Headaches are one of the more worrisome symptoms when they come on. From possible impairment of vision to difficulty focusing an uneasiness, it can be debilitating if not taken proper care of. However, beyond the pain and the discomfort, what we need to be aware of is when to worry with a headache.

Different kinds can have their own set of symptoms, happen for unique reasons, and need different kinds of treatment. Once you know the type of headache you have, you and your doctor can find the treatment that’s most likely to help and even try to prevent them.

Although some headaches can be very debilitating and painful, with work hours lost, if a prior history is present, they can be aptly and quickly diagnosed and treated. Some headaches may have an underlying etiology which may only come to the front once a headache comes on. These are the headaches I would worry about, especially if cloaked under other myriad symptoms. In this article we address a few of the different types of headaches (there are more than 150 types), along with what to do for each, and which ones to worry about.


These headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times per month. Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. When a child has a migraine, he often looks pale, feels dizzy, and has blurry vision, fever, and an upset stomach. Patients with migraines have a very clear history of triggers, and would have been experiencing them for a while. Over the counter painkillers and avoiding triggers are the best ways to deal with migraine.


Also called stress headaches, chronic daily headaches, or chronic non-progressive headaches, they are the most common type among adults and teens. They cause mild to moderate pain and come and go over time. Stress management and OTC pain medication are effective ways of dealing with them.


This type is intense and feels like a burning or piercing pain behind the eyes, either throbbing or constant. It’s the least common but the most severe type of headache. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack.

They’re called “cluster headaches” because they tend to happen in groups. You might get them one to three times per day during a cluster period, which may last 2 weeks to 3 months. The headaches may disappear completely (go into “remission”) for months or years, only to come back again.


Secondary headache is the term given to headaches that are caused by an underlying disease. Most common of these problems are deteriorating eye vision, glaucoma (increased pressure in the eye), sinusitis, malignancy, infection in the brain (rare) and a condition known as subarachnoid hemorrhage, which is a bleed in the brain which may prove fatal if not dealt with on time. You should be worried about a headache if a patient looks more fatigued or worried than you would expect with a primary headache, and has one or more of the following:

Onset of headache after 50 years of age

Headache described as ‘worst headache of my life’

Headache described as a ‘thunderclap’. This is a sign of subarachnoid headache, which is a bleed in the brain.

Red eye and associated halos around objects

Signs of meningeal irritation accompanying the headache, such as fever, neck stiffness and a rash.

Vomiting along with the headache

If any of the above symptoms are accompanying your headache, or if you are feeling more off than usual, visit your GP for a full assessment.

Dr. Annie

Physician, mom and wife

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