How Do I Know If My Headache Is Serious?
/Most headaches are not dangerous, and most people who type this question already suspect that. A small number of headaches are different, and knowing the difference before you are the one with the headache is worth five minutes now. This page lists the warning signs first, then covers what is usually going on for people whose headache turns out to be an ordinary one.
The warning signs that mean today, not later
These signs mean you need a doctor or an emergency room, not a chiropractic appointment. Call 911 or go to the nearest hospital emergency room if your headache comes with any of the following:
- The worst headache of your life, or one that hits full force within seconds or minutes
- Fever along with a stiff neck
- A headache that started after a blow to the head, a fall, or a crash, even if it seemed minor at the time
- Weakness, numbness, vision loss, confusion, or trouble speaking, along with the headache
- A headache that wakes you from sleep, or one that is consistently worse in the morning
- A new kind of headache after age 50, one that does not match anything you have had before
- A headache with visual changes or new swelling, in someone who is pregnant or recently gave birth
- A headache that keeps getting worse over days or weeks, rather than settling
None of these are common on their own. Together they cover a short list of causes, bleeding, infection, a mass, or dangerously high blood pressure, that a chiropractic exam is not built to rule out and a chiropractic adjustment will not fix. If any of these describe your headache, the right next step is medical evaluation, some of them the same day and some of them by calling 911, not a booking with us.
What these signs actually point to
A "worst headache of your life" that peaks in seconds raises concern for bleeding around the brain. Fever with a stiff neck raises concern for meningitis. A new pattern after 50, or one that keeps getting worse, gets taken seriously because it does not fit the usual pattern of a recurring, benign headache. A pregnancy or postpartum headache with visual changes or new swelling can be a sign of preeclampsia, which needs same-day evaluation. None of this is meant to make you think every headache is one of these. It is meant to tell you exactly what to watch for so you are not guessing under pressure.
If none of that describes you
Most recurring headaches are not on that list, and most of the time the honest answer to "how do I know if my headache is serious" is that it probably is not, especially if it is a pattern you have had before and it responds to the usual things: rest, hydration, an over-the-counter pain reliever, time. A large share of headaches that are not on the warning list above trace back to the neck. These are called cervicogenic headaches, and their close cousin, tension-type headache, both tend to start at the base of the skull or feel like a tight band, and both often get worse with long stretches of screen time, phone use, or a bad sleeping position. We cover what that looks like, what is usually going on, and how we treat it on our headaches and migraines page. We are not going to repeat that page here. If your headache fits that description rather than the list above, that is where to go next.
What we do and do not claim
We treat neck-driven headache directly, and our headaches and migraines page describes exactly what that involves. We do not treat migraine, cluster headache, or any other primary headache disorder as a cure. If your headache pattern does not clearly point to the neck, or if you already carry a migraine or other headache diagnosis and something about it has changed, your physician or a neurologist is the right next call, not us.
Getting seen
For a headache that is not one of the warning signs above, and that seems to be coming from your neck, call (340) 690-4994 to book an exam. We take walk-ins and same-day appointments. We are at the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802, just east of Charlotte Amalie and a short drive from the Havensight cruise port and Yacht Haven Grande. Hours are Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun. Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands. His exam checks for the warning signs above before any care is recommended. New patient forms are at forms. Tradewinds Chiropractic has more than 180 five-star Google reviews.
Questions patients ask
How do I know if my headache is serious?
It is a reason for urgent medical care, not a chiropractic visit, if it is the worst headache of your life, comes with fever and a stiff neck, follows a head injury, comes with weakness, numbness, vision loss, confusion or trouble speaking, wakes you from sleep, is a new pattern after age 50, or keeps getting worse over days. Without those signs, most headaches are not a medical emergency.
When should I go to the emergency room for a headache instead of calling a chiropractor?
Go to the nearest hospital emergency room or call 911 if your headache hits full force within seconds, comes with fever and neck stiffness, follows a head injury, or comes with a neurological symptom like weakness, numbness, vision changes, or confusion. A chiropractic exam does not replace that evaluation.
Is a headache that wakes me up at night serious?
It is one of the patterns worth taking seriously, along with a headache that is consistently worse in the morning. Either can point to something beyond an ordinary tension or neck headache and is worth a same-day call to your physician.
Can chiropractic care help with headaches at all?
For headaches that start in the neck, yes, often directly. For migraine or other primary headache disorders, chiropractic care is not a cure, though neck-focused care can sometimes reduce how often a neck component triggers an attack. See our headaches and migraines page for the full picture.
Should I see a chiropractor for a new headache after age 50?
Not first. A new headache pattern after 50 is one of the signs worth a physician's evaluation before anything else, since it does not fit the usual pattern of a recurring, benign headache.
