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Headache Health Article

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Treatment

Alternative remedies can lessen the frequency and severity of headaches. Common treatments include:

Acupressure. The stomach 3 and large intestine 4 points relieve sinus headaches.
Acupuncture. A National Institutes of Health (NIH) panel concluded that acupuncture may be a useful treatment for headache.
Aerobic exercise. Regular aerobic exercise reduces the frequency and intensity of headaches.
Aromatherapy. Massage using the essential oils of lavender, rosemary, or peppermint relieves headache.
Autogenic therapy. Headache may be relieved by learning to put oneself in a semi-hypnotic state.
Chiropractic. Cervical manipulation may relieve tension headaches.
Heat and/or cold. A hot shower or bath can ease tension headaches. Vascular headache may be relieved by placing an ice pack on the forehead, or the feet in hot water and a cold pack on the forehead (hydrotherapy treatment).
Herbals. Feverfew (Chrysanthemum parthenium) can be used for migraine; goldenseal (Hydrastis canadensis) for sinus headache; valerian (Valeriana officinalis), skullcap (Scutellaria lateriflora), or passionflower (Passiflora incarnata) for tension headache; and cayenne (in nostrils) for cluster headache. A German remedy made from butterbur root (Petasites hybridus) is now available in the United States under the brand name Petadolex. The herb, Brahmi (Bacopa monnieri), is used in Ayurvedic medicine to treat headaches related to anxiety.
Holistic medicine. Headaches may be caused by constipation and liver malfunction. Apple-spinach juice relieves constipation, and a blend of carrot, beet, celery, and parsley juices treats the liver.
Homeopathy. Remedies are chosen for each patient and may include Belladonna (throbbing headache), Bryonia (splitting headache), Kali bichromicum (sinus headache), and Nux vomica (tension headache with nausea and vomiting).
Massage. Firm massage of the forehead, neck, and scalp may relieve headache.
Osteopathy. Headache is treated with neuromuscular manipulation and massage of the head, neck, and upper back.
Pressure. A headband tied tightly around the head may relieve migraines in some patients.
Reflexology. Headache is treated using the solar plexus, ear, eye, and head points.
Relaxation techniques. Meditation, biofeedback, and yoga may relieve headache.
Supplements. Vitamins B₂ and B₁₂, niacin, and magnesium (a mineral) may help treat or prevent headache.
Transcutaneous electrical nerve stimulation (TENS). This effective headache treatment electrically stimulates nerves and blocks pain transmission.
Visualization. This relaxation technique controls the images in the mind, replacing negative thoughts and images with positive ones that enhance relaxation.

Medical

Tension headaches are usually relieved fairly rapidly by such over-the-counter analgesics as aspirin (300–600 mg every four hours), acetaminophen (650 mg every four hours), or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (brands include Advil or Motrin) or naproxen (brands such as Naprosyn or Aleve). For patients with chronic tension headaches, the doctor may prescribe a tricyclic antidepressant or benzodiazepine tranquilizer in addition to a pain reliever. A newer treatment for chronic tension headaches is botulinum toxin (Botox type A), which appears to work quite well for some patients.

Nonsteroidal anti-inflammatory drugs, including acetaminophen (e.g. Tylenol), ibuprofen, and naproxen are helpful for early or mild migraines. More severe attacks may be treated with dihydroergotamine; a group of drugs known as triptans; beta-blockers and calcium channel-blockers; antiseizure drugs; antidepressants (SSRIs); meperidine (Demerol); or metoclopramide (Reglan). Some of these medications are also available as nasal sprays, intramuscular injections, or rectal suppositories for patients with severe vomiting.

Sumatriptan (known as the brand Imitrex) or indomethacin (Indameth or Indocin) may be prescribed to suppress a cluster headache.

Surgical

Headaches that are caused by brain tumors, head trauma, dental problems, or disorders affecting the spinal discs usually require surgical treatment. In addition, some plastic surgeons have reported success in treating chronic migraine patients by removing some muscle tissue near the eyebrows, cutting a branch of the trigeminal nerve, and repositioning the soft tissue around the temples (sides of the head).

Psychotherapy

Psychotherapy may be helpful to patients with chronic headaches by interrupting the "feedback loop" between emotional upset and the physical symptoms of headaches.

Expected results

The prognosis for primary headaches varies. Episodic tension headaches usually resolve completely in less than a day without affecting the patient's overall health. The long-term outlook for patients with migraines depends on whether they have one or more of the other disorders associated with migraine. These disorders include Tourette's syndrome, epilepsy, ischemic stroke, hereditary essential tremor, depression, anxiety, and others. For example, migraine with aura increases a person's risk of ischemic stroke by a factor of six.

The prognosis for secondary headaches depends on the seriousness and severity of the cause.

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