When is a headache worth seeing a doctor about?
Almost everyone gets headaches. The overwhelming majority are tension headaches or migraines — unpleasant, sometimes disabling, but not dangerous. That is genuinely reassuring, and it is also why the small number of headaches that do signal something serious are easy to dismiss.
Signs that mean you should be seen urgently
Come to an emergency department the same day, rather than booking an appointment, if a headache comes with any of the following:
- It began suddenly and severely — the worst headache of your life, reaching full intensity within seconds or minutes
- It follows a head injury
- It comes with fever and a stiff neck, or a rash
- It comes with weakness, numbness, difficulty speaking, or a facial droop
- It comes with confusion, drowsiness, or a seizure
- It comes with sudden visual loss or double vision
- It began after the age of 50 and is a new kind of headache for you
Signs that warrant an appointment, but not an emergency visit
- Headaches that are becoming more frequent or more severe over weeks
- Headaches that consistently wake you from sleep or are worst first thing in the morning
- Headaches that reliably worsen when you cough, strain, or bend forward
- Headaches needing painkillers on more days than not — treating pain this often can itself cause headaches
- Any headache pattern that has clearly changed from your usual one
What helps your doctor most
A headache diary is more useful than any scan. For two or three weeks, note when each headache starts, how long it lasts, where the pain is, what you had taken or eaten, how you slept, and what medication you used. Patterns that are invisible day to day often become obvious on paper — and they frequently point to the diagnosis without imaging.
Also bring a list of every medicine you take, including painkillers bought without a prescription, and mention any family history of migraine or neurological illness.
Will I need a scan?
Usually not. Most headaches are diagnosed from your history and an examination, and a normal scan does not make a headache hurt less. Imaging is genuinely useful when there are warning signs, when the pattern has changed, or when the examination finds something unexpected — and in those cases it should not be delayed.
“The question a good headache consultation answers is not "what does the scan show" but "why has this changed".”
This article is general information and cannot tell you what is causing your own headaches. If you are worried, or if anything above sounds like you, please see a doctor.