Most occasional tension-type headaches are easily treated with over-the-counter medications, including:
- Ibuprofen (Advil, Motrin IB, others)
- Acetaminophen (Tylenol, others)
Daily prescription medications, including tricyclic antidepressants, might manage chronic tension-type headaches. Alternative therapies aimed at stress reduction might help. They include:
- Cognitive behavioral therapy
- Massage therapy
Migraines are another common type of headache. They affect three times more women than men. Migraines typically:
- Cause pain that is moderate to severe
- Cause nausea, vomiting, or increased sensitivity to light or sound
- Affect only one side of your head, but can affect both sides
- Worsen with activity such as climbing steps
- Last from four to 72 hours without treatment
Migraine treatment is aimed at relieving symptoms and preventing additional attacks. If you know what triggers your migraines, avoiding those triggers and learning how to manage them can help prevent migraines or lessen the pain.
Treatment might include:
- Rest in a quiet, dark room
- Hot or cold compresses to your head or neck
- Massage and small amounts of caffeine
- Over-the-counter medications such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) and aspirin
- Prescription medications including triptans, such as sumatriptan (Imitrex) and zolmitriptan (Zomig) Fioricet
- Preventive medications such as metoprolol (Lopressor), propranolol (Innopran, Inderal, others), amitriptyline, divalproex (Depakote), topiramate (Qudexy XR, Trokendi XR ,Topamax) or erenumab-aooe (Aimovig)
Seek emergency care if you have:
- A very severe, sudden headache
- Headache after a head injury or fall
- Fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking
- Pain that worsens despite treatment
These symptoms suggest a more serious condition, so it’s important to get a prompt diagnosis and treatment.
Almost everyone gets headaches, and many are nothing to worry about. But if headaches are disrupting your activities, work or personal life, it’s time to see your doctor. Headaches can’t always be prevented, but your doctor can help you manage the symptoms.
When headaches occur three or more times a month, preventive treatment is usually recommended. Migraine treatment is aimed at relieving symptoms and preventing additional attacks. Drug therapy, biofeedback training, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling migraine and other vascular headaches. Drug therapy for migraine is often combined with biofeedback and relaxation training. One of the most commonly used drugs for the relief of migraine symptoms is sumatriptan.
The first step in caring for a tension-type headache involves treating any specific disorder or disease that may be causing it. A physician may suggest using analgesics, nonsteroidal anti-inflammatory drugs, or antidepressants to treat a tension-type headache that is not associated with a disease.
Treatment options for cluster headaches include triptan drugs, non-invasive vagus nerve stimulation (which uses a hand-held device to transmit a mild electrical stimulation to the vagus nere throgh the skin), and oxygen therapy (in which pure oxygen is breathed through a mask to reduce blood flow to the brain).
Certain antipsychotic drugs, calcium-channel blockers, and anticonvulsants can reduce pain severity and frequency of cluster headache attacks.