Get medical help immediately if any of these apply
- The worst headache of your life, arriving suddenly and peaking within seconds or a minute.
- Headache with fever and a stiff neck, or with a rash that does not fade under pressure.
- Headache with confusion, drowsiness, a seizure, or difficulty staying awake.
- Headache with weakness or numbness on one side, drooping face, or trouble speaking or seeing.
- Headache that began after a head injury, especially with vomiting or drowsiness.
- A new headache pattern if you are over 50, pregnant, recently pregnant, or immunocompromised.
- Headache that is consistently worse when lying down, coughing, or straining.
- Headache with scalp tenderness or jaw pain while chewing, in someone over 50.
This list is not exhaustive. Anything sudden, severe, or rapidly worsening needs immediate medical attention regardless of what any website says. In India, call 112 for any emergency or 108 for an ambulance. Elsewhere, use your local emergency number.
What commonly causes a headache
The large majority of headaches are what clinicians call primary headaches — the headache is the condition itself, not a symptom of something else. The rest are secondary: a sign of something separate, ranging from dehydration to infection.
- Tension-type headache — the most common kind. Usually both sides, a dull tightening or pressure, not made worse by activity.
- Migraine — often one side, throbbing, moderate to severe, frequently with nausea and sensitivity to light or sound. Movement typically makes it worse.
- Cluster headache — rare, severe, strictly one-sided around the eye, often with a watering eye or blocked nostril on the same side, in bouts.
- Medication-overuse headache — a headache that develops from frequent, long-term use of pain relief for headaches.
- Everyday triggers — poor sleep, skipped meals, dehydration, alcohol, caffeine withdrawal, eye strain, stress.
- Secondary causes — sinus infection, raised blood pressure, fever and viral illness, and less commonly conditions affecting the brain or its blood vessels.
Patterns worth noticing
What helps a clinician most is not the pain score but the pattern. Before a consultation, try to answer: how quickly did it come on, where exactly is it, what does it feel like, how long does it last, what makes it better or worse, and what comes with it.
- Sudden versus gradual onset — a headache that peaks almost instantly is treated very differently from one that builds over hours.
- New versus familiar — a headache unlike any you have had before deserves more attention than a familiar one.
- Frequency over time — headaches becoming more frequent or more severe over weeks is a pattern worth reporting.
- Time of day — headaches consistently present on waking, or that wake you from sleep, are worth mentioning specifically.
When to see a doctor, without urgency
- Headaches that recur often enough to interfere with work, study, or sleep.
- Headaches needing pain relief more than a couple of days a week.
- A clear change in your usual pattern, frequency, or severity.
- Headaches alongside new vision changes, even mild ones.
- Headaches during pregnancy, which are worth discussing rather than self-managing.
Which doctor treats this
Picking the wrong speciality for a first consultation costs time and money. These are the specialities that commonly handle this, though your particular situation may point elsewhere — work out which specialist to see.
- General physician or family doctor — the right starting point for almost all headaches.
- Neurologist — for migraine that is not responding, cluster headache, or any headache with neurological symptoms.
- Ophthalmologist — where vision problems or eye strain seem to be driving it.
- ENT specialist — where sinus symptoms dominate.
- Emergency department — for any red flag above.
Questions worth asking your doctor
- Does my pattern fit a primary headache, or should something else be ruled out?
- Do I need any imaging or tests, and if not, why not?
- How often is it safe to take the pain relief I am using?
- Could any medicine I already take be contributing?
- What change in my symptoms should bring me back sooner?
How DoctoGuide can help
This page is general information — it cannot know your age, history, medicines, or how your symptoms actually present. DoctoGuide asks those follow-up questions, then gives you guidance specific to what you described, a sense of urgency, the speciality to see, and a written summary to take into the consultation. It is free and needs no account.
DoctoGuide does not diagnose, prescribe, or replace a doctor. What it can and cannot do is set out on the medical safety page.