Commonly Discussed Topics in the Treatment of Headache
This is the template for my little speech I give at the end of nearly every office visit for headache. Follow the links for more information.
Lifestyle
Limit Caffeine
No more than one or two caffeinated beverages per week is the recommendation for patients with frequent headaches. More use than this could cause more frequent headaches.
Stop Smoking
Smokers have twice the number of headaches than non-smokers.
Changing Your Diet
For a few people just being aware of a few common headache trigger foods is sufficient to reduce the number of headaches they suffer. For others it takes a rather dramatic diet change to see substantial benefit. In this case, two types of diet can be suggested: a low fat vegetarian diet and an elimination diet. Try the vegetarian diet first and if that doesn’t work then try the elimination diet. Start with Diet and Headache: The Short Response and then Diet and Headache: In Detail
Aerobic Exercise
Regular aerobic exercise, even just a brisk walk 30-60 minutes per day is enough to cut down on the frequency of headaches
Start a Meditation or Yoga Practice
There is good evidence these will help reduce the frequency of your headaches
Fixing your sleep without resorting to sleeping pills is key to reducing the frequency of headaches. Read up on Sleep Hygiene to see how you can improve your sleep.
Medications
Limit Acute Headache Medication Use
Try to use headache medication only once or twice per week to avoid rebound headaches
In many people, taking headache or other pain medication more than twice per week can lead to the development of more frequent headaches. These are called rebound or withdrawal headaches. If you are already in rebound headache, or think you may be, look at my web pages on rebound headache. Rebound Headache and How to Get out of Rebound
Don’t Use Medications with Narcotics or Barbiturates.
These medications should almost never be used in the treatment of headaches. They will lower your pain threshold and make it more likely for headaches to develop.
Limit Caffeine Containing Medications
No more than once per week, these medications can easily cause rebound or withdrawal headaches.
Take a Prescription Preventative Medication
If you have more than 7 headaches per month, you could consider a preventative medication. If taken daily for a couple of months, approximately 50% of the people taking them will have 50% less headaches. Unfortunately, they don’t work for everyone.
Take a Nutritional Supplement as a Preventative Medication
If you aren’t interested in prescription medications, but still have too many headaches, these supplements may cut down on the number of headaches you have.
Some headache specialists say it’s essential to keep track of your headaches in order to gauge the success of treatment appropriately. Keep a calendar to make sure you are getting the benefit you want.
Try a Triptan for Faster Control
If your headaches are less than twice per week, consider using a Triptan which is a novel class of medications created just for migraines. This type of medication is used at the onset of a headache, and may have a better chance of stopping a headache than medications like Ibuprofen. Careful though, using it more than twice a week can lead to the development of rebound headaches. Note that these medications are not appropriate for people who are at risk of having severe cardiovascular disease or during pregnancy.
Other Treatments
Give Acupuncture or Chiropractic a Try
These may be as effective as some preventative medications in reducing the frequency of headaches
A Velcro Band put around the head may work as well as Ibuprofen to abort a headache.
This may work just as well as Ibuprofen.
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