What to Do If Your Headache Just Won’t Go Away

Most people will get occasional headaches at some point in their lifetime (tension headaches and migraines being common culprits). But some headaches linger for long periods of time and can become chronic. If you have constant headaches, seeking medical help is the first step to figuring out what type of headache you have.

What are the different types of headaches?

There are many different types of headaches. Some have certain features that help your provider determine which kind they may be. 

It’s important to know which type of headache you have so you can select an appropriate treatment. Some of the more common headaches include:

• Tension 

• Migraine 

• Cluster 

• Thunderclap 

• Sinus 

• Ice-pick 

• Secondary 

Tension headache

This is the most common type of headache. It typically feels like a tightening around the head, and it affects both sides of the head. It will not usually cause symptoms like nausea, vomiting, or light sensitivity. 

It can be triggered by stress and fatigue. But it can also often happen without these factors. This headache usually comes on gradually.

Migraine headache

Migraines usually affect a specific part of the head or face. For example, you may have pain behind an eye, or in a specific region like the front of the head. Most people’s migraines recur in the same spot.  

These headaches can have many different triggers. Common triggers are:

• Stress

• Weather

• Hormonal changes

• Environmental factors

• Foods

• Lack of sleep

• Dehydration

Migraines can have symptoms such as nausea, vomiting, and sensitivity to light or sound. In severe cases, migraines can have stroke-like symptoms such as paralysis of one part of the body.

Sometimes people with migraines can also have sensory changes called auras. An aura can be useful for predicting the onset of a migraine and allow you to take appropriate steps to deal with it. 

Auras can show up in different ways. They can either be:

• Visual (such as flashing lights)

• Sensory (such as tingling)

• Speech related (such as slurring words) 

Cluster headache

This headache typically occurs in the front of one side of the head. And it’s usually described as a piercing pain. It often occurs suddenly and can last for a few minutes up to a few hours. 

These intense attacks usually happen in “clusters.” This means there is a certain amount of time during which the headaches occur. But the frequency of the clusters can vary. You may have multiple attacks a day, while others have them every other day.

In addition to headache pain, at least one of these symptoms is usually present in a cluster headache:

• Eye redness or tearing

• Runny nose

• Swelling of the eyelid

• Forehead sweating

• Smaller eye pupil on the side of the headache

These headaches typically occur in those ages 20 to 40 years old, but can be seen at any age. 

Thunderclap headache

This type of headache comes on suddenly and reaches a severe intensity within a few minutes. It will feel like the worst headache of your life. A thunderclap headache can also cause nausea, vomiting, or light or sound sensitivity. But it may not have any other symptoms at all.

One of the most serious reasons for a thunderclap headache is a ruptured brain aneurysm. This can lead to a subarachnoid hemorrhage, or bleeding in the brain tissues.

Other causes of a thunderclap headache include: 

• Constriction of the blood vessels of the brain

• Blood clots in the veins of the brain

• Infection

• Tearing of the arteries in the brain or neck

You should get an immediate medical evaluation for a thunderclap headache.

Sinus headache

These headaches occur where your sinuses are located. You may have pain across the entire front of your head, underneath your eyes, or on your nose. The headache may feel like pressure and can sometimes have other symptoms. You may notice:

• A stuffy nose

• Nasal drainage

• Ear pain

• Postnasal drip

• Fever 

Ice-pick headache

Ice-pick headaches are usually short lived, lasting from a few seconds to 15 minutes. They are often described as a sharp, stabbing pain, like an “ice pick.” Typically, they come on suddenly. You may feel pain near your eye or on the side of your head. They can also change location with each headache. 

There are typically no warning signs with these headaches, and the frequency can vary. Some people can have multiple attacks in a day followed by months of no symptoms.  

Secondary headache

Sometimes headaches can be due to other causes. Untreated chronic diseases or pain from other conditions, for instance, can cause headache pain. These headaches usually go away when the underlying cause improves. 

Common causes of secondary headaches include:

• High blood pressure

• Neck injury

• Dental conditions

• Infections (sinusitis, encephalitis)

• Tumors

• Medication withdrawal

How can I figure out the cause of my headaches?

The first step in determining the cause of your headaches is to see your medical provider. They will do a complete evaluation of your symptoms and medical history. 

It will also help to keep a headache diary. This is useful in documenting the circumstances surrounding your headaches. A good headache diary includes the following elements: 

• What you were doing at the beginning of the headache

• What time it started (tumors may cause headaches that are worse in the morning)

• The severity of the headache

• Which part of the head was affected

• How the headache felt (a stabbing, throbbing, or squeezing sensation, for example)

• How long the headache lasted

• Any other symptoms 

• Anything that made it better or worse

This information will help your doctor classify your headache and see if you need any tests such as a CT scan or MRI. Most headaches can be diagnosed based on the clinical history and physical examination.

Is it bad to have a headache every day?

While most headaches are not life threatening, they can decrease your quality of life. Or they may stop you from enjoying daily activities. If you are having daily headaches, don’t wait to seek help. You need to pinpoint the cause of your headaches so you can receive the best treatment.

How do I know if my headache is serious?

If you’ve been having new, constant headaches that won’t go away, you should seek medical attention. 

Many people wonder whether they should visit a primary provider or seek urgent attention. Where you should go for your headache depends on your symptoms and your medical history. There is no special rule because each circumstance is different. But there are some general guidelines that can help you know whom to contact about your symptoms. 

When to see your primary care provider

Your primary care provider can evaluate most headaches. These include tension headaches, migraines, sinus headaches, and ice-pick headaches. You can go to your provider if:

• The onset is gradual (comes on slowly)

• There are no associated symptoms

• It usually gets better with over-the-counter (OTC) medications

• You have no other medical issues (like very high blood pressure)

If you continue to have chronic headaches, your provider may refer you to a neurologist for further care.

When to go to urgent care

Urgent care is the next level of treatment for headaches. That’s because they can provide some treatments that you may not receive in your provider’s office — such as intravenous (IV) fluids, medications, and oxygen. These treatments are sometimes helpful for headaches like migraines or cluster headaches. 

You should go to urgent care if:

• You have mild symptoms such as nausea, minimal vomiting, or light or sound sensitivity.

• You have a diagnosis for your headaches and your symptoms are exactly the same as they’ve been before.

When to go to the emergency room:

Finally, there are times when your headache may be serious and you may need emergency care. You should go to the emergency room if you have any of these red flags:

• Your headache is sudden, severe, and reaches maximum intensity.

• You have other symptoms such as fever, neck pain, severe nausea, and vomiting.

• You have neurological symptoms such as weakness, numbness, vision loss, seizure-like movements, or problems with your balance or coordination.

• You are not getting relief from your usual home remedies. 

• Your headache occurs during strenuous activities like sexual intercourse or straining to have a bowel movement.

• Your headache is worse in the morning.

Why trust our experts?

Written by:

Mobola Kukoyi, MD, MPH

Dr. Mobola Kukoyi is a board-certified emergency and trauma physician with expertise in medical education, consulting, and public health. She earned her medical degree from Duke University School of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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