Certain red-flags can differentiate between ordinary tension headaches and more serious conditions:[1]
- The headache is sudden and severe, and reaches maximal intensity immediately.
- The headache is the “worst of your life”.
- The headache occurs upon performing the Valsalva maneuver (bearing down), possibly while lifting a heavy object, straining during a bowel movement, or having sexual intercouse.
- The headaches only started after 50 years of age or after pregnancy.
- The headaches worsen or improve when changing positions from sitting up to laying down (or vice-versa).
- The headaches are worse in the morning, and get better during the day on most days.
- Other symptoms start along with the headache (fever, muscle pain, weight loss, neurological symptoms)
Note that the following list is not comprehensive, and when in doubt, always check with a health-care provider.