Headache That Won't Go Away: Causes, Warning Signs and What to Do Next

A Nigerian Doctor's Guide to Why It Keeps Coming Back, When to Worry, and What to Do About It

It is 2 p.m. and your head is pounding again.

You have had water. You have had Panadol. Someone said it was malaria, so you did the test. It came back negative. Someone said BP, so you checked. Normal. Someone said stress. Someone said "too much thinking."

And still it comes back.

If that is your story, the problem may not be that you have not tried hard enough. It may be that nobody has told you three things:

•      Which kind of headache you may have, because "headache" is not one condition.

•      Which signs mean go to hospital now, and which can wait for an appointment.

•      What your tablets may be doing, because for some people the tablets become part of the pattern.

Here is what the research says

•      In one neurology clinic in Benin City, 56% of 110 patients had treated their headache themselves before coming. Among those who did, 37% had used antimalarials.

•      The World Health Organization advises testing for malaria before treating it. A negative test means other causes should be looked for.

•      The international headache classification notes that more than half of people with headache on 15 or more days a month have medication-overuse headache, a headache linked to taking tablets too often.

None of this is carelessness. It is what people do when the chemist is nearby and the specialist is far away. This guide closes that gap.

Meet the author

I am Prince Joshua, a general practitioner in Lagos. I work in a Lagos State general hospital, and I have also worked in private general hospitals here. In four years of practice, one complaint has followed me from clinic to clinic: chronic headache.

Patients sit down, hold their heads, and say it will not go away. They want to understand it, and they want to know what to do. But a busy clinic leaves little time for long explanations.

So I wrote down the conversation I wish I had time to have with every one of them.

Your first win in 20 minutes

You do not have to read the whole guide before you get value. Chapter 1 gives you a quick win. In one sitting you will:

1.      Run a 12-question danger-sign check, so you know in minutes whether your headache needs hospital now, a doctor soon, or neither.

2.      Count your headache days and tablet days for the last 30 days, and compare them with the warning lines used by headache specialists.

3.      Start your first diary entry, and get a colour: Green, Amber or Red, with a clear next action.

What is inside

40 pages. 10 chapters. A fill-in tool in every chapter. Each chapter ends with something you can do today.

•      Introduction: The headache nobody can explain.

•      Ch 1, The 20-Minute Headache Snapshot: your danger check, 30-day count and first diary entry.

•      Ch 2, Red Flags: the signs that mean go to hospital now, with a one-page Quick Card you can show your family.

•      Ch 3, Headache Is Not One Condition: tension-type, migraine and cluster, with a Pattern Spotter table and an 8-question self-check.

•      Ch 4, Other Causes Doctors Check For: blood pressure, "sinus" headache, the neck, and caffeine, with the questions to ask your doctor.

•      Ch 5, The Malaria Mix-Up and the Tablet Trap: test before you treat, and the Pill-Day Counter that shows if your tablets are over the line.

•      Ch 6, Your Triggers, Nigerian Style: stress, noise, sleep, generator fumes, water, hormones, and a 14-day test to find yours.

•      Ch 7, Seeing the Doctor Well: what to bring, what to say, and whether you really need a scan.

•      Ch 8, Treating an Attack Safely: what the evidence says about tablets and home measures, with your own Attack Plan card.

•      Ch 9, Preventing the Next One: habits with evidence behind them, what a doctor may add, and a 4-week plan.

•      Ch 10, Keeping It Under Control: a Monthly Scorecard, a Relapse Plan and a one-page "What do I do next?" decision path.

What makes this guide different

•      It is written by a practising Nigerian doctor, for Nigerian life: the malaria mix-up, the generator, Sunday service, the busy clinic.

•      It names its sources. The guide draws on the international headache classification (ICHD-3), the UK's NICE headache guideline, the SNNOOP10 red-flag list, Cochrane reviews and WHO malaria guidance. The sources are listed at the back.

•      It is honest. Where something is my own clinical judgement and not a research finding, the guide says so. Where I found no evidence, I say that too.

•      It gives you tools, not just information. Fill them in, take them to your doctor, and keep them.

Free bonuses when you order today

•      Bonus 1: Headache and Pill Diary, with a monthly summary, to track your days and tablets.

•      Bonus 2: Red-Flag Quick Card, the warning signs on one page. Save it as a screenshot on your phone.

•      Bonus 3: Doctor-Visit Checklist, what to bring, tell and ask at your appointment.

Is this for you?

This guide is for you if you are an adult with headaches that keep coming back, you have been treating them yourself, and you want to understand what is going on and walk into your next appointment prepared. It is also for family members who want to know when to worry.

This guide is not a diagnosis and not a replacement for a doctor. It will not cure your headache. The goal is fewer headache days, milder ones, and fewer tablet days. It tells you when to go to hospital, and it expects you to go.

My 7-day action guarantee

Do the Chapter 1 danger-sign check and make your first diary entry. If the guide is not clear and useful to you, send your request within 7 days and I will refund you in full. 

Questions people ask

Will this cure my headache?

No. No guide can promise that. It helps you find out which pattern you may have, know the danger signs, see whether your tablets have crossed the warning line, and plan the next step with your doctor.

Do I have to stop my tablets?

The guide does not tell you to stop on your own. If your count is over the warning line, the advice is to see your doctor and talk about supervised withdrawal.

Is it only about migraine?

No. It covers tension-type headache, migraine, cluster headache, medication-overuse headache, and other causes doctors check for.

Can I use it instead of seeing a doctor?

No. It is designed to make your visit better, and to tell you when you should not wait.

Is it hard to read?

No. It is written in plain English, in short paragraphs, with fill-in tools. You can start with the 20-minute check and read the rest in your own time.