5 Unusual Headaches: Signs to Watch For and What to Do

Headaches are a common occurrence that affects many people worldwide. Though relatively harmless, headaches can disrupt daily life activities, decrease productivity, and cause discomfort. There are different kinds of headaches, each presenting varying symptoms, causes, severity, and treatments. In this article, we will delve beyond the ordinary headaches and concentrate on uncommon types that are often overlooked, including thunderclap headaches, sinus headaches, and rebound headaches. We will also focus on other non-headache symptoms to watch for, when to see a doctor, and prevention and self-care strategies. This article's purpose is to educate and emphasize the need to seek medical attention if experiencing unusual headaches.

Unusual Headaches and Symptoms

Headaches are a common ailment, with an estimated 99% of adults experiencing one during their lifetime. Generally, headaches are caused by stress, anxiety, muscle tension, sinus problems, and dehydration. However, there are times when the headaches experienced may be unusual and require immediate medical attention due to their potential severity.

Thunderclap Headaches

Thunderclap headaches are a rare form of headache that can be so severe that they feel like lightning striking inside the skull. They are called thunderclap headaches because they come on suddenly, reach peak intensity in less than a minute, and cause intense pain for hours. Thunderclap headaches may be associated with other symptoms that include:

  • nausea and vomiting
  • a stiff neck
  • dizziness

Thunderclap headaches can be caused by a variety of medical conditions, including subarachnoid hemorrhage and cerebral venous thrombosis. Subarachnoid hemorrhage is a bleeding vessel located in the brain, and it can be fatal, so if you experience the sudden onset of severe headaches, it is crucial you seek immediate medical attention.

Sinus Headaches

Sinus headaches tend to occur when nasal passages become congested or inflamed. They result in a dull pain above the eyes, around the forehead and cheeks, coupled with other symptoms such as:

  • tenderness around the face
  • pressure-like pain
  • difficulty breathing

Sinus headaches can be caused by an infection or allergic reaction, and in milder cases, they can be treated by over-the-counter medications or home remedies. In moderate to severe cases, a doctor's attention is necessary.

Rebound Headaches

Rebound headaches, also known as medication overuse headaches, generally occur when there is an over-dependence on drugs meant to treat headaches. This leads to the body's overuse of the drug, resulting in the worsening of headaches. Symptoms of rebound headaches include:

  • a dull, persistent pain in the head
  • a feeling of "heaviness" in the head
  • irritability

Risk factors for rebound headaches include frequent use of over-the-counter painkillers and prescription drugs meant to treat headaches. The best way to treat rebound headaches is to stop using the drugs causing them and then seek medical assistance.

Non-Headache Symptoms to Watch For

Headaches often bring along other symptoms, and this is especially true for migraines and cluster headaches. Understanding these associated symptoms is crucial in identifying and seeking out treatment for these types of headaches.


Migraines can come with additional symptoms that include, but are not limited to:

  • Nausea and vomiting
  • Sensitivity to light and sound
  • Pulsing or throbbing sensation on one side of the head
  • Blind spots or temporary vision loss
  • Tingling or numbness in the face or limbs

If you experience migraines that are accompanied by any of these additional symptoms, it's best to seek medical attention promptly. Severe migraines with accompanying symptoms can be indicative of more severe medical conditions and should not be ignored, especially if they occur frequently or disrupt your daily life.

Cluster Headaches

Cluster headaches are another type of headache that tend to be associated with additional symptoms, including:

  • Facial sweating and flushing
  • Nasal congestion
  • Restlessness or agitation
  • A drooping eyelid or other changes in vision
  • The sensation of being stabbed in the eye

Cluster headaches tend to occur in patterns or "clusters" over a period of days or weeks and can be excruciatingly painful. If you have recurring headaches with these additional symptoms, it's essential to convey those symptoms to your doctor to achieve a correct diagnosis and treatment plan.

When to See a Doctor

A headache is not always a cause for concern - in fact, many headaches go away on their own without any medical intervention. However, understanding when to seek medical attention can be crucial in managing potential underlying health problems or preventing severe complications.

