Acting early
Headaches and migraine: when to get help
Most headaches are not dangerous, but some patterns need same-day attention. Knowing which is which — and recognising medication-overuse headache — changes the outcome.
6 min read · Updated
Headache is close to universal, which is exactly why the genuinely serious ones get missed — they arrive wearing familiar clothes. A few patterns are worth committing to memory.
Get emergency help now
Call 911 or go to an emergency department for:
- A sudden, severe headache that reaches maximum intensity within seconds or a minute — often described as the worst of your life.
- Headache with face droop, arm weakness, or slurred speech. That is stroke until proven otherwise.
- Headache with fever and a stiff neck, or a rash that does not fade under pressure.
- Headache after a head injury, especially with vomiting, confusion or drowsiness, or if you take blood thinners.
- Headache with new confusion, seizure, double vision or loss of vision.
See a doctor soon
A headache pattern that is new or clearly changed; a first significant headache after age 50; headaches that consistently wake you from sleep or are worst on waking; headaches that steadily worsen week over week; or new headaches alongside cancer, HIV or a suppressed immune system.
Tension-type and migraine
Tension-type headache is typically a dull band-like pressure on both sides, mild to moderate, without nausea, and not worsened by routine activity.
Migraine is usually one-sided, throbbing, moderate to severe, made worse by movement, and accompanied by nausea or sensitivity to light and sound. Some people get an aura — visual zigzags or numbness — in the preceding hour. Migraine is a neurological condition, not a bad headache, and it is both common and very treatable.
The trap worth knowing about
Taking pain relief for headaches on more than about 10 to 15 days a month can cause medication-overuse headache — the treatment starts generating the problem. The pattern is a gradual increase in headache days alongside a gradual increase in tablets. Breaking the cycle usually means stopping the offending medication, which temporarily gets worse before it gets better, and is much easier with a doctor's help.
On scans
Choosing Wisely Canada advises against routine neuroimaging for headaches without red flags or abnormal neurological findings. A normal scan can be reassuring, but scanning everyone finds incidental oddities that lead to more tests and more worry without improving anything.
What helps day to day
Keep a simple diary — date, duration, likely triggers, what you took. Patterns emerge that neither you nor a clinician would otherwise spot. Regular sleep, meals and hydration genuinely reduce frequency for many people. Where neck tension is part of the picture, physiotherapy or massage therapy can help. If you are having several migraine days a month, ask about preventive treatment: many people endure years of attacks without knowing prevention exists.
These articles summarise public health guidance and are not a substitute for care from a regulated health professional who knows your situation. If this is an emergency, call 911. For a mental-health crisis, call or text 9-8-8. See our Crisis resources.