Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.


Almost everyone has headaches from time to time. Some headaches are mild. Other types can cause severe pain. 

We classify headaches as either primary or secondary.

Primary headaches have no clear cause. They are due to disturbances in the brain's pain system. They may involve increased sensitivity to something inside or outside the body. Primary headaches include migraines and cluster headaches. 

Secondary headaches are caused by other medical conditions. High blood pressure, or an infection, can cause headaches. Head trauma, even a mild one, can also cause headaches. A headache can also be a symptom of an intracranial disease, such as meningitis or encephalitis. 

Most headaches can be treated with self-care and stress management. We recommend:

  • Eating healthy meals at regular times.
  • Getting plenty of sleep.
  • Exercising regularly.


Chronic daily headaches

Chronic daily headaches occur 15 or more days a month. Most people with chronic daily headaches are also migraine sufferers (also called migraineurs). The migraines may become more frequent until the headaches occur almost daily. Migraineurs who suffer from chronic daily headaches usually describe two types of headaches: 

  • A milder tension-type headache.
  • A more disabling headache, like a severe migraine, on top of their regular tension headache.

People who do not have migraines also suffer from chronic daily headaches. These headaches are usually tension-type headaches. These cause:

  • Tight, pressing pain on both sides of the head. 
  • Mild to moderate pain in the back of the head and neck.

Recent research indicates that chronic daily headaches occur when the nervous system becomes overly sensitive. Frequent use of pain medications seems to promote this.  These medications include: 

  • Over-the-counter pain medications, such as acetaminophen and ibuprofen
  • Combination migraine medicines that include caffeine
  • Triptans (migraine medications)

Overuse of pain medication can cause headaches. We call this rebound headaches. However, not all chronic daily headaches are rebound headaches.

Additional References:

Other Types

Many headaches fall within these 3 main types, depending on the symptoms.

Migraine headaches

A migraine is a headache lasting between 4 and 72 hours, with nausea and/or vomiting and light and sound sensitivity. You may have pulsating pain on one side of the head. The pain may get worse with exertion, such as walking up a flight of stairs. Migraines can be an inherited condition.

Tension headaches

Most headaches are tension headaches, and they may affect adults and children. Tension headaches can:

  • Cause aching pain and tightness around the forehead, temples, or back of the head and neck.
  • Feel like a pressing, tightening band around the head.
  • Increase your sensitivity to lights or sound, but not both.
  • Last from 30 minutes to 7 days.
  • Develop into chronic headaches.  
Cluster headaches

Cluster headaches are far less common than either migraine or tension headaches. The symptoms include:

  • Intense, disabling pain on one side of the head, with a watery eye and stuffy nose on the same side.
  • Pain that starts suddenly.

They occur in groups, or clusters, over a few weeks to months.


We’ll ask you about your symptoms and past medical history, and examine you. This helps us rule out more serious conditions that could be causing your headaches.

We may order additional tests if your: 

  • Headaches are a new problem.
  • Symptoms change.
  • Exam shows you may have another condition.

Some types of headaches, particularly chronic daily headaches, can be caused by depression. We’ll also evaluate you for depression.


Most headaches are treated at home with lifestyle changes and over-the-counter medications. We may recommend additional treatment depending on the frequency, severity, and type of headaches you’re experiencing.

You can manage headache symptoms by:

  • Eating healthy meals at regular times.
  • Getting plenty of sleep.
  • Exercising regularly.
  • Identifying triggers or activities that cause your headaches. Keeping a headache diary is a good way to do this.

Although over-the-counter pain medications are effective at treating occasional headaches, overuse can cause more headaches. We’ll help you develop a plan to gradually reduce your dependence on these drugs.

Some headache medications are not recommended during pregnancy. If you’re pregnant, or planning to become pregnant, and taking medications to control your headaches, we’ll review these medications and come up with a safe treatment plan.

Additional References:

Lifestyle Recommendations

Many headaches can be prevented or managed by following a healthy lifestyle that includes:

  • Healthy eating
  • Regular exercise
  • Restful sleep (8 hours or more per night)
  • Stress management
Manage anxiety and depression

Anxiety and depression can be underlying causes of headaches. Talk to us if you think you need to be evaluated or treated for depression and/or anxiety.

Find a support group

Join a headache support group. We have headache management classes at many of our medical centers. A number of community organizations also have online or in-person support groups for headache sufferers.

Headaches and pregnancy

Some women have headaches in early pregnancy. There is usually no specific cause. By midpregnancy, symptoms improve or disappear. Later in pregnancy, a new headache may be a sign of pregnancy complications. Tell your doctor if you’re having ongoing or severe headaches. 

When to Call Us

Though the vast majority of headaches can be treated at home, sometimes medical care is needed. Rarely, headaches are a sign of a more serious condition.

Call our 24-hour Appointment and Advice line at 866-454-8855 immediately if:

  • Your first headache occurs after age 50.
  • You have new, severe symptoms unlike your usual headaches.
  • You have the worst headache you’ve ever experienced.
  • Your headaches are getting worse over time.
  • Your headache gets worse with physical exertion, or with coughing, sneezing, or sexual activity.
  • You feel drowsy, feverish, or suddenly weak.

Your Care with Me

Most headaches can be treated at home with over-the-counter pain relievers. If you have regular headaches that do not respond to these medications, or if you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.

If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:
  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Classes and Coaching

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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