Headache: signs you shouldn't wait

What to record

Time of onset, speed of onset, location and intensity of pain, previous similar episodes and accompanying symptoms are useful for assessment. Write down the medicines you have taken and their effects.

A headache cannot be reliably classified on the Internet alone. A new or significantly different headache deserves a discussion with a health professional.

Red flags

Special attention is required for headaches after an injury, with fever and a stiff neck, after exertion, with a disturbance of consciousness or in a person with a severely weakened immune system.

• sudden onset and worst pain yet
• drooping corner of the mouth, arm or leg weakness
• slurred speech, confusion or a new vision disorder
• pregnancy or the postpartum period with a new severe headache

If there are no red flags

Rest, fluids, and monitoring triggers sometimes help, but frequent use of painkillers can perpetuate the headache itself. For repeated or increasingly frequent complaints, arrange an examination.

What to record before assessment

Note when the headache began, how quickly it reached maximum intensity, where it is felt, how long it lasts and whether it resembles earlier episodes. Record associated signs such as fever, stiff neck, vomiting, visual disturbance, weakness, numbness, speech difficulty or loss of consciousness.

Mention pregnancy or the period after birth, recent head injury, new medicines, blood-thinning treatment and known conditions. These circumstances can change the urgency of assessment even when the pain is not the most severe you have experienced.

Use a headache diary safely

For recurrent non-urgent symptoms, a diary may reveal a pattern. Record timing, duration, possible triggers, sleep, meals, menstruation, medicine taken and its effect. The diary supports a clinical conversation; it is not a tool for self-diagnosis.

Frequent use of pain medicines can itself perpetuate headaches in some people. If medicine use is increasing, the pattern changes or headaches disrupt daily function, arrange an assessment rather than repeatedly self-treating.

Preparing for a non-urgent review

Bring the diary and a list of all pain medicines, including non-prescription products and caffeine. State how many days per month headaches occur and how many days medicine is used, because frequency can affect the next step.

Assessment may include a neurological examination, blood pressure, vision and other checks guided by symptoms. Imaging is not needed for every headache; the decision depends on the pattern and risk signs.

• date and duration
• speed of onset and intensity
• associated neurological symptoms
• medicine used and the response