Managing Headaches Day to Day, and When to See a Doctor

Common headaches and dangerous ones are different

Headaches are extremely common, and most are not caused by anything seriously wrong in the brain. Recurring types such as tension-type headaches, which feel like a dull band of pressure, or migraines, which throb on one side and make light and sound hard to bear, are closely linked to sleep, meals, stress and posture. Rarely, though, a headache is the first sign of something that needs urgent treatment, such as bleeding in the brain or an infection. So it helps to think on two tracks: reduce your usual, recurring headaches through daily habits, and get care without delay when something feels different from your normal pattern.

Use a headache diary to find triggers

The same kind of headache can have very different triggers from person to person. Instead of simply blaming stress, try keeping notes for two to four weeks. Clearer patterns often appear than you would expect, such as a headache every time you sleep in on the weekend, or worse afternoons on days you skip lunch. A diary is also very useful for a doctor if you do seek care.

• When it started and how long it lasted
• Where it hurt and what it felt like: pressing, throbbing, stabbing
• How long you slept the night before and which meals you ate
• How much coffee or alcohol you had, and when
• Any medicine you took, whether it helped, and other symptoms

Keep sleep and meals on a steady rhythm

The most common thread among people with frequent headaches is a disrupted routine. Headaches can follow too much sleep as well as too little, which is why catching up on sleep at the weekend can lead to a Monday headache. Waking at roughly the same time on weekdays and weekends is a good place to start. Skipping meals or eating very late is another frequent trigger, so even on busy days a small meal on time is better than nothing. Some people notice a heavy head on afternoons when they have not drunk enough, so sip water through the day rather than waiting until you feel thirsty.

With caffeine and alcohol, consistency matters more than amount

Coffee can briefly ease a headache, but if you drink it daily and then suddenly stop, or have it much later than usual, a withdrawal headache can follow. A weekend morning headache is sometimes as much about the delayed coffee as the lie-in. If you want to cut back, reducing the amount gradually over several days is easier than quitting overnight. Alcohol is a classic cause of next-day headaches, and some people react strongly to particular drinks. If your diary shows alcohol and headaches often going together, drink less or avoid that type.

Ease screen strain, posture and tension

Long hours sitting at a screen stiffen the neck and shoulder muscles, and that tension easily spreads into a tight headache at the back of the head or the temples. Setting the top of the screen at about eye level and getting up every 30 to 60 minutes to roll your shoulders makes a real difference. Clenching your teeth is also linked to pain at the temples, so check now and then whether your jaw is tight during the day. If your eyesight has changed but you are still wearing old glasses, squinting alone can cause headaches, so an eye test is worth considering.

Count how often you use painkillers

Over-the-counter painkillers help with occasional headaches, but reaching for them every time can lead to medication overuse headache, where headaches actually become more frequent. If you find yourself taking painkillers on around ten or more days a month, stop trying to manage alone and see a doctor to discuss preventive treatment. Follow the package leaflet and a pharmacist's advice on dose and timing, and if you have stomach or liver problems or take other medicines, ask a pharmacist or doctor before choosing a product.

Common mistakes and judgment calls

Two mistakes are common: putting up with frequent headaches without doing anything, and reaching for pills at the first twinge. If headaches disrupt your day several times a month, that alone is a good reason to see a doctor alongside changing your habits. And if your headaches start to feel different from before, do not dismiss them as your usual ones.

• For headaches during pregnancy or in children, talk to a doctor or pharmacist before using medicine
• If headaches began after starting a new medicine, tell whoever prescribed it
• If you have high blood pressure, check it on days with a bad headache
• After a knock to the head, keep watching a headache even as time passes

Warning signs that need care right away

Some situations are not for waiting it out. Call emergency services immediately for a sudden, severe headache that peaks within seconds to a minute, the worst headache you have ever had, or a headache with weakness in an arm or leg, slurred speech or sudden loss of vision. A headache with fever and a stiff neck, a worsening headache with vomiting or confusion after a head injury, and any loss of consciousness or seizure are also emergencies. A new headache that starts after age fifty, one that gets steadily worse over weeks, or one that wakes you from sleep should be checked promptly. This article is general information and does not replace diagnosis or treatment. If symptoms continue or worry you, talk to a medical professional.