Treatment of Headache – No Absolute Cure

While there is still no absolute cure for headache, there are a number of treatment options, both medications and other forms including complementary therapies. ALWAYS CONSULT YOUR MEDICAL PRACTITIONER before taking any form of treatment. (Please note-advances in medical science occur rapidly and some of this information about medications and treatment may soon be out of date).
To get more research, headache sufferers will have to unite with Headache Australia to lift the funding.

HEADACHE MANAGEMENT IS A GREAT CHALLENGE. A NUMBER OF TREATMENT OPTIONS, PREPARATIONS AND METHODS OF ADMINISTRATION MAY HAVE TO BE TRIED BEFORE YOU DISCOVER WHAT WORKS BEST FOR YOU.

Medications

Some medications are given once the headache has begun (acute treatment) and others are taken daily to reduce the frequency of attacks (prophylactic treatment).

Acute Treatment

Over-the-counter medications taken to treat headache include

  • pain killers or analgesics such as aspirin and paracetamol (eg Panadol)
  • pain killers or analgesics combined with codeine (eg Panadeine)
  • pain killers or analgesics combined with a sedative (eg Mersyndol, Fiorinal)
    non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (eg Nurofen).

These products are effective and safe when taken according to the directions. Always check with your doctor or pharmacist, as some products are not recommended with certain health conditions or for children. Mild tension-type headaches usually respond readily. For severe headaches that do not respond, if medication is required several times a week, or for problems in taking medication, a doctor should be consulted.
Prescription medications taken to treat more severe headaches include

  • Stronger NSAIDs
  • Analgesics containing stronger narcotic-type analgesics
  • Ergots such as ergotamine (eg Cafergot) that have a specific action against migraine
  • Triptans such as sumatriptan (eg Imigran), naratriptan (eg Naramig), zolmitriptan (eg Zomig) that have a specific action against migraine
  •  Anti-nausea drugs such as metoclopramide (Maxolon), prochlorperazine (Stemetil) and domperidone (Motilium).

Prophylactic ( Preventative ) Treatment

Prophylactic/preventative medication is taken daily, regardless or whether a headache is present, to reduce the incidence of severe or frequent headaches. These include:

  • Pizotifen (Sandomigran), probably the most commonly prescribed
  • Beta Blockers (Betaloc, Lopresor, Inderal, Deralin) block the beta-receptors on which adrenaline works in the nervous system as well as on blood vessels
  • If the above are not working for you, or as a first option, topiramate (Topamax) and valproate (Epilim) are neuro-modulators that have been shown to act against most forms of headache.
  • Amitriptyline and similar tricyclic antidepressants (Tryptanol and other brands) have an action on headache that is independent of their antidepressant action.
  • Methysergide (Deseril)
  • Feverfew, an herbal extract, shown to be effective in migraine prevention.

All are effective. All have side effects and, except feverfew, are prescription drugs. Many were initially introduced for some other problem and were also observed to reduce headache.

Medication Overuse

Overusing medication can actually lead to chronic daily headache. Medications containing ergotamine, codeine and caffeine have been specifically implicated but frequent use of any of the medications used to treat an attack can lead to daily headache. Your doctor will be able to help you find out what type of medication is best suited and safest for your needs. It is important that your doctor is consulted should you wish to reduce or discontinue any medications.

OtherTherapies

There are a number of options available. Most are concentrated on releasing tension in the body, thus easing pressure in the head. Not all these options will work or be available to everyone. This is just a brief run-down – a qualified practitioner should be consulted before trying any of these therapies:

Acupuncture Stimulating acupoints may ease pain by encouraging production of endorphins (natural painkillers).
Alexander technique Can help prevent tension headaches by relieving poor posture and pressure that results from it.
Aromatherapy Combines various scented oils and promotes relaxation and eases tension.
Biofeedback Can be used to treat tension-type and migraine headaches – patient learns to control blood pressure, heart rate, and spasms in the arteries supplying the brain through a sensory device.
Chiropractic Therapy Based on the theory that most diseases of the body are a result of a misalignment of the vertebral column with pressure on the adjacent nerves that may affect blood vessel and muscle function. Manual techniques purport to adjust the misalignment.
Homeopathy Uses active substances found in certain medications highly diluted.
Hydrotherapy Splashing your face with cold water before lying down for an hour can ease headache. Alternating hot and cold showers dilates then constricts the blood vessels, stimulating circulation. Ice pack on head is another option. Can help sufferer deal with headache by altering the way the body interprets messages of pain.
Massage Can reduce muscle tension throughout the body, thereby reducing headache.
Meditation A recent study on migraine prevention through meditation has had very promising results, all participants reported less severe migraines.
Naturopathy Uses only natural substances in small amounts and aims to provide a healthier balance of bodily processes.
Osteopathy Manipulation of the neck or cranial, osteopathy may be used to correct misalignments of the vertebrae that can cause migraines.
Physiotherapy Treating muscle tension can release pressure that may lead to headache.
Relaxation Techniques Geared towards reducing pressure in the body and the level of stress chemicals that may worsen headache.
Shiatsu Combination of massage and pressure can restore the “energy balance” and induce relaxation.
Yoga Can relieve muscle tension in the back of the neck and correct posture.

References

  • Migraine and Other Headaches 2000 Professor James Lance
  • Wolff’s Headache and Other Head Pain 7th ed Silberstein, Lipton & Dalessio
  • The Complete Guide: Integrated Medicine 2000 David Peters & Anne Woodham
  • Conquering Headache 1995 Alan Rapoport & Fred Sheftell