Headaches are a normal part of life. Even migraines are prevalent among the general population. About 1 in 4 households in the United States has a member who deals with migraines, making it the third most prevalent illness in the world, according to the Migraine Research Foundation.
People who regularly get tension headaches and migraines but feel OK in between those episodes typically don’t have anything to worry about, said Stephen Silberstein, professor and director of the Jefferson Headache Center in Philadelphia. It’s when you’re dealing with unusual headaches that you want to take note of.
“If the headache feels different than it usually does or if it’s the first time you’ve had this type of headache, then it’s important to look more closely at what’s going on,” Silberstein told HuffPost.
These types of headaches are called secondary headaches, according to Merle Diamond, president and managing director of the Diamond Headache Clinic in Chicago and member of the National Headache Foundation. And while they only make up about 3 to 4% of all headaches reported, they can signal some severe health concerns.
Below, experts share the major red flags that your headache may be more than just run-of-the-mill pain and what to do if you start to experience one of these types of pain.
An extremely painful headache out of the blue
It’s smart to pause when this happens, especially if you don’t usually get headaches.
“Head pain that happens really fast and is really bad could be the sign of a brain aneurysm,” Diamond said.
During a brain aneurysm, the blood vessels in your brain start to bulge due to weakness in the vessel wall. As blood continues to build up, it can lead the vessel to leak or rupture into the brain, causing a stroke. This type of headache is often referred to as a thunderclap headache, which is named for its painful and sudden nature, Silberstein said.
It’s important that if you have this type of pain you contact your doctor immediately or go to an urgent care center or hospital to get evaluated.
New head pain that’s worse in the morning
Some people may assume that sudden headaches can be a sign of a brain tumor, but Diamond said this isn’t usually the case.
Headaches associated with tumors are often localized to the part of the brain where the issue is, Diamond said. With a tumor-related headache, you might also notice that your head pain is persistent, and that it’s worse in the morning.
A headache along with other symptoms, like a fever
Dealing with a headache on top of a fever, rash or stiff neck could be a sign of a viral infection such as meningitis.
“This is an acute bacterial infection of the lining of the brain,” Diamond said. “Even if you typically suffer from headaches, it’s important to take note of what else is going on in the body so you can seek care if you need to.”
The same goes for a headache accompanied by a fever and other symptoms such as a loss of taste or smell, chills, shortness of breath or fatigue. This could be an indicator of a coronavirus infection.
Headaches that come and go when you stand up or get worse over time
These types of headaches may indicate too high or low pressure in the head, Silberstein said. Similarly, if you have a headache that is getting worse over time, that can be a red flag for a variety of issues and it’s best to get it checked out. In general, any chronic pain should not go unaddressed.
Headaches that appear after a certain age
Something else to keep in mind is your age.
“If someone is 50 years or older and has never had problems with headaches before, this could be something called giant cell (or temporal) arteritis,” Silberstein said.
This is when the arteries around the scalp become inflamed, leading to vision problems, scalp tenderness and jaw pain in addition to severe headaches.
If you’ve had headaches your whole life but now they’re suddenly different, you’re experiencing what’s known as a “fundamental change” and should get medical attention.
“Let’s say you are 40 years old with a new onset of a completely different headache or a change in symptoms,” Diamond said. “You need to let your medical provider know this, because now the characteristics of your headaches has changed, and we need to figure out why.”
How to get the right care for your headache
In an effort to make things easier for yourself when you get a headache, here are some guidelines on what kind of care you should seek and when:
If your head pain is associated with a neurological issue, get emergency care.
This includes issues such as blurred vision, weakness in an arm or leg and/or slurred speech. Go to a hospital and get evaluated.
If your normal headaches have changed, don’t hesitate to call your doctor.
Your physician should be aware of any fundamental change in the type of head pain you typically experience. “It can be hard to get in to see your doctor quickly in this COVID era of care we’re living in, so if for some reason they can’t see you right away, don’t be afraid to go to an emergency room or [urgent care],” Diamond said.
For headaches that are persistent but mild, bring them up at your next appointment.
Make sure to mention them your doctor so they can help you find relief and monitor accordingly. “If you have a headache you’ve had all your life and this one feels worse than normal, that’s not necessarily a warning sign,” Silberstein said. “But if you suddenly have a headache that comes on with no other reasons, that’s a warning sign you need care fast.”
