How Are Headaches Diagnosed?

Updated on April 17, 2024

Medically reviewed by

young woman explaining her headache to female doctor — SDI Productions / Getty Images

There are different tests for headache diagnosis. Headaches—or pain or discomfort in the face or head—are common but debilitating conditions that most people experience. There are three types of primary headaches: migraine, tension, and cluster. You might also have a secondary headache, which is a symptom of another underlying condition, such as a sinus infection or head injury.

When headaches become severe or interrupt your daily life, it’s good practice to see a healthcare provider to get tested and learn about treatment options to improve your symptoms. During your appointment, a healthcare provider will usually learn about your medical history, perform a physical exam, and order lab or imaging tests, if necessary. Here's what to know about tests for headaches.

Medical History

A healthcare provider will usually start your appointment with a medical history intake. They may request you to fill out a written questionnaire or ask you questions verbally. The medical history intake helps them learn more information about your personal and family medical history and your current concerns or symptoms.

To get a better understanding of your personal history and family history, the provider may ask you:

Are you taking any medications?
Does anyone in your family experience headaches or have a history of migraine?
Have you ever had an injury or illness that could have caused trauma to your head or brain?
When did you first start having headaches?

The provider may also you several questions about your symptoms, including:

Has your pain remained consistent? Are you experiencing episodes that come and go?
How long have you had symptoms?
How severe is your pain?
Is there anything that might have triggered your symptoms?
What does your headache feel like?
What symptoms are you experiencing?
Where are you having pain?

It is also common for a provider to learn about your lifestyle. They could ask you questions such as:

Do you drink coffee or other caffeinated beverages?
Do you smoke or drink alcohol?
Have you skipped any meals recently?
How many hours of sleep are you getting each night?
How much time do you spend on your phone, computer, or TV?
What do you eat in a day?

Physical Exam

After learning more about your medical history, lifestyle, and symptoms, the provider will perform a physical exam. During this exam, they will likely:

Check your head or face for signs of swelling, bruising, or pain
Examine your neck, shoulders, and spine for stiffness or aches
Measure your vital signs like your temperature, blood pressure, and heart rate
Take a look at your eyes for redness, infection, or light sensitivity

Blood Tests

There are no specific lab or blood tests for headaches, but they may use blood tests for diagnosis. The results from tests can help rule out any other related conditions that might be contributing to a secondary headache, such as a sinus infection, virus, diabetes, anemia, or dehydration. In some cases, a provider may also order a C-reactive protein test, which checks for inflammation in the brain and body.

Imaging Tests

A healthcare provider may order imaging tests if they have concerns about your symptoms or suspect an issue with your brain structure. While imaging tests are not common practice for a headache diagnosis, a provider may err on the side of caution during the diagnostic process—especially if you are experiencing severe or frequent headaches.

The provider may ask you to undergo one of these imaging tests if needed:

Computed tomography (CT) scan: Uses several X-rays to create images of your brain
Magnetic resonance imaging (MRI): A type of imaging test that produces detailed pictures of the internal structure of your brain

Diagnostic Criteria

The Classification Committee of The International Headache Society has developed diagnostic criteria for each different type of headache. A healthcare provider will determine the type of headache you have based on various factors, including symptoms, severity, duration, and location of your pain.

	Migraine	Tension Headache	Cluster Headache
Type of pain	Pulsing or throbbing pain	Dull aches, tightness around your head	Sharp, stabbing pain
Severity	Moderate to severe pain	Mild to moderate pain	Severe pain
Duration	Four to 72 hours	30 minutes to seven days	15 minutes to three hours
Location of pain	One side of your head	Both sides of your head	One side of your head and your eye (on the same side of the head)
Onset of symptoms	Symptoms develop gradually (usually for 24 to 48 hours)	Symptoms develop gradually	Symptoms occur suddenly
Accompanying symptoms	Light sensitivity, noise sensitivity, nausea, seeing bright lights or zig-zag lines (a phenomenon known as aura)	Neck and shoulder pain, difficulty sleeping	Drooping eyelid, tears, eye redness, stuffy nose, sweating

A Quick Review

It's a good idea to visit a healthcare provider if you begin to experience severe pain or headache symptoms that interrupt your daily life. The provider will ask you about your personal and family medical history, lifestyle, and symptoms.

They will also perform a physical exam and order any additional lab, blood, or imaging tests for headaches if necessary. Getting a diagnosis for headaches is important because it can help you and your provider figure out how to move forward with treatment and find ways to reduce your symptoms.

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