Headache in older adults

Overview

A headache is pain or discomfort in the head, scalp, or neck. In older adults, headaches can be different from those in younger people—they may be a sign of an underlying health condition or a side effect of medicines.

Headaches are less common in older adults than in younger people, but they still affect many. About 1 in 5 adults over 65 report having headaches regularly.

Headaches can affect anyone over 65, but some types are more common in certain groups—for example, giant cell arteritis is more common in people over 50 and slightly more common in women.

Symptoms

Common symptoms

• Dull, aching pain or pressure on both sides of the head
• Tightness around the forehead or back of the head
• Mild to moderate pain that may last a few hours to days

Symptoms in children

• Children can get headaches too, often from dehydration, stress, or lack of sleep. In children, headaches usually improve with rest, water, and time.

Symptoms in older adults

• Headaches that are new, different, or severe
• Pain that gets worse with activity or lying down
• Tenderness over the temples (side of the head) or scalp
• Jaw pain when chewing
• Vision changes (blurred or double vision)
• Headache with a fever or stiff neck

Causes

Main causes

• Tension headaches—from stress, fatigue, or poor posture
• Medication overuse headaches—painkillers taken too often can actually cause more headaches
• Giant cell arteritis—inflammation of blood vessels in the head, especially in people over 50
• Cervicogenic headache—pain coming from the neck joints or muscles
• High blood pressure (hypertension) that is not well controlled
• Dehydration or poor sleep
• Side effects of medicines, including blood pressure drugs, painkillers, or antidepressants

Risk factors

• Age over 50
• Being female (slightly higher risk for tension headaches and giant cell arteritis)
• Taking certain medicines regularly, like painkillers for other conditions
• Having other health conditions like high blood pressure, diabetes, or arthritis

When to see a doctor

See a doctor urgently if:

• If you have a sudden, severe headache—call your local emergency number immediately
• If headache comes with a stiff neck, fever, confusion, or trouble breathing
• If headache follows a recent head injury

Book a routine appointment if:

• If you have a new type of headache that lasts more than a few days
• If your headaches are getting worse or more frequent
• If you have tenderness over your temples, jaw pain when eating, or vision changes

Diagnosis

Your doctor will ask about your headache pattern, how long it lasts, what makes it better or worse, and any other symptoms. They will also check your pulse, blood pressure, and temperature.

Tests that may be done

• Blood tests to check for inflammation (ESR or CRP) if giant cell arteritis is suspected
• Imaging tests like CT scan or MRI if a serious cause is possible
• Eye exam if vision changes are present

What to expect at your appointment

The doctor may recommend keeping a headache diary for a few weeks to note when headaches happen, what you were doing, and what helps. This can help find triggers and the best treatment.

Treatment

Treatment for headaches in older adults depends on the cause. Simple self-care can often help. If a specific condition is found, the doctor will treat that condition. Medicines are used carefully because older adults may be more sensitive to side effects.

Self-care at home

• Rest in a quiet, dark room
• Apply a cold or warm compress to your forehead or neck
• Drink enough water throughout the day
• Try gentle stretching or relaxation exercises
• Avoid triggers like loud noises, bright lights, or strong smells

Medical treatments

Doctors may prescribe medicines to reduce inflammation (for conditions like giant cell arteritis), treat high blood pressure, or prevent headaches. They may also recommend changing or stopping medicines that could be causing headaches. All medicine changes must be done under a doctor's supervision—never stop a prescription suddenly on your own.

When is surgery considered?

Surgery is rarely needed for headaches in older adults. In very rare cases, if a headache is caused by a bleeding blood vessel in the brain, emergency surgery may be required.

Living with this condition

Living with headaches can be frustrating, but keeping a routine can help. Try to go to bed and wake up at the same time each day. Manage stress with simple activities like walking, listening to music, or talking with friends.

Lifestyle tips

• Stay active with gentle exercise like walking or swimming
• Maintain a regular sleep schedule
• Avoid skipping meals—eat balanced meals at regular times
• Limit caffeine and alcohol, as they can trigger headaches

Diet and exercise

Eating a healthy diet rich in fruits, vegetables, and whole grains may help prevent headaches. Drink 6-8 glasses of water a day unless your doctor advises otherwise. Gentle stretching and walking can improve blood flow and reduce tension.

Mental health and emotional wellbeing

Headaches can make you feel frustrated, anxious, or sad, especially if they happen often. It is important to talk to your doctor if headaches affect your mood or daily life. You are not alone—help is available.

Prevention

Not all headaches can be prevented, but you can reduce the chance by staying hydrated, managing stress, sleeping well, and avoiding medicine overuse. If you get regular headaches, your doctor may suggest a preventive plan.

Complications

If left untreated

• If the headache is from a serious cause like giant cell arteritis, not treating it can lead to permanent vision loss
• Medication overuse headaches can become chronic and hard to treat
• Untreated high blood pressure can damage blood vessels and increase risk of stroke

Long-term outlook

Most headaches in older adults can be managed well with proper care. Even when a serious cause is found, early treatment often leads to a good outcome. With the right help, many people find relief and return to their normal activities.

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