Primary Care · Symptom guide
Headaches that get in the way of work
A recurring headache that wrecks a meeting, a screen, or a morning is a reason to be evaluated. It is not a diagnosis you can finish from a page, and it is not a promise of a prescription.
Educational information, not a diagnosis. A sudden severe headache, weakness, or trouble speaking needs emergency care now.
What this page is for
Working adults, not a catalogue of headache drugs.
People book because the headache is costing the workday: light that hurts, a screen they cannot finish, a morning that starts in pain. The clinical work is which pattern this is, what else is going on, and whether something urgent has to be ruled out first. This page describes those distinctions. It does not rank a reader’s headache, and it does not say which medicine is appropriate.
How migraine and tension-type headache are described
These are classification criteria. They are not your result.
Migraine without aura, in the International Classification of Headache Disorders, is a series of attacks: at least five, each lasting 4 to 72 hours untreated, with at least two of one-sided pain, a pulsating quality, moderate or severe intensity, and worsening with ordinary activity, plus nausea or vomiting, or both light sensitivity and sound sensitivity. 1 A single bad day does not meet that. Meeting the words on a page does not either. The history has to be taken.
Tension-type headache is a different description: a pressing or tightening pain, on both sides, mild or moderate, not worsened by ordinary activity, and without the nausea or the light-and-sound pair that defines migraine. 2 “Migraine” is not a synonym for any severe headache, and “tension” is not a conclusion from a stressful week.
Medication-overuse headache is its own diagnosis: headache on 15 or more days a month, in someone who already has a headache disorder, with regular use for more than three months of medicines taken to treat headache. 3 That is why a visit asks what is already being taken, and how often. Stopping a medicine is a clinical decision, not a step this page assigns.
When a headache should not wait
Call emergency services for a headache that is sudden and severe, or a headache with weakness, trouble speaking, vision loss, confusion, fainting, fever, or a stiff neck. Those are not telehealth symptoms. A headache that is new, progressive, or arriving with other illness still needs a clinician to decide whether it can be assessed remotely.
What else belongs in the history
Unrefreshing sleep and a morning headache are a reason to ask about breathing pauses, snoring, and daytime sleepiness. That conversation is on the sleep page. The headache does not diagnose apnea.
A headache that tracks a cycle, or shows up in the menopause transition, belongs in the same history as bleeding pattern, sleep, and mood. That is on the hormonal health page. Cycle timing is a clue. It is not a named diagnosis from this page.
Iron deficiency can include headache among nonspecific symptoms. That sorting is on the exhaustion page.
What a visit is
Licensed care in California, Texas, Pennsylvania, and Florida. Eligibility is confirmed from where you are at the time of the visit.
A clinician reviews the pattern, what the pain stops you from doing, the medicines you already use, sleep, and whether anything in the story needs urgent or in-person care. If a primary headache pattern fits, acute and preventive options can be discussed. A prescription is not guaranteed. Pharmacy cost is separate. Published visit pricing is on the pricing page.
Common questions
No. Migraine is a defined pattern of attacks, not a synonym for a severe headache. Tension-type headache is a different pattern. A page can describe the criteria. It cannot apply them to a person.
A sudden severe headache, or a headache with weakness, trouble speaking, vision loss, confusion, fever, or a stiff neck, needs emergency care. Do not wait for a telehealth slot.
Unrefreshing sleep and morning headache travel together often enough that sleep, including apnea, belongs in the history. Morning headache does not diagnose apnea.
A prescription is not guaranteed. The visit is a history and a plan. Acute and preventive options are discussed when the pattern fits, after the clinician has reviewed medicines already in use.
References
- Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Migraine without aura. https://ichd-3.org/1-migraine/1-1-migraine-without-aura/
- Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Tension-type headache. https://ichd-3.org/2-tension-type-headache/
- Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Medication-overuse headache. https://ichd-3.org/8-headache-attributed-to-a-substance-or-its-withdrawal/8-2-medication-overuse-headache-moh/
Bring the pattern to a clinician
What the headache stops you from doing, how often it comes, and what you already take is enough to start.
Prefer to ask questions first? Book a free Meet & Greet. That call is not a medical visit.