Home Remedies and Lifestyle

Depending on the type of headache you have, you may benefit from avoiding various environmental, emotional, and food triggers that induce your headache pain. This applies to both primary headaches, which occur on their own, and secondary headaches, which arise from illness, pregnancy, menopause, medications, or other causes.

By way of the example:

Migraines may be alleviated by resting in a dark, quiet locating, and placing a cool compress on your forehead. Drinking water also helps. Tension headaches often improve when you get enough sleep each night or correct your eyeglass prescription. Cluster headaches can be difficult to treat but you can sometimes reduce the frequency by reducing your alcohol consumption and smoking cessation. Rhinogenic headaches, also known as sinus headaches, can often improve with nasal irrigation or breathing in steam from a simmering pot of water. Exertional headaches can be improved by warming up prior to exercise, increasing the intensity of exercise gradually, and cooling down after activity. Hypnic headaches can often be relieved by drinking caffeine. Hormonal headaches caused by oral contraceptives may improve if you omit the placebo pill break or switch birth control type. Cervogenic headaches, caused by referred pain from the neck, can often be relieved by placing a cold compress on the back of the neck or doing gentle neck stretches.

All headaches will generally improve if you can take the time to rest quietly away from bright lights and noise whenever symptoms develop.

Some people find that soaking in a warm bath helps (with the exception of cluster headaches, which can be induced by heat). Others prefer placing a cool cloth over their eyes, especially those experiencing migraine or exertional headaches. Ample hydration and improved sleep hygiene also help across the board.

Diet

Certain foods are associated with migraine symptoms. These foods appear to do so in different ways: some by triggering vasoconstriction (the narrowing of blood vessels), others by inducing vasodilation (the widening of blood vessels), decreasing serotonin levels, or stimulating pain receptors in the brain.

Among the substances associated with migraine food triggers are:

Alcohol Aspartame Caffeine Histamine Monosodium glutamate (MSG) Phenylethylamine Tyramine Yeast

An elimination diet can often help identify food triggers. This involves the elimination of one suspected food group from your diet for a specific period of time, after which the foods are gradually re-introduced to see if migraine occurs.

Alternately, a food diary can help you identify the specific foods that may give rise to your headaches.

Over-the-Counter (OTC) Therapies

The most commonly used medications to treat headaches are over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, Advil (ibuprofen), and Aleve (naproxen). NSAIDs reduce headache symptoms by reducing the production of chemicals called prostaglandins that cause inflammation, pain, and fever. These medications block enzymes called cyclooxygenases (COX) that the body uses to produce prostaglandins.

Analgesics like Tylenol (acetaminophen) can also help and without the gastrointestinal side effects associated with NSAIDs. With that said, Tylenol may not be as effective for treating certain types of headaches. The exact mechanism of action of the drug is unknown, but Tylenol is believed to work on centrally activating pathways that decrease pain.

While Tylenol is safer on the stomach, liver damage can occur if the drug is overused or taken with alcohol.

OTC antihistamines and steroid nasal sprays may be beneficial for treating sinus headaches caused by seasonal allergies.

Prescriptions

There are a wide variety of prescription drugs that can help reduce headaches if OTC options don’t provide you with relief. Each type of headache is treated with a different prescription medication.

Migraine

Migraines may be treated with a class of oral drugs known as triptans, like Imitrex (sumatriptan) and Maxalt (rizatriptan) that act on serotonin receptors in blood vessels, causing them to relax. Dihydroergotamine (DHE), a vasoconstrictor, and Topamax (topiramate), an anticonvulsant, may also be useful for treating migraine episodes.

To relieve nausea and vomiting that accompany migraines, antiemetic drugs like Reglan (metoclopramide) and Zofran (ondansetron) may be prescribed; these may be delivered either by mouth or rectally. Intravenous Reglan may be prescribed in severe cases lasting longer than 12 hours.

Since triptans only work for the acute phase of migraines, healthcare providers will often prescribe other medications to prevent migraines, such as beta-blockers, antidepressants, anticonvulsants, and CGRP inhibitors. These interventions may be effective for some people, though not all.

Tension Headaches

Triptans are not effective for treating tension headaches. If NSAIDs and Tylenol are not helpful, the tricyclic antidepressant Elavil (amitriptyline) may be prescribed. Elavil has analgesic effects and works by increasing the availability of serotonin and norepinephrine in the brain.

Cluster Headaches

Cluster headache episodes generally improve with triptans. Sumatriptan can be taken via a nasal spray or taken as a subcutaneous injection beneath the skin. Both methods are effective in stopping ongoing cluster headaches. Dihydroergotamine and intranasal oxygen can also be useful.

Cluster headaches can be difficult to prevent, but can sometimes be prevented by Verelan (verapamil), a calcium channel blocker that is usually used to treat high blood pressure. If Verelan is not effective, lithium or a short course of prednisone may be prescribed.

Other Prescription Options

Your healthcare providers may prescribe another medication for you if the first- and second-line options don’t provide you with relief. Picking the right option can take time, especially if the underlying cause of your headache is unknown.

Before surgery is considered, other specialist modalities would be explored, including physical therapy, botox, and psychotherapeutic approaches like cognitive behavioral therapy.

Physical Therapy

If your headaches are caused by muscle tension, physical therapy may be prescribed to treat and relieve your muscular issues. Treatment protocols vary, but most involve multiple treatments over the course of weeks or months, with adjustments made depending upon your improvement.

