When you have a splitting headache, all you can think about is how to stop the pain. Fortunately, there are many treatment options for headaches, including medications, home remedies, and even medical devices that can bring relief. You can also adopt lifestyle changes and other strategies that help prevent headaches.
Keep in mind that there are different types of headaches, which can vary according to their symptoms and triggers. Work with your doctor to develop a headache treatment and prevention plan that’s right for you. Here are some common treatment options for different types of headaches.
Tension Headache Treatments
If you feel like your head is being squeezed by a giant vise, that’s probably a tension headache — the most common form. No one knows what causes tension headaches, but doctors think that they begin when muscles in your neck and head contract, or tighten up. A tension headache usually feels like dull, steady pain on both sides of the head. Some common treatments that can help ease and prevent tension headaches include:
OTC pain relievers. You probably have one or more OTC pain relievers in your medicine chest. They include:
- Acetaminophen (Anacin, Panadol, Tylenol)
- Aspirin
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve, Anaprox, Naprosyn)
You should use these pills with caution because taking them too often can cause hard-to-treat rebound headaches (also called medication-overuse headaches). If you need to use these drugs often, see your doctor. Don’t give aspirin to anyone under age 19 — it raises their chance of having a serious condition called Reye's syndrome.
Antidepressants. These drugs treat depression, but some also seem to help prevent tension headaches. In particular, your doctor may prescribe a medication known as a tricyclic antidepressant. They include amitriptyline (Elavil), nortriptyline (Pamelor), and protriptyline (Vivactil). If a tricyclic antidepressant doesn’t help prevent your tension headaches, your doctor may suggest trying another form of these drugs, called selective serotonin reuptake inhibitors (SSRIs). Some SSRIs that may help include venlafaxine (Effexor XR) and mirtazapine (Remeron).
Anti-seizure medications. This category of medicines prevents seizures in people with epilepsy, but doctors sometimes prescribe them to reduce tension headaches, too. Some anti-seizure medications occasionally prescribed for headache prevention include gabapentin (Gralise, Horizant, Neurontin) and topiramate (Topamax, Qsymia, and others).
Muscle relaxants. If you have persistent tension headaches, a doctor may prescribe a type of drug called a muscle relaxant, such as tizanidine (Zanaflex), to prevent them.
Migraine Headache Treatments
Migraine headaches tend to cause throbbing pain, usually on one side of your head. When you have a migraine attack, you may also feel queasy and throw up. You might also find it hard to tolerate bright lights or loud sounds.
About 25%-30% of people who have migraines sometimes experience a kind of “warning sign” called an aura shortly before they notice headache symptoms. During a migraine aura, you might see strange shapes or dots floating before you. You may also feel tingly or numb. Some people have a hard time talking. A migraine aura may last a few minutes or up to an hour.
Medications that can treat migraine attacks include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin and other NSAIDs can help if you take them at the first sign of a migraine attack. NSAIDs also include ibuprofen and naproxen. Celecoxib (Elyxyb) is a prescription NSAID that comes in liquid form. Other NSAIDs include diclofenac (Voltaren XR and others), ketoprofen (Actron and others), and ketorolac (Toradol).
Triptans. If NSAIDs don’t relieve your migraines or your pain is severe, your doctor will likely prescribe a triptan. These drugs appear to relieve migraines by altering blood flow and pain signals in the brain. Triptans are available as pills, injections, and nasal sprays. There are many forms of triptans, including:
- Almotriptan (Axert)
- Eletriptan (Relpax)
- Frovatriptan (Frova, Migard)
- Naratriptan (Amerge)
- Rizatriptan (Maxalt)
- Sumatriptan (Alsuma, Imitrex, Sumavel, Onzetra Xsail, Tosymra, Zembrace)
- Zolmitriptan (Zomig)
Calcitonin gene-related peptide (CGRP) receptor inhibitors: These drugs treat migraine by blocking a protein in the brain that plays a role in triggering pain. They include:
- Rimegepant (Nurtec)
- Ubrogepant (Ubrelvy)
- Zavegepant (Zavzpret)
Other medications for migraines:
Ditans. There is one ditan approved in the U.S. for treating migraine symptoms, known as lasmiditan (Reyvow). This drug works by blocking CGRP from being released in the brain, which stops it from producing pain signals.
