Headaches: When should you go to a doctor?

July 12th, 2019
A man holds his temples, as if having a severe headache
Headaches can be debilitating. It’s important to know when a headache can be treated with over-the-counter medications and when you should see your doctor. Photo by Getty Images.

Headaches can range from slightly annoying to absolutely debilitating. So when do you treat it yourself, see your doctor, go to urgent care or even seek help at an emergency room?

Dr. John Prucha, a primary care physician (PCP) with UCHealth Primary Care Clinic – Uptown, in Denver, has some answers.

Self-care

If you have a normal tension headache, you often can take care of it with over-the-counter medications, plus hydration, at home, Prucha said.

“If the headaches are occurring daily, however, it’s time to see your PCP,” he advised.

Morning headaches can sometimes indicate sleep apnea and you should see a PCP for diagnosis, he said.

Dr. John Prucha
Dr. John Prucha

Maybe it’s not just a tension headache, however. Maybe it’s a migraine. Migraines can be triggered by stress, lack of sleep, alcohol consumption or flashing lights.

“If your headache can’t be managed with over-the-counter medications, it would be most helpful to see your doctor,” Prucha said.

He explained that migraines often affect just one side of the head and can cause nausea and sensitivity to light and sound. Some are preceded by what sufferers call an “aura.”

“The second you get the aura, or realize you are starting to have (a migraine), try one of the over-the-counter medications for migraines. If that doesn’t help, get to your doctor or urgent care for more powerful medication to eliminate the pain. If this happens more than four times a month, your doctor can prescribe prophylactic medications to reduce the frequency and duration,” he added.

Other reasons to see your PCP would include “if you also are having fevers, experiencing weight loss, have had exposure to viral agents like HIV, if they wake you up at night, or if you get a headache with sexual activity or bowel movements.”

Urgent Care

If you are unable to see your primary care physician right away for a severe headache that’s not going away with home remedies, go to urgent care,” Prucha said.

Emergency Room

If you have headache after head trauma, “it could be a concussion – or worse, a brain bleed,” Prucha said.

“If you are experiencing ‘the worst headache of your life,’ or what they call a ‘thunderclap headache,’ or if there’s confusion associated with it,” then get to an emergency room, he suggested. If you’re having associated neurologic symptoms like facial droop, or neck pain, confusion or altered consciousness, or if you’re having seizures, get to an ER, he said.

Also go to the ER if you have a headache associated with illicit drug use, such as cocaine, meth or other stimulants, he added.

A physician’s advice

“One thing patients need to watch out for is headaches caused by Tylenol or ibuprofen. Taking them more than twice a week, can actually cause headaches.

“Sometimes just stopping all the medications a person is taking for headaches can stop the headaches,” Prucha said. “It seems counterintuitive, but it’s true.”

About the author

Linda DuVal is a freelance writer based in Colorado Springs who writes articles for UCHealth.