Headache? When to take action

Could your ‘caffeine headache’ be a brain tumour? Doctors reveal when to panic and when to put your feet up…

THERE’S one question our patients really want answered. The one that gnaws at them at night, that prompts them to make an appointment for the first time in years.

The one that keeps them from ignoring that weird new symptom that’s probably nothing but…

“OMG, what if it isn’t nothing, and what if it’s an early sign of something serious? Am I dying?”

The answer, of course, is, yes. From the moment you were born!

The real question is: will it be sooner than you had expected?

Thankfully, most new symptoms turn out to be no big deal.

Sometimes a headache isn’t just a headache, and can be the sign of a life-threatening condition. But in the middle of the night, even just a 1% chance of a terrible outcome starts to feel like a 98% chance.

Of course, you could just Google your symptoms. Go ahead. Oh, it says your stuffy nose is a sign of cancer? (By the way, where did Dr Google go to medical school?)

If you have a new symptom, what should you do?

Here, we go through the most common symptoms and provide guidance on the next steps –whether you can relax and make yourself a cup of tea, should pick up the phone to make an appointment with your GP or rush off to hospital.

The good news is that most of the time your symptoms will be benign, and you can go ahead and enjoy that cup of tea.

It’s impossible to cover every scenario: when in doubt, ask a doctor. Also, we assume you’re a generally healthy adult who doesn’t have a diagnosis related to your symptoms. If you have severe chest pain and had heart surgery two weeks ago, please call your doctor.

If you know or suspect that you have a health problem, it is recommended you seek your physician’s advice before embarking on any medical programme or treatment.

Today, we look at headaches. Most of us know the familiar pounding sensation that occurs at the end of a long week. But what if this headache is different?

Before you panic, let’s pause to review the facts. Many people have experienced headaches severe enough to warrant a trip to the emergency room. In fact, one in 50 visits there is about headaches.

Yet most of those people survive, and you probably will, too.

TREAT YOURSELF AT HOME

YOUR headache is mostly in your forehead or face and you’ve recently had symptoms of a cold, such as a fever and runny nose:

¡ One of your sinuses is probably jammed with mucus and is too swollen to drain properly.

¡ You can try to thin out the mucus by inhaling warm vapour. Take ibuprofen along with a decongestant such as pseudoephedrine or phenylephrine (available over the counter from your pharmacist). If the pain gets steadily worse and lasts for more than a week, you might need antibiotics; make an appointment to see your doctor.

You also have a fever, body aches, pains in your muscles and have a sore throat:

¡ You probably have the flu.

¡ You have recently kicked your coffee habit. You’re in caffeine withdrawal. You’ll need to ride this out, preferably with the help of a pain reliever, such as ibuprofen.

Your headache feels like a band around your skull, but gets better with rest and medications such as paracetamol:

¡ The symptoms are typical of a tension headache, the most common and least dangerous type of headache. They don’t require medical attention unless they’re happening often enough to interfere with your quality of life. The pain is uncomfortable but not intolerable. It came on gradually and isn’t associated with any other symptoms:

¡ Some headaches don’t fit any specific pattern but also don’t have any alarming features.

¡ Take a pain reliever with a tall glass of water and lie down in a quiet room. Give the medicine at least an hour or two to work. You should feel better soon.

¡ If the pain keeps getting worse or becomes more regular, take a look through the next sections.

SEE YOUR GP

YOU’RE having frequent or intense headaches but never used to before: ¡ High levels of stress, poor sleep, or a sudden decrease in caffeine intake can cause new-onset headaches in a person who doesn’t normally have them. ¡ If there’s no obvious explanation, however, you should see your doctor to rule out rare but dangerous causes of headache.

You occasionally have gradualonset throbbing headaches along with nausea and increased sensitivity to light and sound:

¡ This pattern is classic for migraines. If you think you’re having migraines, see a doctor to confirm the diagnosis and get on the right medications.

You’re over 50, your scalp hurts when you brush your hair and your jaw gets tired after chewing for a few minutes:

¡ You may have temporal arteritis, a condition where the arteries on the side of your face become diseased and narrowed. Major symptoms include headache, scalp tenderness, jaw fatigue after chewing and vision changes or loss. If the disease isn’t quickly diagnosed and treated, permanent vision loss can occur. See your doctor ASAP.

GO TO HOSPITAL

YOUR speech has also become slurred, or you feel weak or numb in an arm, leg, and/or the side of your face:

¡ You could be having a stroke. You’re feeling groggy and generally not quite right: ¡ A headache associated with confusion, excess sleepiness, or personality changes might indicate high pressure around the brain from infection, tumour or bleeding.

You have a fever and your neck also hurts:

¡ An infection around the brain, known as meningitis, causes high fevers, headache and neck stiffness/pain. Some people also become sensitive to bright lights. The headache came on fast:

¡ Ones that go from zero to 10 within a few minutes are known as thunderclap headaches. They’re often a sign of a serious and rapidly progressing problem, such as bleeding into the brain. You’ll need an urgent brain scan.