Headaches: Managing a Headache

You can reduce how many headaches you get and how bad they are when you do get them. Try to:

• Find and avoid triggers that cause your headaches.
• Carry your medicine with you so you can treat a headache right away when you feel one starting. This is especially important if you get migraines.
• Don't take over-the-counter pain relievers more than 3 times a week, because you may get rebound headaches. These headaches usually occur after pain medicine has worn off. This prompts you to take another dose. After a while, you get a headache whenever you stop taking the medicine.
• Take drugs that cause the fewest side effects, such as nonsteroidal anti-inflammatory drugs (NSAIDs) (for example, aspirin and ibuprofen).
• Exercise regularly, eat well, and reduce stress.
• Work with your doctor to find the best treatment for your headaches.

 What is the best way to treat and prevent headaches?
 Why should you quickly manage your headache?
 How do you manage a headache?
 Where to go from here

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Taking medicines and reducing stress can help you treat and prevent migraines and tension headaches.

• Reducing stress may be all you need to stop or prevent a mild tension headache. But you may need to take medicine if your symptoms get worse.
• You may need to try several medicines and ways of reducing stress to find the best treatment for you.
• Medicines to stop a headache include pain relievers (prescription, over-the-counter, or both).
• Medicines to prevent a headache include antidepressants and seizure medicines. The type of medicines you take will depend on the type of headache you have and how bad your symptoms are.
• A counselor or therapist can help you reduce stress. He or she also can help treat anxiety or depression if you have those health problems. Anxiety and depression can cause headaches.

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Early treatment may keep your headache from getting worse and may help you feel better sooner. This is especially true if you have migraine headaches. You will miss less work or school, and you may improve the quality of your life.

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You can try several things to stop a headache after it starts:

• Stop what you are doing, and begin treatment. Don't wait for the headache to get worse.
• Apply a cold, moist cloth or ice pack to your forehead and temples.
• Rest in a quiet, comfortable, dark room.
• Take medicines to stop your headache (abortive medication) as needed.
• Take your medicines exactly as prescribed by your doctor.
• Begin stress-relief methods as soon as your headache starts.
• Have a massage to relax tense muscles in your head, neck, temples, face, or jaw.

You can do things every day to help prevent headaches:

• Find and avoid your headache triggers by using a headache diary(What is a PDF document?) .
• Sit and stand with good posture to avoid muscle tension.
• Live a healthy lifestyle. Get regular sleep, eat healthy foods at regular times, avoid alcohol and drugs, and avoid foods that may trigger your headaches.
• Don't get too tired from hard physical activity.
• Don't take over-the-counter pain relievers more than 3 times a week, because you may get rebound headaches.
• Try to reduce stress and headache pain with one or more of these treatments:
  • Biofeedback is a relaxation method to help you learn to control a body function—such as muscle tension—that you normally don't control.
  • Acupuncture involves putting very thin needles into the skin at certain points on the body. Research shows that acupuncture can help prevent tension headaches.¹
  • Transcutaneous electrical nerve stimulation (TENS) uses a mild electrical current to reduce pain.
  • Cognitive-behavioral therapy or problem-solving therapy. Counseling with these methods can help with tension headaches. For more information, see Positive Thinking With Cognitive-Behavioral Therapy.
  • Yoga
  • Meditation
  • Peppermint oil. Some research shows that peppermint oil rubbed on your temples or on the tight muscles in your head, neck, and shoulders may help relieve tension headaches.

Other treatments that may help if you get migraines include:

• Butterbur. This is an herb that has been shown to help prevent migraines in some people.²
• Feverfew. This is an herb that—some small studies show—may help prevent migraines in some people. But most experts aren't sure how well it works for migraines.³
• Magnesium, which some doctors recommend. Studies have found that some people with migraines have low levels of magnesium in the brain.⁴
• Riboflavin (vitamin B2) and coenzyme Q10. In small studies, both have been shown to help prevent migraines.⁵

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Now that you have read this information, you are ready to start managing your headaches.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of pages where you have questions.

Take your headache diary with you when you visit your doctor. Be sure to let him or her know if you have any change in your symptoms.

Talk with your doctor about the best way to manage your headaches.

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Citations

1. Linde K, et al. (2009). Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews (1).

2. Lipton RB, et al. (2004). Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology, 63(12): 2240–2244.

3. Pittler MH, Ernst E (2004). Feverfew for preventing migraine. Cochrane Database of Systematic Reviews (1).

4. Evans RW, Taylor FR (2006). "Natural" or alternative medications for migraine prevention. Headache, 46(6): 1012–1018.

5. Sándor PS, et al. (2005). Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology, 64(4): 713–715.