Headaches: Treatment depends on your diagnosis and symptoms

Do you take aspirin or acetaminophen for all your headaches? For some types of headaches, that's not the best approach. Here's why.

By Mayo Clinic Staff

Your head hurts. Again! The first step in thwarting your recurring headaches is to determine what type you have. Sometimes headaches are a symptom of another disease or condition. In other cases, no clear cause can be found.

To better understand your headaches, take a close look at your signs and symptoms. To aid in diagnosis, your doctor may suggest you keep a headache diary in which you note when your headaches occur, what your signs and symptoms are and any triggers you can identify.

Are the headaches dull and achy?

Tension-type headaches, the most common variety of headaches:

  • Often feel like a tight band around your head
  • Usually cause mild to moderate pain on both sides of the head
  • May be triggered by stress, neck strain, missed meals, depression, anxiety or lack of sleep
  • May occur occasionally or more than 15 days a month (chronic)
  • Can last from 30 minutes to an entire week

Most intermittent tension-type headaches are easily treated with over-the-counter medications, including:

  • Aspirin
  • Ibuprofen (Advil, Motrin IB, others)
  • Acetaminophen (Tylenol, others)

In addition, alternative therapies aimed at stress reduction may help. They include:

  • Meditation
  • Relaxation training
  • Cognitive behavioral therapy
  • Biofeedback
  • Massage

Are the headaches throbbing and severe?

Migraines affect three times more women than men. Migraines:

  • Often are accompanied by nausea, vomiting, or increased sensitivity to light or sound
  • May affect only one side of your head
  • May include pain that worsens with routine activity
  • Untreated, typically last from four to 72 hours

Migraine treatment is aimed at relieving symptoms and preventing additional attacks. If you know what triggers your migraines, avoiding those triggers will help prevent headaches. Treatment may include:

  • Over-the-counter medications
  • Prescription medications
  • Rest in a quiet, dark room
  • Hot or cold compresses to your head or neck
  • Massage and small amounts of caffeine

Do the headaches recur for weeks at a time?

Cluster headaches, which are rare, occur off and on for weeks at a time. At least one episode usually occurs at the same time of day or night. During a cluster period, which can last for several months, you may experience one or more cluster headaches a day. These headaches, which occur more often in men than in women and more often in smokers:

  • Typically begin quickly without warning and reach maximum intensity within minutes
  • Usually affect just one side of your head
  • May be accompanied by tearing or redness of the eye or a droopy eyelid on the affected side of the head and a runny or stuffy nose
  • Typically last from 15 minutes to three hours
  • May cause a sense of agitation

Because the pain of a cluster headache strikes suddenly and may subside quickly, over-the-counter pain relievers aren't effective. Steps that may help include:

  • Preventive medications
  • Injectable medications, such as sumatriptan (Imitrex, Sumavel Dosepro, others), for quick relief during an attack
  • Prescription triptan nasal sprays, such as zolmitriptan (Zomig) or sumatriptan (Imitrex)
  • Inhalation of 100 percent oxygen through a mask
  • Pacing, rocking or head rubbing because most people feel restless during a cluster headache

Do you have headaches nearly every day?

Chronic daily headaches are headaches that occur 15 days or more a month. The term encompasses different types of headaches that are characterized by their frequency and duration. The signs, symptoms and time frame vary depending on the type of headaches you have, and the pattern of signs and symptoms may change over time. An accurate description of your headache symptoms will help your doctor diagnose your condition and determine the best course of treatment.

Treatment for any underlying diseases or conditions often stops chronic daily headaches. When no underlying diseases or conditions are present, treatment focuses on preventive medication.

Aug. 17, 2012 See more In-depth