and tightness on both sides of the head. They can occasionally be caused by stress; the pain comes and goes. Tension headaches are typically treated with an over-the-counter pain reliever. Some people also find relief with a hot shower or a short nap.
  • Migraine: Pounding, throbbing pain, visual auras, blurry vision and sensitivity to light or sound are all symptoms of migraines, painful headaches which often affect just one side of the head and typically occur one to four times a month. Some people who experience migraines may also feel nauseous or vomit.

    "Some migraines are associated with triggers like changes in the weather, a lack of sleep, fatigue, emotional stress, loud noises or strong smells, or diet-related triggers such as missing a meal, an increase or decrease in caffeine, alcohol or chocolate," said Dr. Roy.

    If migraines are caught early, they can sometimes be treated with over-the-counter pain relievers. Migraines may also be treated with prescription medication.
  • Cluster headache: Cluster headaches happen in groups of one to eight per day for 30 to 60 minutes; the clusters last a few weeks to a few months. They’re the most intense type of headache; people typically experience piercing or constant pain behind the eyes. Some people experience cluster headaches, then go into remission for months or years. Many cluster headache sufferers have a difficult time sitting still during an attack, and instead pace or jog when one strikes.
  • Rebound headache: Rebound headaches, also called medication-overuse headaches, can develop as a result of regular, long-term use of medication to treat headaches, such as migraines. Taking pain relievers to treat headaches on a regular basis for a longer period of time, usually three months, can actually trigger daily rebound headaches. Once the medication overuse is stopped, however, the rebound headaches will typically subside.
  • Sinus headache: Pain between the eyes and above the nose is a sinus headache, which occurs a result of inflammation in the sinuses. People with these headaches usually experience other symptoms like a runny nose or feeling full in the face.

When to worry about headache pain

"Headaches are most often treated with over-the-counter pain relievers or by working closely with your doctor," said Dr. Roy. "However, there are some warning signs you should look out for that warrant medical attention."

These warning signs could include:

  •  A change in the pattern of your headaches. This could be a sign of a more serious condition.
  •  Headaches that are accompanied by weight loss, slurred speech, vision change, weakness, numbness, seizures or cognitive dysfunction. This could be a brain tumor.
  •  A headache along with a stiff neck, fever, nausea, vomiting, confusion or decreased alertness. This could be meningitis.
  •  Headaches following a blow to the head. This could be a sign of brain swelling or bleeding around the brain. Seek medical attention immediately.
  •  Exceptionally bad pain. If you feel you’re having the worst headache you’ve ever experienced, it may be a sign of an aneurysm with leak blood or burst.
  •  Headaches upon awakening that get worse with movement or when coughing, straining or lifting weights.

While it’s rare to experience any of these medical issues, it’s also important not to ignore these issues if you feel your headache is not normal.

"It’s always better to be safe than sorry. A doctor will conduct the appropriate tests to confirm whether your headache is just a headache or something to be concerned about," said Dr. Roy.

Geisinger neurologist Uzzal Roy, MD, sees patients at Geisinger Community Medical Center in Scranton. To schedule an appointment with Dr. Roy or another Geisinger neurologist, please call 800-275-6401 or visit

woman holding head in hand