Symptoms guide
Headache
A headache is pain or discomfort in the head or face. Headaches are very common, and most are not caused by a serious illness, though a small number signal conditions that need urgent care.
At a Glance
- Most headaches are primary headaches, such as tension-type headaches, migraines, or cluster headaches.
- Secondary headaches are caused by another condition, such as an infection, injury, or medication overuse.
- Tension-type headaches are the most common type in adults.
- A sudden, extremely severe headache, often described as the worst headache of a person's life, is generally treated as a medical emergency; in the US, people are advised to call 911.
- Keeping a headache diary is a commonly used way to share patterns with a clinician.
What It Is
Headache describes pain anywhere in the head, including the forehead, temples, back of the head, or behind the eyes. The pain can be dull, throbbing, sharp, or pressing, and can last from minutes to days.
Doctors generally divide headaches into two groups. Primary headaches are conditions in themselves, such as migraine and tension-type headache. Secondary headaches happen because of another problem, such as a sinus infection, a head injury, high blood pressure crisis, or, rarely, bleeding in the brain.
Although most headaches are not dangerous, certain features are commonly treated as warning signs that call for prompt medical evaluation.
Common Terminology
- Primary headache
- A headache that is not caused by another condition, such as migraine, tension-type, or cluster headache.
- Secondary headache
- A headache caused by another condition, such as infection, injury, or a problem with blood vessels in the brain.
- Tension-type headache
- A common headache often felt as a tight band or pressure around the head.
- Migraine
- A neurological condition causing recurring, often throbbing headaches, frequently with nausea and sensitivity to light or sound.
- Cluster headache
- Severe, one-sided headaches around the eye that occur in groups or cycles.
- Medication-overuse headache
- Frequent headaches linked to regular use of headache relief medicines over time; also called rebound headache.
- Thunderclap headache
- A sudden, severe headache that reaches peak intensity within about a minute and is generally treated as an emergency.
Common Causes and Associations
Headaches are commonly associated with the following. This list is general education, not a way to identify the cause of a particular headache.
- Primary headache disorders, including tension-type headache, migraine, and cluster headache.
- Everyday triggers such as stress, poor sleep, skipped meals, dehydration, eye strain, and caffeine withdrawal.
- Infections, including colds, flu, sinus infections, and, rarely, meningitis.
- Frequent use of pain relief medicines, which can lead to medication-overuse headache.
- Head or neck injuries, including concussion.
- Less common serious causes, such as bleeding in or around the brain, stroke, very high blood pressure, or a brain tumor.
Symptoms and Features
This is a general description of how this symptom is often described, not a diagnostic checklist.
- Tension-type headaches are often described as a dull, pressing, or band-like pain on both sides of the head.
- Migraines are often throbbing, may be on one side, and may come with nausea, vomiting, or sensitivity to light and sound.
- Some people with migraine experience an aura, such as flashing lights or zigzag lines, before the headache.
- Cluster headaches are typically severe, one-sided pain around the eye, sometimes with a watery eye or runny nose on the same side.
- Headaches from sinus problems may come with facial pressure and congestion.
Tests and Evaluation
Most headaches are diagnosed based on a careful history and physical and neurological exam. Tests are used when a secondary cause is being considered.
- A detailed history of headache pattern, timing, triggers, and associated symptoms.
- A neurological exam to check vision, strength, reflexes, coordination, and sensation.
- Imaging such as a CT scan or MRI of the head when certain warning features are present.
- Blood tests to look for infection, inflammation, or other conditions in some cases.
- A lumbar puncture (spinal tap) in specific situations, such as suspected meningitis or bleeding.
Treatment Overview
Headache treatment depends on the type and cause, as identified by a healthcare professional.
- Many headaches are managed with general measures such as rest, fluids, regular meals, and adequate sleep.
- Over-the-counter pain relievers are commonly used for occasional headaches, though frequent use can contribute to medication-overuse headache.
- Migraine care may include specific medicines to stop attacks and, for frequent migraines, preventive treatments.
- Identifying and reducing triggers, such as stress or irregular sleep, is a common part of long-term management.
- Secondary headaches are treated by addressing the underlying condition.
When Professional Care May Be Discussed
Health organizations generally describe these headache features as reasons for urgent or prompt evaluation.
- A sudden, extremely severe headache is generally treated as a medical emergency; in the US, people are advised to call 911.
- Headache with fever, stiff neck, confusion, seizure, or a rash that does not fade under pressure is generally treated as an emergency.
- Headache with weakness, numbness, drooping of the face, trouble speaking, or vision loss may signal a stroke and is generally treated as an emergency.
- A headache after a head injury is commonly evaluated promptly, especially with vomiting, drowsiness, or confusion.
- Headaches that are new after age 50, steadily worsening, or changing in pattern are commonly discussed with a healthcare professional.
Questions to Ask a Healthcare Professional
General questions people often find useful to bring to an appointment:
- What is the difference between a tension-type headache and a migraine?
- What are common headache triggers?
- When is imaging such as a CT or MRI generally used for headaches?
- What is medication-overuse headache and how is it generally managed?
- Which headache warning signs are considered emergencies?
- How can a headache diary be useful?
Sources
This guide was written in plain language from the following authoritative references.
Last updated October 8, 2026. FreeDoc guides are general educational information and are not a substitute for care from a qualified professional.