Massage therapy may also be beneficial for tension headaches. Many of these headaches are triggered by muscular tension, bony misalignment, postural patterns, temporomandibular joint (TMJ) disorders, ligament irritation, or other musculoskeletal imbalances. Massage, when used on an ongoing basis, may offer sustained headache relief.

Botox

Onabotulinumtoxin A, or Botox, was approved by the U.S. Food and Drug Administration in 2010 for the treatment of chronic migraines in adults. It works by blocking the transmission of pain signals near the site of injection.

The procedure typically involves a series of injections in the face and neck every 12 weeks. Injection site pain and reactive headaches are common side effects.

Cognitive Behavioral Therapy

Everyone has different responses to pain and different pain thresholds. In some cases, the reaction to headaches amplifies the perceived pain and diminishes tolerance levels and overall quality of life.

Cognitive-behavioral therapy (CBT) is a psychological approach that may benefit people who have unremitting tension headaches or migraines. CBT can help you manage the vicious cycle in which headaches trigger stress, anxiety, and depression, causing pain to increase.

CBT is administered by a certified psychologist on a one-on-one or group counseling basis. The aim of counseling is to increase your coping skills and teach relaxation techniques whenever headaches occur.

Surgery

Surgery is generally reserved only for the most severe, treatment-resistant migraine cases. One of the surgical approaches is a procedure called surgical decompression in which pressure points around the head are surgically released.

Surgical decompression, more accurately referred to as migraine trigger site deactivation, is performed on an outpatient basis by removing sections of muscle and tissues around peripheral nerves of the head, neck, or face. Doing so “re-routes” nerve signals away from the trigger points known to instigate migraine pain.

Success rates vary. In recent years, many dubious migraine centers have sprung up across the United States offering “cures” to desperate migraine sufferers. The cost of the procedure can be as high as $15,000 with no guarantee of relief.

Other surgical options include septoplasty (a surgical procedure that corrects a deviated septum) and turbinectomy (the removal of bone and soft tissue in the nasal passages) for people with severe rhinogenic headaches.

Complementary and Alternative Medicine (CAM)

Many people with unremitting headache pain will turn to complementary and alternative therapies when standard medical approaches fall short. The various modalities can broadly be described as mind-body therapies, musculoskeletal adjustment, homeopathy, and acupuncture.

Mind-Body Therapies

Mind-body therapies are based on the understanding that the mind can directly influence physical health. With respect to pain, mind-body therapies focus on relaxation techniques that can remedy the imbalances that lead to pain.

Many of these techniques are incorporated into standard medical practices as healthcare providers increasingly acknowledge the role that stress plays in illness, including headaches.

Among some of the more common mind-body therapies used for headaches are:

Meditation Aromatherapy Tai chi Yoga Pranayama (controlled breathing exercises) Guided imagery Biofeedback Progressive muscle relaxation (PMR)

Chiropractic Therapy

Chiropractic therapy is a discipline that is concerned with the treatment of mechanical disorders of the musculoskeletal system, especially the spine. Chiropractors have proposed that such disorders affect general health via the nervous system.

When used to treat headaches, chiropractors typically focus on spinal manipulation around the neck to relieve tension or compression caused by injury, poor posture, age, weight, or joint deterioration. Treatments are typically delivered on an ongoing basis until symptoms improve or on an as-needed basis for acute episodes.

In addition, the chiropractor may offer you advise on posture, ergonomics, exercise, and relaxation.

Homeopathy

Homeopathy is a medical system based on the belief that the body can cure itself. It is meant to treat a person as a whole rather than as a body of unrelated symptoms, often with the help of natural remedies. Many of these remedies have no proven benefit but are nevertheless widely embraced by many people with chronic pain.

Among the homeopathic remedies commonly suggested for headaches are:

Belladonna Bryonia Gelsemium Glonoinum Ignatia Iris versicolor Natrum muriaticum Nux vomica Sanguinaria (bloodroot) Sepia Silicea

Always speak with your healthcare provider before taking any such remedy to ensure that it poses no medication interaction or other concerns.

Acupuncture

Acupuncture is one of the most popular alternative therapies used to relieve pain. It involves the insertion of tiny needles into specific parts of the body to promote energy flow and pain relief. Despite assertions that acupuncture is quack medicine, the evidence supporting its use is promising.

According to a comprehensive review in the Cochrane Database of Systematic Reviews in 2016, acupuncture appears effective in reducing the frequency of episodic or chronic tension‐type headaches in adults.

The review, which involved 12 clinical trials and 2,349 adults, reported that 51% of the participants provided acupuncture had 50% fewer headaches compared to those provided a sham acupuncture procedure. The quality of the studies was considered moderate.

To date, there is little evidence that acupuncture can deliver the same results in people with cluster headaches or migraines given that the mechanisms for these conditions are different.

A Word From Verywell

To ensure the appropriate treatment of severe, chronic, or recurrent headaches, it is important that you see a healthcare provider rather than live with the pain. By getting an accurate diagnosis, you can treat your headaches more effectively, while minimizing the risk of complications and side effects.

Although it can take time to uncover the cause, try to remain patient and don’t dismiss your symptoms. If needed, seek a second opinion or ask for a referral to a neurologist or board-certified headache specialist in your area. Persistent headaches should never be considered normal.

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