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 foiling your frequent headaches is determining what type of headache you're battling. Sometimes headaches are a symptom of another disease or condition; sometimes there's no clear cause.

Take a close look at your headache signs and symptoms. Your doctor may suggest you keep a headache diary to help diagnose your headache type. Write down when your headaches occur, accompanying symptoms, and any potential triggers such as food, changes in sleep or stress.

Are the headaches dull and achy?

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

  • May be experienced as a tight band of pain around your head, a dull ache or pressure
  • May 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
  • Vary widely in frequency
    • Can be occasional
    • May occur more than 15 days a month (chronic)
  • Last from 30 minutes to a week

Treatment

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

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

Daily prescription medications, including tricyclic antidepressants, may manage tension-type headaches. Medications combined with behavior therapies may be more effective.

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

  • Meditation
  • Relaxation training
  • Cognitive behavioral therapy
  • Biofeedback
  • Massage and gentle neck stretches
  • Heat therapy (warm compress or shower)

Are the headaches throbbing and severe?

Migraines affect three times more women than men. Migraines may:

  • Cause pain that is moderate to severe and may pulsate
  • Cause nausea, vomiting, or increased sensitivity to light or sound
  • May affect only one side of your head or may affect both sides of your head
  • Worsen with daily activity
  • Last from four to 72 hours without treatment

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 may help prevent and lessen migraine pain. Treatment may 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)
  • Preventive medications, such as metoprolol tartrate (Metoprolol, Lopressor), propranolol (Propranolol HCL), amitriptyline, divalproex sodium (Depakote, Depakote ER, Depakote Sprinkle) or topiramate (Topamax)
  • Transcranial magnetic stimulation (therapy using electrical currents to stimulate nerve cells in the brain) for migraine with aura

Do you have headaches nearly every day?

Chronic tension-type headaches and chronic migraines are both types of chronic daily headaches, which are those that occur 15 days or more a month. Other common types of chronic daily headaches include hemicrania continua (a one-sided headache that may feel like a migraine) and new daily persistent headache (headaches that generally occur in people who do not ordinarily have headaches and occur daily).

These types of headaches are characterized by their frequency and duration. The symptoms and characteristics vary between chronic daily headache types and over time.

There are also several types of rare chronic daily headaches, including hypnic headaches, which generally occur after the age of 50 and can wake you from sleep, earning it the nickname the "alarm clock headache." Primary stabbing headaches (which last for a few seconds and may occur several times throughout the day), primary exertional headaches (from coughing or exercise) and chronic paroxysmal hemicranias (sharp, one-sided headaches that may cause tearing or nasal congestion) are also types of chronic daily headaches.

Treatment

Treating an underlying disease or condition often stops chronic daily headaches. If headaches aren't caused by another health problem, treatment focuses on preventive medication.

For chronic migraines, for example, tricyclic antidepressants (Amitriptyline) may help prevent future migraines.

July 28, 2015 See more In-depth