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When To Worry About Headaches

A 3 step approach to quickly take control of your headaches

We all get headaches, from minor to major. Other than the headaches that go away with a couple of paracetamols, never to come back again, all other headaches need attention.



1. Headaches could be a sign of a life-threatening problem

2. It could be a sign of a disorder of the body

3. Headaches can disrupt daily activities and prevent performance

4. It can lead to other problems such as loss of job, depression and anxiety


How do you know when to take headaches seriously?

Actually, consider all headaches seriously, but if we think of it systemically, in the following 3 step method, we can rule out most causes and decide what to do and when to see the doctor.



If you have had a fall or an accident, and had bumped your head, then this headache needs to be monitored. Take mild analgesic such as paracetamol, and rest. If headache persists and there are associated symptoms such as vomiting, drowsiness or confusion, then go to your family physician immediately or walk into the emergency room for assessment. X rays and/or CT scans of the head may need to be done.

If you develop a sudden, very severe headache, with or without vomiting, loss of consciousness or paralysis of any part of your body, it is best to get to the emergency room immediately as it could be a brain hemorrhage. And quick action saves lives.



If no trauma or fall, headaches could be due to many reasons. So first step, is to take simple analgesic like paracetamol and take rest. Consider the following and correct them:

Lack of sleep (take a nap and plan to sleep better from now on, 7-8 hours every night)

Dehydration (headache is one of the symptoms of lack of hydration, so drink more fluids, and plan to have 2 to 2 ½ litres of fluid daily)

Tech neck - pain in neck, shoulder and back of head due to strain in the neck from prolonged use of computer, phones, tabs in an improper posture (posture correction and time away from technology equipment)

Cold and runny nose and fever (take home remedies for the cold, and paracetamol, rest and fluids. Steam inhalation helps reduce nasal congestion due to the cold and will help relieve headache

Stress – psychological stress stems from worrying too much and doing too much (take time for yourself, rest, consider what you are worrying about, talk to family members or work colleagues and get help)

Weak Body – nutritionally weak and unconditioned body can get affected by the daily demands of living, working and studying. (ensure you are eating a balanced diet with a lot of green vegetables and that you do regular exercise for at least 30 minutes daily. Practising yoga is an added benefit)



If headache persists or keeps recurring despite all the above correction and elimination, then it needs to be assessed by your family doctor. Doctor will want to know the characteristics of your headache, such as where you feel the pain on your head, how long you have had it, is it continuous or intermittent, if intermittent then how often, and how long does it last, is it associated with any other symptoms such as flashes in the eye, vomiting, giddiness etc., what makes the headache worse or better, is there any foods or activity that trigger the headache. So, it is important to pay attention to these factors prior to seeing your doctor.

Headaches that are continuous or recurrent will need investigation, treatment and control. These headaches could be:

Migraine - this is a recurrent headache which can be triggered by certain foods or activity. It is not life threatening but can interfere with day to day living. It can be controlled by prescription migraine tablets after the diagnosis by your family doctor. Sometimes when migraines are not getting controlled by the first-line of medication, your doctor might refer you to a neurologist.

Cervical Strain (Tension Headaches) - strain and muscle spasm of the neck which can lead to headaches and neck trouble and again can interfere with working and concentration. It needs to be diagnosed and treated with posture correction and neck muscle strengthening by the doctor and physiotherapist.

Cervical Spondylosis - this is due to wear and tear in the spinal bones and joints in the neck. Requires investigations, diagnosis and treatment by your doctor and physiotherapist and sometimes referral to an orthopedic specialist.

Acute or Chronic Sinusitis - this is when the sinuses (which are air pockets within the bones of our face) become filled with infected phlegm/ pus. Your doctor will ask for X rays for diagnosis and this can be treated with the right combination of medicines. Sometimes your doctor will refer to an ENT specialist if it is persistent after treatment.

Brain tumours - any persistent headaches which does not subside with treatment quickly will need to be investigated for something more sinister such as tumours. Your doctor will do a brain scan to rule this out. If a tumour is found, then your doctor will refer you to a neurosurgeon for further treatment.


By following the 3 step approach, you can quickly get control of your headaches with the right treatment approach from your family doctor.


-         Dr. Kayathri Periasamy (Consultant Physician Healthy Life Clinic)

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