A Heads Up About Headaches

Few things ruin your day like a pounding headache. Whether it's a dull ache behind your eyes, a tight band around your forehead, or a throbbing pain that makes you want to hide in a dark room – headaches are miserable.

But here's the thing: most headaches are not dangerous. They're annoying, exhausting, and disruptive, but they're rarely a sign of something serious.

However, a small number of headaches are emergencies. Knowing the difference could save your life.

Let's break down the common types, what causes them, and – most importantly – the red flags that mean you need urgent help.

The Most Common Types of Headaches (And What They Feel Like)

1. Tension Headaches – The "Everyday" Headache

This is the most common type. It feels like a tight band squeezing your forehead, temples, or the back of your neck. The pain is annoying but not disabling.

Common causes: Stress, poor posture, staring at screens for too long, skipping meals, or not sleeping well.

What helps: Rest, water, over-the-counter pain relief, a warm shower, or gentle neck stretches. If these headaches are frequent, an online doctor can help you identify triggers and suggest preventive strategies.

2. Migraines – The "Hide in the Dark" Headache

Migraines are a whole different beast. They're not just bad headaches – they're a neurological event.

Typical symptoms include:

· Throbbing pain, usually on one side of the head

· Nausea or vomiting

· Extreme sensitivity to light, sound, or smells

· Some people see flashing lights, zigzag lines, or blind spots before the pain starts (this is called an "aura")

Triggers vary: Hormones, certain foods (aged cheese, red wine, chocolate), weather changes, strong smells, lack of sleep, or stress.

If you get migraines, an online GP can prescribe medication to stop an attack or prevent future ones – all without you having to sit in a waiting room with a throbbing head.

3. Cluster Headaches – The "Alarm Clock" Headache

These are rare but extremely painful. They occur in "clusters" – often at the same time of day or year.

What they feel like: Intense burning or piercing pain, usually behind one eye. The eye may become red and watery, and your eyelid might droop.

Cluster headaches are often called "suicide headaches" because of their severity. If you think you have them, see a doctor promptly – an online consultation can help you get the right diagnosis and treatment plan.

4. Sinus Headaches – The "Stuffy Face" Headache

When your sinuses are inflamed (from allergies, a cold, or infection), you might feel pressure in your forehead, cheeks, or behind your eyes. The pain gets worse when you bend forward.

Not every sinus headache is actually sinusitis – migraines are often mistaken for sinus headaches. An online GP can help you tell the difference and prescribe the right treatment (e.g., antibiotics if it's a bacterial infection, or migraine medication if it's actually a migraine).

Red Flags: When a Headache Is an Emergency

Most headaches are not emergencies. But some are. If you or someone with you experiences any of the following, do not wait – seek urgent medical care immediately.

Sudden, severe headache – "thunderclap" that peaks in under a minute

Headache after a head injury – even if days ago

Headache with fever and stiff neck – can't touch chin to chest

Headache with confusion, slurred speech, or weakness on one side of the body

Headache with seizure Possible brain infection, tumour, or other serious condition

Headache with vision changes – double vision, sudden blurring, or loss of vision

Headache that wakes you from sleep or is worse when lying down

New headaches in someone over 50

If you or a loved one has any of these red flags, go to the nearest emergency room or call 10111 immediately. This is not something an online consultation can handle.

How an Online GP Can Help With Your Headaches

For the vast majority of headaches – tension headaches, migraines, sinus headaches, and cluster headaches – an online doctor is perfectly suited to help.

Here's what we can do during a virtual consultation:

· Take a detailed history (what the pain feels like, where it is, what triggers it, what makes it better or worse)

· Help you identify patterns and triggers

· Prescribe appropriate medication (acute relief or preventive treatment)

· Provide a referral if you need a neurologist or further tests (like an MRI or blood work)

· Write a sick note if your headache is affecting your ability to work

· Issue a repeat prescription for your regular migraine medication

You don't need to drive anywhere, sit in a waiting room, or take a whole morning off work. A 15‑minute video call from your home or office is often enough to get you back on track.

What You Should Do Before Your Online Consultation

To make the most of your online GP visit, have this information ready:

· When did the headaches start?

· How often do they happen (daily, weekly, monthly)?

· How long do they last (minutes, hours, days)?

· Where is the pain? (forehead, one side, back of head, behind eyes?)

· What does the pain feel like? (throbbing, squeezing, stabbing, dull?)

· What makes it better? (rest, medication, cold compress?)

· What makes it worse? (light, noise, bending over, exercise?)

· Do you get any other symptoms? (nausea, vomiting, visual changes, runny nose or watery eye?)

This helps me make an accurate diagnosis and recommend the right treatment – without you ever leaving home.

Take Headaches Seriously (But Not Too Seriously)

Most headaches are a nuisance, not a danger. They can often be managed with lifestyle changes, better sleep, hydration, stress management, and the right medication.

But if your headaches are changing, getting worse, or interfering with your daily life, don't ignore them.

And if you hit any of the red flags above – get emergency help immediately.

For everything else, an online doctor is just a few clicks away. You can be seen today, from wherever you are.

Book an online consultation to discuss your headaches. No waiting room. No commute. Just care when you need it.

Dr. Sonja Brandt is an online GP helping South Africans manage migraines, tension headaches, and other common conditions – conveniently and legally from home.