There are a wide range of conditions that can present as headache, where the headache is a secondary problem. Some of these conditions however rare, require medical attention. You should see your doctor for an assessment if:
Your headache is new and severe. Any new presentation of severe head pain should be examined for an underlying medical cause.
You have a sudden change in your headache presentation. For people with a long standing history of headaches this could involve s change in the usual area, intensity, frequency or duration of your symptoms.
You have an unusual headache after suffering trauma to the neck.
Your headache changes significantly when you lay down or stand up.
In benign headache or migraine the symptoms first appear between the age of 15 and 50 years old. Any new headache or migraine appearing earlier or later than this should be assessed.
You develop a stiff neck, thoracic (mid back) or lumbar (low back) ache and sciatica (pain down the back of one leg) within a few days of a severe headache
Headache accompanied by neurological signs such as numbness, pins and needles, confusion, loss of coordination or cognitive ability.
If your symptoms have been consistent over a long period of time, and your headaches or migraines follow predictable patterns, and you have seen your doctor and had investigations, it is highly likely that you have benign primary headache and should have a skilled assessment of your upper cervical spine.