General guidelines for when to seek medical attention

Here are some rules of thumb for when to seek out medical attention for your headaches:

  • Headaches that come on suddenly and severely
  • Headaches accompanied by symptoms such as vomiting, fever, or neck pain
  • Headaches that disrupt your daily life, including interfering with work or school
  • Headaches that are associated with a head injury or accident
  • Headaches that are worsening despite over-the-counter remedies or previously successful treatments
  • Headaches that are associated with vision changes or confusion

Urgent care versus the emergency room

When you need to seek medical attention for your headaches, you have the option of visiting an urgent care center or heading to the emergency room. While both offer prompt medical attention, here are the general guidelines for when to choose one over the other:

  • If you have a primary care physician, it's usually best to try to see them first
  • Go to urgent care centers for mild to moderate headaches or symptoms that are not immediately life-threatening, such as sinus pain or tension headaches
  • Head to the emergency room if you are experiencing a sudden, severe headache or headache accompanied by symptoms such as confusion, paralysis, or slurred speech. These could indicate a more serious underlying condition, such as a stroke or brain aneurysm.

Diagnosis and Treatment Options

If you decide to seek medical attention for your headaches, various options are open to you in terms of diagnosis and treatment. Your doctor may:

  • Recommend over-the-counter pain relievers to manage mild to moderate headaches
  • Prescribe stronger pain relievers or preventative medications for chronic or severe headaches
  • Perform diagnostic tests, such as CT scans or MRIs to look for underlying conditions that could be causing your headaches
  • Suggest alternative therapies, such as chiropractic care or acupuncture

It's important to communicate openly with your doctor about your symptoms and concerns to ensure the most accurate diagnosis and appropriate treatment plan.

Prevention and Self-Care

While medications and medical interventions can be effective in managing unusual headaches, there are also many self-care techniques you can use to reduce the frequency and intensity of headaches. Here are some different approaches to prevention and self-care:

Lifestyle changes

By making changes to your daily routine, you can help reduce the triggers that lead to headaches. Some effective lifestyle changes include:

  • Stress management techniques: Stress can be a major trigger for headaches, so practicing stress-reducing activities such as yoga, meditation, or deep breathing exercises can be helpful.
  • Regular sleep routine: Erratic sleep patterns can disrupt the body's natural rhythms and lead to headaches. Aim for seven to eight hours of sleep per night, and stick to a regular sleep schedule as much as possible.
  • Dietary changes: Certain foods and drinks can trigger headaches, so keeping a food diary and identifying potential triggers can help in preventing future headaches. Common triggers include processed meats, soy products, alcohol, and caffeine.
  • Avoiding environmental triggers: Some people are more sensitive to changes in light, noise, and temperature than others, so identifying and avoiding your triggers can reduce the likelihood of headaches.

Alternative Therapies

In addition to lifestyle changes, there are many alternative therapies that have been found to be effective in reducing the frequency and severity of headaches. Here are two promising options:

  • Chiropractic care: Many people find relief from headaches through chiropractic adjustments, which can release tension in the neck and back that can trigger headaches. Chiropractors can also provide nutritional and lifestyle counseling that can help reduce headache triggers.
  • Acupuncture: Acupuncture involves the insertion of small, thin needles into certain points on the body to stimulate the body's natural healing response. Acupuncture has been found to be effective in reducing the frequency and intensity of headaches, particularly migraines and tension headaches.

If you are considering alternative therapies, it's important to seek out practitioners who are licensed and well-trained in their field. Always speak with your doctor before starting any new treatment regimen.


Unusual headaches can be distressing and disruptive to daily life, but with the right approach, they can be effectively managed. Here are the key takeaways from this article:

  • Unusual headaches can present in a variety of ways, including thunderclap headaches, sinus headaches, and rebound headaches, among others.
  • It's important to be aware of non-headache symptoms that may indicate a specific type of headache, such as migraines or cluster headaches.
  • Knowing when to seek medical attention is crucial, and urgent care or emergency room visits may be necessary in some cases.
  • There are many self-care techniques that can reduce the frequency and intensity of headaches, including lifestyle changes and alternative therapies such as chiropractic care and acupuncture.

If you are experiencing unusual headaches, don't hesitate to seek help from a medical professional. With their guidance and your own proactive self-care, you can manage your headaches effectively and reclaim your quality of life.

Remember, prevention is key, so be sure to make lifestyle changes to reduce your triggers and promote overall well-being. By doing so, you can decrease the likelihood of future headaches and feel your best for years to come.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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