If you experience a very painful headache, getting an imaging test such as a CT scan or MRI is often not the route to go, according to Dr. Matthew Messoline, a family medicine doctor with Sharp Rees-Stealy Medical Group.
“Most headaches are typically migraines or tension headaches, both of which can be very painful,” says Dr. Messoline. “But imaging tests don’t necessarily help with pain and rarely show the cause of your headache.”
He says that your doctor can usually diagnose a headache during an office visit by taking a medical history, which includes asking about symptoms.
“Your doctor would then typically perform a neurologic examination, including a test of your reflexes. If both your medical history and exam seem normal, an imaging test usually will not show a serious problem,” he says.
There are risks associated with CT scans, such as radiation exposure — even with the low doses used for scans of the head, cautions Dr. Messoline. “Radiation exposure may add up over time, so it’s best to avoid unnecessary radiation and any associated risks,” he says. “Also, results of your CT scan may be unclear and can lead to more tests and even treatment that you don’t need.”
When you should have an imaging test for your headache
“You might need a CT scan or MRI if your doctor cannot diagnose your headache based on your exam and medical history, or if your exam indicates something that is not normal,” says Dr. Messoline. He recommends you see your doctor right away if your headache:
- Comes on suddenly or you feel a surge of pain in your head
- Feels different from other headaches you’ve had, especially if you are age 50 or older
- Happens after you have been physically active
- Is accompanied by other serious symptoms, such as loss of control, a seizure or fit, or change in speech or alertness
Self-care for your headache
Dr. Messoline offers the following tips for avoiding common headache triggers:
- Quit smoking
- Manage stress
- Get enough sleep
- Try an over-the-counter pain reliever
“If you have migraines, you should avoid bright lights or wear tinted glasses, and be sure not to skip meals,” he says. “Avoid tension headaches by not getting overtired, keeping your jaw relaxed and holding your back and neck straight when you sit or stand.”
At Sharp Rees-Stealy, we want to empower you to make well-informed choices about tests and treatments for your family. That’s why we’ve made it our priority to support our doctors in helping you make smart and effective decisions by participating in Choosing Wisely®.
Wisely, an initiative of the ABIM Foundation, educates patients and doctors on selecting the most effective treatment available and avoiding unproductive, costly procedures. Sharp Rees-Stealy is the only medical group in Southern California to participate in this national campaign.