A feeling of pressure, tightness or heaviness in your head is most often a tension-type headache. The NHS describes it as feeling like something is pressing on your head or being tightened around it, usually on both sides. Other common causes are sinusitis after a cold, migraine and stress or anxiety. These are not usually a sign of anything serious.
High blood pressure is a less likely explanation than many people think, because it rarely causes symptoms. Rarely, a pressure headache is a sign of raised pressure inside the skull. That is why some headache features need urgent attention, listed below.
If you already know you get headaches and want to work out which type, see migraine, tension or cluster: how to tell them apart.
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Call 112 or 999 in Ireland, 999 in the UK or 911 in the US, or go to an emergency department, if you have a headache and:
Get an urgent GP appointment the same day (or NHS 111 in the UK) if:
This is the headache that most closely matches "pressure". The NHS describes these features:
Tension headaches last at least 30 minutes and sometimes several days. The NHS lists stress, sleep problems and caffeine as common causes. It says tension headaches are not a sign of an underlying condition.
NICE calls them chronic when they happen on 15 or more days a month for more than 3 months.
There is a catch with painkillers. Taking them too often or for a long time can cause headaches of its own, called medication overuse headache. If you are taking something for headache on many days a month, read about how that happens before your next appointment.
Sinusitis is swelling of the sinuses, usually after a cold or flu. The NHS lists these main symptoms:
The NHS says it usually clears up within 4 weeks, and antibiotics are rarely needed because it is usually viral. The NHS suggests a GP if you are not better after 3 weeks of self-care. The HSE suggests one if there is no improvement after 1 week.
Many people who have repeated "sinus headaches" may have migraine. In one US study, 2,991 patients with a history of sinus headache were assessed. None had a previous migraine diagnosis or signs of infection. Of these, 88% met criteria for migraine or a closely related migraine-type headache. Sinus pressure was the most reported symptom, in 84%.
It was one clinic study, so not every sinus headache is migraine. But if "sinus" pressure keeps returning without a cold, fever or coloured mucus, ask about migraine.
The NHS says migraine usually causes a throbbing headache, often on one side, that gets worse when you move. Feeling sick and sensitivity to light and sound are common. Attacks usually last between 4 hours and 3 days.
The NHS lists headaches and feeling tense among the physical symptoms of anxiety. Stress is also on the NHS list of common headache causes. If worry is constant and hard to control, it may be more than everyday stress. Our guide to anxiety the feeling and anxiety the disorder can help you work out which.
The NHS also lists colds, alcohol, bad posture, eyesight problems, irregular meals, too little fluid, too many painkillers, periods and the menopause.
Myth: you can feel high blood pressure as pressure in your head.
Fact: high blood pressure usually causes no symptoms. The NHS says that rarely it can cause headaches, blurred vision or chest pain. The only way to know is to have your blood pressure checked.
The International Headache Society's classification (ICHD-3) says mild or moderate long-term high blood pressure does not appear to cause headache. Mild means readings of 140–159/90–99 mmHg, and moderate means 160–179/100–109 mmHg. Studies tracking blood pressure over 24 hours found no convincing link between its ups and downs and headache.
ICHD-3 says blood pressure headache usually comes with a sudden rise to 180 or more systolic, or 120 or more diastolic. It settles once blood pressure falls.
Fact: a check is quick, and worth having anyway. The NHS advises a check if you are 40 or over and have not had one for more than 5 years. You can have it at a pharmacy or GP surgery. The NHS advises getting help from NHS 111 if you often have headaches or blurred vision. How blood pressure affects the brain over time is covered separately.
The NHS calls a build-up of pressure around the brain intracranial hypertension. It can happen suddenly after a severe head injury, a stroke or a burst brain aneurysm. It can also be caused by a brain abscess, a brain tumour, meningitis or encephalitis.
When there is no known cause, it is called idiopathic intracranial hypertension (IIH). The NHS says it is rare and mainly affects women in their 20s and 30s, most often women who have gained weight.
The NHS lists these symptoms:
The main risk is to your sight. The NHS says raised pressure can make the optic nerve swell, and you could lose vision. Tell your doctor straight away if you notice changes in your vision.
ICHD-3 notes that IIH headache can look like chronic migraine or tension-type headache. Most people with IIH have optic nerve swelling, called papilloedema, so an eye examination matters. UK consensus guidance sets three aims: treat the underlying disease, protect vision and reduce headache.
Temporal arteritis (giant cell arteritis) is inflammation of the arteries, especially at the temples. The NHS lists frequent severe headaches, tender temples or scalp, jaw pain when eating or talking, and vision problems. It needs urgent treatment because it can lead to stroke or blindness.
Carbon monoxide poisoning can cause headache, dizziness, nausea, tiredness and confusion. The NHS says symptoms may ease when you leave the building. If you suspect it, stop using the appliance, go outside and get advice urgently.
Serious sinus complications are uncommon. NICE advises hospital referral if sinusitis comes with swelling around the eye, double vision or reduced vision. It also advises referral for swelling over the forehead bone, a severe frontal headache, or signs of meningitis.
A stroke can cause sudden weakness, numbness or speech problems. Learn the FAST signs.
Your GP will ask what the pressure feels like, where it is, how long it lasts and how often. They will ask about vision changes, being sick, any change from your usual pattern, and how many days a month you take painkillers.
They may check your blood pressure and examine you, which can include your eyes.
A headache diary helps. NICE suggests recording for at least 8 weeks:
Most people with a typical tension-type headache or migraine do not need a scan. NICE advises against brain imaging solely for reassurance in these diagnosed headaches. If IIH is suspected, the NHS says a specialist may arrange an eye assessment, a brain scan and a lumbar puncture.
For an ordinary headache, the NHS suggests:
For tension headaches, the NHS adds exercise, yoga or massage, a low firm pillow, heat or cold packs for the neck, and less caffeine. For sinusitis, rest, fluids and a salt water nose rinse can help, and the HSE suggests a warm face cloth.
See a GP if you get headaches several times a week, they are severe, or self-help is not working. A pharmacist can advise on painkillers, including in pregnancy.
Very rarely. The NHS says most headaches go away on their own and are not serious. Doctors look for warning features, such as new headache with vomiting, a changed pattern, or neurological symptoms.
Usually not. Mild or moderate high blood pressure does not appear to cause headache. Blood pressure headache usually happens at very high readings. The only way to know is to have it measured.
With a cold, this is often sinusitis, which causes pain and tenderness around the cheeks, eyes and forehead. But the NHS says a headache triggered or made worse by coughing, sneezing, bending or exercise needs an urgent GP appointment. This applies especially if there is no cold, or you also have vision changes.
Sinusitis usually follows a cold, with a blocked nose, coloured mucus or fever. Repeated "sinus" headaches without those features may be migraine, especially with nausea or sensitivity to light. A GP can help you tell the difference.
This article is general information, not medical advice. It cannot diagnose the cause of your symptoms. Talk to your GP or pharmacist about your own headaches, and before starting, stopping or changing any medicine.
Reviewed by: Proco Team
Last updated: November 2026