Possible causes of headaches

Get well soon. Headaches can have many causes; the most common are tension headaches, migraines, sinusitis, neck and muscle tension, dehydration/caffeine withdrawal, eye strain, and high blood pressure. Cluster headaches, which are more common in men, are also possible. A few quick questions to help you more clearly:

• How long have you had them, and how did they start (suddenly or gradually)? Is the intensity 0–10?
• Where in your head is the pain, and what kind is it (throbbing, pressure, squeezing, around the eyes, unilateral/bilateral)?
• Do you have light/sound sensitivity, nausea, or vomiting? Do you experience redness or watery eyes, or a runny/stuffy nose on the same side?
• Do you have nasal congestion, facial or toothache, or fever (suggesting sinusitis)?
• Have you experienced blurred vision/double vision, slurred speech, arm or leg weakness/numbness, dizziness, or neck stiffness? - Have you recently experienced decreased water intake, skipped meals, reduced alcohol or caffeine intake, insomnia, or excessive screen time?
• Do you have neck pain/tension, teeth clenching/grinding?
• Have you had a recent head injury? Is it triggered by exertion, coughing, or sexual activity?
• Have you taken your blood pressure? What were your last readings?
• Are there any medications you take regularly or have you started recently? How many days a week do you take painkillers?

Preliminary assessment (until information is complete):

• Tension type: Tightening in the forehead/temples/back of the neck, mild to moderate, increases towards the end of the day; triggered by stress and muscle tension.
• Migraine: Usually unilateral, throbbing, lasting 4–72 hours, nausea, light/sound sensitivity; may be triggered by insomnia, hunger, and certain foods.
• Sinusitis: May be accompanied by facial/toothache, nasal congestion/discharge, increased pain when bending forward, and fever. - Cluster headache: Severe, one-sided headache around the eye, lasting 15–180 minutes, redness and watering in the eye, and a runny nose on the same side; may usually begin at night.

Other headaches: Dehydration/caffeine withdrawal, visual impairment/screen fatigue, neck and muscle tension, high blood pressure, and headaches due to medication overuse.

What you can do (for now):

• Drink plenty of water, eat regularly, and consume small to moderate amounts of caffeine if you haven't stopped drinking suddenly.

• Rest in a quiet/dark environment; try cold and hot compresses to your forehead, temples, or the back of your neck; do gentle neck stretching exercises.

• Take eye and screen breaks (20-20-20 rule).

• If you need pain relief: Paracetamol 500–1000 mg or ibuprofen 200–400 mg (with food to protect your stomach; avoid ibuprofen if you have an ulcer, kidney disease, or a bleeding tendency). Do not exceed 2–3 days per week to avoid developing a "medication overuse headache."

• Measure your blood pressure. If it recurs ≥140/90 mmHg, evaluation is necessary; if it is ≥180/120 mmHg and there is a headache, urgent evaluation is necessary.

When to see a doctor?

• Neurology: Severe/recurring migraine-like pain, suspicion of cluster headache, new and different pain.
• Ear, Nose, and Throat: If signs of sinusitis are evident.
• Ophthalmology: Blurred vision/double vision, new eye pain/fatigue.
• Internal Medicine: High blood pressure, systemic findings.

Emergency warning signs (go to the emergency room immediately if present):

• Sudden, "lightning bolt" headache, the worst headache of your life.

• Neck stiffness, high fever; new neurological findings (speech disturbance, weakness, numbness, vision loss), pain following a head injury.

• Headaches that have been worsening and are new onset in people over 50, with a history of cancer or immunosuppression.

• Severe pain triggered by exercise/cough/sexual activity; severe eye pain and vision loss.

Can you answer my questions? I can narrow down the possible causes and recommend the most appropriate course of action.

I am not a doctor, and this is not a medical diagnosis.