Migraine and Headaches: When to See a GP
Headaches are one of the most common health complaints — most people experience them occasionally, and for many they resolve with rest and simple pain relief. But recurring, severe, or debilitating headaches can significantly affect quality of life and may need medical assessment. This guide explains the main types of headache and when to see a GP.
Types of Headache
- Tension headache: The most common type. Tight, band-like pressure around the head, usually mild to moderate. Often related to stress, poor posture, or eye strain.
- Migraine: Severe, throbbing headache usually on one side, often with nausea, vomiting, and sensitivity to light and sound. May be preceded by visual disturbance (aura).
- Cluster headache: Very severe one-sided pain around the eye, often with watering or a blocked nostril. Attacks occur in “clusters” of days or weeks.
- Sinus headache: Pressure over the forehead, cheeks, or behind the eyes, usually with nasal congestion or discharge.
- Medication overuse headache: Caused by taking painkillers more than 10–15 days per month. Breaking the cycle requires supervised withdrawal.
Red Flags — See a GP or ED Urgently
Most headaches are benign, but some signal a serious condition. Seek urgent medical care for any of these “thunderclap” or warning features:
- Sudden, severe headache reaching maximum intensity within seconds (“thunderclap”) — possible brain bleed
- Headache with fever, stiff neck, or rash — possible meningitis
- Headache with confusion, altered consciousness, or seizures
- Headache with new weakness, numbness, or speech difficulty — possible stroke
- Headache that worsens with coughing, bending, or exercise
- New headaches starting after age 50
- New headaches in someone with a history of cancer
- Headache after a head injury
- Persistent vomiting with the headache
- Progressively worsening headache over days or weeks
When to Book a Routine GP Appointment
- Recurring headaches interfering with work, school, or daily activities
- Headaches getting more frequent or more severe
- Over-the-counter medications no longer working
- Taking painkillers more than 2 days a week
- New type of headache different from your usual pattern
- Headaches disrupting sleep
- Headaches affecting your mood or mental health
What to Expect at the GP Appointment
Your GP will ask detailed questions about your headache pattern — when they happen, how long they last, what makes them worse or better, associated symptoms, and family history. Keeping a headache diary for 2–4 weeks before your appointment is extremely helpful — note the date, time, duration, severity, triggers, symptoms, and any medications.
Physical and neurological examination is usually normal with tension headache and migraine. Imaging (CT or MRI) is only needed if red flags are present.
Migraine Treatment Options
- Acute (attack) medication: Paracetamol, ibuprofen, or migraine-specific triptans (e.g. sumatriptan). Take at the earliest sign of an attack.
- Anti-nausea medication: Metoclopramide or similar if nausea is significant.
- Preventive medication: Daily medication to reduce frequency — beta blockers, topiramate, or amitriptyline. Considered if you have 4+ migraines per month.
- CGRP antibodies: Newer preventive injections for chronic migraine. Available under the PBS for eligible patients with severe migraine.
- Lifestyle: Regular sleep, regular meals, hydration, stress management, and avoiding known triggers.
Common Migraine Triggers
- Irregular sleep (too little or too much)
- Skipped meals or dehydration
- Alcohol — especially red wine
- Stress and anxiety
- Hormonal changes (menstrual cycle)
- Certain foods: aged cheese, chocolate, MSG, processed meats
- Bright lights, strong smells, weather changes
- Too much or too little caffeine
Medication Overuse Headache — A Common Trap
If you take painkillers (including over-the-counter paracetamol or ibuprofen) more than 10–15 days per month for headache, you can develop a chronic headache caused by the medication itself. Breaking this cycle requires a supervised withdrawal period — your GP can help. Do not just stop all medications abruptly.
Mental Health and Chronic Headache
Chronic headaches and mental health are closely linked. Anxiety, depression, and chronic pain often feed each other. If your headaches are affecting your mood, ask your GP about a Mental Health Treatment Plan — psychological therapy can be very effective for chronic pain.
Find a Family Doctor Clinic Near You
Do not accept severe or recurring headaches as something you have to live with. Most headaches are treatable with the right diagnosis and a structured plan.
Frequently Asked Questions
Do I need a brain scan for headaches?
Usually not. For headaches with a clear pattern and no red flag symptoms, examination is normal and imaging does not change management. Your GP will order a CT or MRI only if there are warning features that suggest a possible underlying cause.
How do I know if it is a migraine or a tension headache?
Migraines are typically one-sided, throbbing, severe enough to stop you functioning, and often come with nausea and sensitivity to light and sound. Tension headaches are usually bilateral, pressing or tight, mild to moderate, and you can usually still work through them.
Can I still work during a migraine?
Most people with a significant migraine cannot work effectively during an attack. Medicare-eligible telehealth consultations are an option if you need a medical certificate — visit mygponline.com.au.
Are migraine preventives safe long-term?
Yes, for most people. Common preventive medications (propranolol, topiramate, amitriptyline) have decades of safety data. Your GP will review you regularly and taper the dose once your migraines are well controlled — preventive treatment is not necessarily lifelong.