In most people, headaches can be greatly controlled with a combination of lifestyle changes, headache medications and complementary therapies. These treatment plans vary from patient to patient. Patients are encouraged to schedule an appointment with a physician specifically to discuss their headaches, rather than trying to discuss them during an office visit scheduled for another reason.

A number of prescription and over-the-counter medications are used to treat headaches. The type of medication prescribed will usually depend on the characteristics of the headache, including its frequency and severity. A patient’s response to different medications, side effects and the patient's overall health are also taken into consideration.  

Drug therapy for headaches may include:

• Acute treatment. Also known as abortive treatment, acute treatment is aimed at stopping or reducing the pain of an existing headache. For maximum effectiveness, this type of treatment should be used at the first sign of a headache. Examples of medications used in acute treatment include:
  
  
• • Analgesics
  • Triptans
  • Dihydroergotamine
  • Decongestants (for sinus headaches)
    
    
  Oxygen administered through a breathing mask can also be used as a form of acute treatment.
  
  
• Preventive treatment. This type of treatment requires the daily use of medication to reduce the frequency and severity of headaches. Examples of medications used in preventive treatment include:
  
  
• • Beta blockers. These drugs decrease the workload of the heart and lower blood pressure.
    
    
  • Calcium channel blockers. These drugs increase the flow of oxygen–rich blood to the heart, lower blood pressure and reduce the workload of the heart.
    
    
  • Tricyclic antidepressants. These drugs are commonly used to treat depression. Antidepressants, however, may increase the risk of suicidal thinking and behavior in children and adolescents. As a result, the U.S. Food and Drug Administration (FDA) recommends that people being treated with these drugs be closely monitored for unusual changes in behavior.
     
  • Corticosteroids. These drugs are commonly used to relieve inflammation.
    
    
  • Lithium. A drug commonly used to treat bipolar disorder.
    
    
  • Ergot alkaloids. This group of drugs is used to treat a variety of conditions including headache.
    
    
  • Antihistamines. These drugs are commonly used to treat allergic reactions.
    
    
  • Indomethacin. This NSAID is commonly prescribed to relieve pain, tenderness, inflammation and stiffness.

Patients taking medications for headache should follow their physician’s dosing instructions carefully. Overuse of over-the-counter or prescription headache medication can cause analgesic rebound headaches and chronic headaches.  

Medications used to treat headaches have variable effectiveness in different people. In many cases, a number of medications may be tried before an effective drug, or combination of drugs, is found.

Patients should contact their physician when medications are not effective in relieving pain or when undesirable side effects develop. Physicians may choose to change the type of medication being used.

A number of other therapies may be used in conjunction with medication. These include:

• Cryotherapy (cold treatments)
• Relaxation techniques (e.g., meditation, progressive muscle relaxation, self-hypnosis)
• Physical therapy
• Cognitive behavioral therapy
• Biofeedback
• TENS or other electrical therapy
• Acupressure or acupuncture
• Nerve block (see Injection Therapy)

If other treatments fail, surgery may be an option in some cases, such as surgery on the sinuses for people suffering sinus headaches or migraines.

Recent research indicates that some populations may be undertreated for headaches, including men and adolescents. Anyone suffering from headaches is advised to take the initiative in seeking help.

Patients may reduce the frequency of headaches by avoiding factors that trigger the headaches. Patients may identify these triggers by keeping a headache diary. To compile this journal, patients record certain information after each headache occurs, including:

• When the headache occurred
• How severe the headache was
• Where the headache was located
• How long the headache lasts
• Additional symptoms experienced with the headache
• What was eaten before the headache occurred
• Sleep patterns and amount of sleep
• Menstrual cycles
• Medications taken prior to and after the headache
• Events prior to the headache (e.g., consumption of alcohol)

Some triggers, such as the hormone changes caused by menstruation or pregnancy, cannot be avoided. When medications are identified as the trigger, however, physicians are often able to find treatment alternatives.

Patients may also be able to reduce the frequency of headaches by making a few lifestyle changes, including:

• Avoiding cigarette smoking, caffeine and alcohol
• Exercising regularly
• Maintaining a nutritious diet
• Getting enough sleep and keeping a regular sleep pattern
• Practicing proper posture and ergonomics
• Using relaxation techniques such as progressive muscle relaxation or meditation