Headache

Definition

  • Pain or discomfort of the scalp or forehead
  • Pain is not in the face or ears

Some Basics...

  • Almost everybody has had a headache at some point in their lives. Headache is a very common symptom.
  • Headaches can vary from mild to severe. The pain can feel sharp, dull, throbbing, or aching. The type, severity, and location of the pain depend on the cause of the headache.
  • Most headaches do not have a serious cause. The most common causes are muscle tension headache, migraine headache, and sinus infection.
  • Simple treatment will often help people with headaches feel better.

Common Causes

During the course of any year, most adults will get a headache. There are many common causes.

  • Muscle Tension Headaches: Most headaches are caused by muscle tension. The tension may also be felt in the neck and shoulders. These headaches are made worse by emotional stress.
  • Migraine Headaches: Also called vascular headaches. The headache is moderate to severe. It is described as throbbing or pulsing pain on one side of the head. People may also vomit or have an upset stomach. Some people will have visual warning signs before they get these headaches.
  • Sinusitis: Sinusitis can cause headaches. The headache is most often felt in the forehead. The nose may also be runny and stuffy from the sinus infection.
  • Fever: People with fever will often get a mild to moderate headache. Fever may be from the flu or common cold.  A severe headache that lasts after the fever may have a more serious cause.
  • Caffeine Withdrawal Headache: This happens to people who usually drink large amounts of caffeine, and then suddenly stop. They can get a headache from not having caffeine. Some caffeine drinkers even get headaches after waking up. These usually go away after their first cup of coffee or tea.

Some Serious Causes of Headache

  • Stroke ("Brain Attack")
  • Meningitis, encephalitis
  • Temporal arteritis
  • Brain tumor
  • Being exposed to carbon monoxide

Pain Scale

  • None: No pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

When to Call Us for Headache

Call 911 Now (your child may need an ambulance) If

  • Trouble waking up or acting confused
  • New weakness of the face, arm, or leg on one side of the body
  • New numbness of the face, arm, or leg on one side of the body
  • Start to slur speech or have trouble speaking
  • You think you have a life-threatening emergency

Call Us Now (night or day) If

  • You feel weak or very sick
  • Pain is severe and it's the worst headache of your life
  • Pain is severe and you have not had severe headaches before
  • Stiff neck (cannot touch chin to chest)
  • Blurry eyesight or seeing double
  • Unsteady walking
  • Fever of 103°F (39.4°C) or higher
  • Fever of 100.5°F (38.1°C) or higher and over 60 years old
  • Fever and have diabetes
  • Fever and have a weak immune system from:
    • HIV positive
    • Cancer chemo
    • Long-term steroid use
    • Splenectomy
  • Fever and are bedridden (nursing home patient, stroke, chronic illness, or recovering from surgery)
  • May have been exposed to carbon monoxide

Call Us During Weekday Office Hours If

  • You have other questions or concerns
  • Headache lasts more than 24 hours
  • You have had headaches off and on for weeks or months

Parent Care at Home If

  • Mild to moderate headache
  • Had a migraine headache like this before
  • Had a muscle tension headache like this before

CARE ADVICE FOR HEADACHE

What You Should Know:
  • Headaches can vary from mild to severe. The pain can feel sharp, dull, throbbing, or aching. The type, severity, and location of the pain depend on the cause of the headache.
  • Most headaches do not have a serious cause.
  • You can treat most headaches at home.
  • Here is some care advice that should help.
Migraine Headache:
  • This type of headache is called a vascular headache. It can be mildly to severely painful. People who get migraines often describe them as throbbing or pulsing. A migraine headache is often felt on just one side of the head.
  • You may also vomit or have an upset stomach. Some people will have visual warning signs before they get migraines.
Muscle Tension Headache:
  • Most headaches are caused by muscle tension.
  • People say the headache feels like a tight band around their head. You may feel tension down into your neck and shoulders. These headaches can be made worse by emotional stress.
  • These headaches are painful. There are pain medications you can take to help the pain.
Pain Medicines:
  • You can take one of the drugs listed below if you have pain.
  • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
Acetaminophen (Tylenol):
  • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
  • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
  • Do not take more than (3,000 mg) of this drug per day.
Ibuprofen (Motrin, Advil):
  • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
  • A second choice is to take 3 pills (600 mg) every 8 hours.
Naproxen (Aleve):
  • Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
  • A second choice is to take 2 pills (440 mg) every 12 hours.
Extra Notes:
  • Use the lowest amount of a drug that makes your pain feel better.
  • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
  • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
  • Caution- Acetaminophen: Do not take it if you have liver disease.
  • Caution- Ibuprofen and Naproxen:
    • Do not take ibuprofen or naproxen if you are pregnant.
    • Do not take these drugs if you have stomach problems or kidney disease.
    • Do not take these drugs for more than 7 days without checking with your doctor.
  • Read all package instructions.
Migraine Medication: Take your prescription migraine medicine as soon as it starts.
Rest: Lie down in a dark, quiet place and try to relax. Close your eyes and try to relax your whole body.
Cold Pack: For pain, put a cold pack or cold wet washcloth on your forehead for 20 minutes.
Stretching: Stretch and massage any tight neck muscles.
Call Your Doctor If:
  • Headache lasts more than 24 hours
  • You get worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Author and Senior Reviewer: David A. Thompson, M.D.

Copyright 2000-2013. Self Care Decisions LLC; LMS, Inc.