Ergotamine. This medicine, which comes in several forms, treats migraine by improving blood flow and blocking pain signals in the brain.
Prevention medication for migraines
If you have four or more severe, prolonged migraine headache days each month, your doctor may suggest you try medicine and other strategies to prevent your attacks. These could include:
Blood pressure drugs. Certain blood pressure drugs may help reduce migraines, including:
- Atenolol (Tenormin)
- Candesartan (Atacand)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard)
- Propranolol (Inderal, Inderal LA, Inderal XL, InnoPran XL)
Antidepressants. Several of these depression-fighting drugs may reduce the incidence of migraine, including:
- Amitriptyline
- Duloxetine
- Nortriptyline
- Venlafaxine
Anti-seizure drugs. For migraine prevention, your doctor may recommend topiramate (Qudexy XR, Topamax, Topamax Sprinkle, Trokendi XR) or valproate (Depakote, Depakene, Stavzor).
CGRP monoclonal antibodies. Similar to CGRP medicines that treat migraine symptoms, these treatments help prevent them by blocking a protein in the brain that helps produce the sensation of pain. They include:
- Eptinezumab (Vyepti)
- Erenumab (Aimovig)
- Fremanezumab (Ajovy)
- Galcanezumab (Emgality)
CGRP receptor antagonists. Several CGRP-targeted drugs that treat migraine also help prevent them, including:
- Atogepant (Qulipta)
- Rimegepant (Nurtec)
Relaxation and biofeedback. Using relaxation techniques, such as meditation and biofeedback (a mind-body technique that helps you gain control over bodily functions such as breathing and heart rate), can help reduce migraines, especially when combined with medication.
Medical devices. Some medical devices may help lower your number of monthly migraine attacks. These include:
- Cefaly: This small headband device sends electrical pulses through your forehead to stimulate a nerve linked with migraines.
- SAVI Dual: This device gives off a magnetic pulse that stimulates part of your brain. You hold it against the back of your head at the first sign of a headache.
- gammaCore: This hand-held portable device is also known as a noninvasive vagus nerve stimulator (nVNS). When you place it over the vagus nerve in your neck, it sends a mild electrical stimulation to the nerve's fibers to relieve pain.
Botulinum toxin. You probably know this product as Botox, a treatment for wrinkles. However, the FDA has approved Botox to prevent chronic migraine headaches in adults. If you have a migraine 15 or more days per month, you can get Botox shots in your head and neck about every 3 months.
Cluster Headache Treatments
Cluster headaches are a rare and very painful type of headache. A cluster headache usually lasts between 15 minutes and 3 hours and may return several times later in the day. They’re called cluster headaches because they tend to happen in bunches. You might be pain-free for months, then get cluster headaches for days or weeks.
Common pain relievers such as aspirin, ibuprofen, and acetaminophen don’t help much with cluster headaches, so your doctor may suggest one or more of the following treatments:
Oxygen therapy. About two-thirds of people who have cluster headaches get relief from inhaling 100% oxygen. This treatment works fast, often within 10 minutes. You can go to an emergency room and receive oxygen therapy through a face mask, though some people have canisters that they keep at home.
Triptans. These drugs may help if you take them at the first sign of a cluster headache. You can take them as a nasal spray or by injection. Two recommended triptans for treating cluster headaches are sumatriptan (Alsuma, Imitrex, Onzetra Xsail, Sumavel DosePro, Zembrace SymTouch) and zolmitriptan (Zomig).
Lidocaine. About 1 in 3 people with cluster headaches get relief from this form of pain medicine, which you inhale through the nose.
Preventive medicines for cluster headaches
Preventive medicines often work when you take them at the first sign of a new cluster of headaches. Choices include the blood pressure medicine verapamil (Calan, Covera HS, and Verelan) or a short course of a steroid such as prednisone.
Sinus Headache Treatments
You may develop a sinus headache if you have sinusitis, which is an infection in your sinuses (the passages that deliver air inhaled through your nose to your lungs). Treating sinusitis can help relieve your sinus headache. Two options include:
Decongestants. These medications relieve swelling in the nose and sinuses. Decongestants are available as pills, liquids, sprays, and drops. Some options include pseudoephedrine (Sudafed and others) and oxymetazoline (Afrin, Zicam).
