If you have a headache or have been diagnosed with tension headaches, use the following information to help you decide when to call your doctor.

Call911or other emergency services if:

• You have a very sudden, severe, "thunderclap" headache that seems to come on instantly and is unlike any headache you have had before.
• You have symptoms of a stroke:
  • Sudden numbness, paralysis, or weakness in your face, arm, or leg, especially on only one side of your body.
  • New problems with walking or balance.
  • Sudden vision changes.
  • New problems speaking or understanding simple statements, or feeling confused.
  • Drooling or slurred speech.
  • A sudden, severe headache that is different from past headaches.

Call your doctor now or go to the emergency room if:

• You develop fever and a stiff neck.
• You have new nausea and vomiting, or you cannot keep food or liquids down.

Watch closely for changes in your health, and be sure to contact your doctor if:

• Your headache does not get better within 24 hours.
• Your headache wakes you up at night.
• Your headaches get worse or happen more often.
• You start to have new symptoms.
• You have any problems with your medicine.
• You are older than 50 and have new or more frequent headaches.
• Your headaches occur after physical exercise, sexual activity, coughing, or sneezing.
• Your life is disrupted by your headaches (for example, you miss work or school regularly).

Watchful Waiting

Watchful waiting is a wait-and-see approach. If your headache gets better on its own, you won't need treatment. If it gets worse or your headaches become more frequent, you and your doctor will decide what to do next. Watchful waiting and using nonprescription pain relievers are appropriate if you have tension headaches that are not disabling. But if you have at least 15 tension headaches a month over a 6-month period, you may want to seek treatment for chronic tension headaches.

Who To See

Most health professionals can recognize and treat tension headaches. You may seek treatment from any of the following:

• General practitioner
• Family medicine physician
• Internist
• Nurse practitioner (NP)
• Physician assistant (PA)
• Neurologist, if your headaches are severe or do not get better with treatment

If you think your headaches are caused by depression or anxiety, seeking treatment from a psychiatrist, psychologist, or other licensed mental health counselor may help reduce the frequency or severity of your headaches, as well as relieve your symptoms of anxiety or depression.

To prepare for your appointment, see the topic Making the Most of Your Appointment.