Thinking Through Head Pain: When a Headache Is Something to Worry About

Every year, almost half of the world's adults experience a headache -- pain or discomfort in the neck, scalp, or head. But few people understand what causes them. Here's what you should know about different headache disorders, what causes head pain, and when the pain could be more than just a headache.

Triggers and Headache Types

Headaches can be triggered by many factors, including the environment, your health, and your behavior. These triggers include dehydration, alcohol consumption, low blood sugar, awkward neck positioning, bright lights, loud sounds, changes in caffeine levels, and so on. This type of head pain goes away when you address the cause.

The most common type of headache is a tension headache, which feels like someone is pressing on or squeezing your head -- sometimes spreading to or from the neck. The cause is attributed to tightness in the muscles of the neck, jaw, scalp, and shoulders.

The next most common headache type is a migraine. Thirty million Americans suffer from this headache disorder, which is characterized by a throbbing pain on one or both sides of the head. Migraines can be mild or severe, and they come with a host of side effects such as light and sound sensitivity, nausea, and even vomiting. This type of pain is not fully understood, but it has something to do with blood vessels opening wide enough to push on the nerves. Migraines have triggers that include certain types of foods, a lack of sleep, skipping meals, and, for some women, the onset of their menstrual cycle. Sometimes auras precede migraines, and these warning symptoms can include numbness and tingling in the hands and face, flashing or dancing lights, and strange smells or tastes.

How to Discuss Head Pain With Your Doctor

It's always good to broach any health concerns with your primary care provider. Whether or not your headache fits into any of above categories, make an appointment with your doctor if you experience any of the following:

• Recurrent headaches for the first time
• More severe headaches than usual
• Headaches with symptoms like numbness and tingling, vomiting, or vision changes
• Pain in your eyes, ears, and/or sinuses
• Difficulty functioning and enjoying your life

Knowing When Your Headache Is an Emergency

If your headache is so intensely painful that visiting an emergency room seems reasonable, please do so immediately. If you're not sure whether it's worth a trip to the ER, here are some questions to consider:

• Have you had pain like this before?

If this headache seems familiar to you -- you've experienced it before or experience it regularly -- there's less of a chance that it might be an emergency.

• Apart from the head pain, how do you feel?

Do you have a fever and neck pain? Has your vision changed? Is your vision blurry, or have you lost vision in one eye? Are you having trouble walking, talking, or moving any of your limbs normally? If the answer to any of these questions is yes, you should be seen by a doctor as soon as possible.

• Was the headache sudden or brought on by trauma?

People seeking emergency treatment for head pain are often worried about infection, stroke, or tumors. Headaches due to infection have other signs, like fever or recent exposure to sickness. Stroke-induced headaches will often be sudden and excruciating, and headaches from tumors will be persistent, will be unresponsive to at-home treatment efforts, and are often accompanied by seizures. Headaches after a trauma, like a fall or blow to the head, should be evaluated by a doctor right away.

If you experience head pain that persists even after you try avoiding known triggers, make an appointment to see your doctor, and start keeping a daily diary describing when the headaches occur, where the pain is located, what you ate that day, how much caffeine you drank, how much you exercised, what you did for the headache, and whether that remedy worked. Bring that diary of information with you to your appointment. Your doctor will use that information to work with you toward a solution for the pain.