Antibiotics. If your doctor determines that a bacterial infection is causing your sinusitis, they will prescribe an antibiotic such as amoxicillin (Amoxil, Moxilin, Sumox, Trimox), amoxicillin-clavulanate (Amoclan, Augmentin, Augmentin ES-600, Augmentin XR), or sulfamethoxazole-trimethoprim (Bactrim, Bactrim DS, Septra, Septra DS, SMZ-TMP Pediatric, Sulfatrim, Sulfatrim Pediatric). If your infection doesn’t go away in a week or so, your doctor may switch you to a different antibiotic.
How to Avoid Headache Triggers
A headache trigger is anything that you experience in your daily life that causes you to develop pain inside your skull. Headache triggers vary from one person to another. And some triggers are more common in specific types of headaches. For example, eating chocolate can set off a migraine attack for some people. Here are some common headache triggers:
- Stress
- Alcohol
- Some foods and beverages, especially chocolate, certain cheeses (such as brie and Stilton), processed meats, coffee (in excess -- modest amounts may ease a headache), and carbonated beverages
- Weather changes, such as storms, rising temperatures, and humidity
- Menstrual periods (for women)
- Bright or flashing lights
- Smoking
If you know the things that trigger your headaches, try to avoid them. To learn more about what brings on your attacks, keep a headache diary that includes answers to these questions:
- When did your headaches first start?
- How often do you have them?
- Do you have any symptoms before the headache starts?
- Where is the pain?
- How long does it last?
- At what time of day do the headaches happen?
- Do you seem to get them after you eat certain types of food?
- For women, at what time in your monthly cycle do they happen?
- Are the headaches triggered by something in your environment, such as smells, noise, or some kinds of weather?
Home Remedies for Headaches
Some lifestyle changes and things you can do at home may help reduce the number of headaches you get and offer relief.
Try an ice pack or heating pad. Both cold and heat therapy can help ease headache pain. Choose whichever method you prefer.
Manage your stress. Psychological stress is a major cause of tension headaches. If you’re feeling freaked out much of the time, find a stress-busting strategy that works for you. Some possibilities include yoga, meditation, tai chi, and even simply taking some deep breaths.
Exercise regularly. Getting plenty of physical activity seems to help prevent headaches.
Drink plenty of water. Getting dehydrated causes tissues in your brain to tighten up, which causes pain. There’s no special rule about how much water or other fluids you should drink every day. Just be sure you don’t get thirsty and drink more fluids if it’s hot or if you exercise.
Get a good night’s rest. Sleeping too little or too much can trigger some types of headaches, including migraines. If you’re an adult, aim for 7-9 hours of sleep a night; kids need a bit more.
Consider dietary supplements. Some dietary supplements, which you can buy without a prescription, may offer headache relief. In particular, the following supplements may help reduce the frequency of your migraine attacks:
- Coenzyme Q-10
- Feverfew
- Magnesium
- Riboflavin
There is only a modest amount of research supporting the use of these supplements for preventing migraines. Before you take any dietary supplement, check with your doctor first to be sure it’s safe.
Alternative Headache Treatments
These treatments aren’t as common, but there is evidence that they can help prevent and relieve headaches in some people. Discuss using these as complementary treatments with your doctor.
Osteopathy. Osteopaths can use manipulation and soft tissue techniques on the head, neck, and upper back.
Acupuncture. Studies show that this practice of placing thin needles at specific points on the body may help relieve tension and migraine headaches.
Mind-body medicine. Hypnosis, deep breathing, visualization, meditation, and yoga may ease pain by helping you deal with stress. It may be especially helpful for tension headaches. Hypnosis also may lower your perception of pain.
Cognitive behavioral therapy (CBT). It mixes meditation and relaxation with education on motivation, behavior, and how to handle emotions. With the help of a psychotherapist, you can learn to change negative thoughts and attitudes as well as the way you respond to stress. Those skills may help you avoid tension-type and migraine headaches.
Takeaways
Headaches are one of the most common medical complaints, but you have many different options for treating and preventing them. The strategy that’s right for you depends on several factors, including what type of headaches you’re having. Ask your primary care doctor to help you develop a plan for preventing headaches and coping with them when they strike.
