What can you do if a headache won’t go away? Discover the underlying causes behind lingering headaches, from migraines to concussions, and learn effective ways to find relief.

Recognizing Concerning Headache Symptoms

While headaches are a common occurrence, a persistent headache that lasts for days can be a sign of a more serious underlying condition. It’s important to seek medical attention if you experience:

• A severe headache that began abruptly (within a few seconds)
• A migraine that has lasted several days or even weeks
• Any new symptoms along with the headache, such as disorientation, vision changes, fatigue, or fever
• Headache associated with kidney, heart, or liver disease
• Severe or ongoing headache during pregnancy, which could indicate complications like preeclampsia
• Headache associated with HIV or another immune system disorder
• Headache accompanied by fever and a stiff neck

Common Causes of Persistent Headaches

There are several conditions that can lead to a headache that lasts for more than a day, including:

Rebound Headaches

Regularly taking over-the-counter (OTC) pain medication for headaches can actually cause your head to hurt between doses. This type of headache often doesn’t last long, but it can recur throughout the day.

Migraines

Migraines are a severe type of headache that can last for days or even weeks. They are often accompanied by symptoms like throbbing pain, nausea, vomiting, and sensitivity to light, sound, and odors.

Stress or Mood Disorders

Anxiety, stress, and mood disorders can trigger headaches that persist for more than a day. People with panic disorder or generalized anxiety disorder tend to experience prolonged headaches more often.

Cervicogenic Headaches

These headaches originate from the neck, often due to injuries, arthritis, bone fractures, tumors, or infection. Poor posture or sleeping in an awkward position can also cause cervicogenic headaches.

Concussions and Head Injuries

After a concussion or similar head injury, you may experience post-concussion syndrome, which can cause recurrent or ongoing headaches, as well as other symptoms like fatigue, dizziness, and difficulty concentrating.

Treating Persistent Headaches

There are various treatment options, both at home and with medical care, that can help alleviate the symptoms of a prolonged headache:

Home Remedies for Rebound Headaches

If you’re experiencing rebound headaches from overusing OTC pain medications, you can try reducing the amount of medication you take. It’s generally recommended to not take pain medication for more than 15 days out of every month, and to avoid prescription pain medications for more than 10 days out of every month.

Migraine Management

For migraines, your doctor may prescribe preventive medications or abortive treatments to help stop the headache once it starts. Lifestyle changes, such as managing stress, getting enough sleep, and avoiding migraine triggers, can also be helpful.

Treating Cervicogenic Headaches

Addressing the underlying issue in the neck, such as through physical therapy, chiropractic care, or medication, can help relieve cervicogenic headaches. Improving posture and using proper neck support can also be beneficial.

Recovering from Concussions

For post-concussion syndrome, treatment may involve a combination of rest, medication, and rehabilitation therapy to address the various symptoms, including persistent headaches.

Coping with Persistent Headaches

Living with a persistent headache can be challenging, but there are strategies you can use to manage the discomfort and improve your quality of life:

Stress Management

Incorporating stress-reducing techniques, such as meditation, deep breathing, or yoga, can help alleviate the impact of stress-related headaches.

Lifestyle Adjustments

Maintaining a healthy sleep schedule, staying hydrated, and avoiding potential headache triggers (like certain foods or environmental factors) can all contribute to managing persistent headaches.

Seeking Support

Don’t hesitate to reach out to your healthcare provider, support groups, or loved ones for help in coping with the emotional and physical toll of a persistent headache.

Preventing Recurring Headaches

While some headache causes may be out of your control, there are steps you can take to reduce the frequency and severity of persistent headaches:

Identifying and Addressing Triggers

Keep a headache diary to help pinpoint and avoid potential triggers, such as certain foods, stress, or hormonal changes.

Developing Healthy Habits

Practicing good sleep hygiene, staying hydrated, and engaging in regular exercise can all contribute to preventing recurring headaches.

Seeking Professional Help

If home remedies and lifestyle changes don’t provide relief, don’t hesitate to consult with your healthcare provider. They can help identify the underlying cause and develop a comprehensive treatment plan.

Dealing with a persistent headache can be a frustrating and debilitating experience, but understanding the potential causes and exploring effective treatment options can help you find the relief you need.

What to Do If a Headache Won’t Go Away

A long lasting headache that persists for days can be a symptom of a neurological condition, such as migraine, a headache disorder, or an injury. You may need medical care, especially if you have other symptoms.

Everyone experiences a headache from time to time. It’s even possible to have a headache that lasts for more than one day. There are many reasons why a headache can last a while, from hormonal changes to more serious underlying conditions.

While it can be alarming for a headache to last a long time — so long that you may not be able to sleep it off — most headaches aren’t life threatening. But it’s no fun when a lingering headache affects your ability to do the things you enjoy.

Let’s take a look at what can cause these headaches and how you can get relief.

If you’ve been experiencing the same headache for more than one day, it’s possible that you could have a more serious underlying condition that requires emergency medical care. Seek medical attention right away if you’re experiencing:

• a severe headache that began abruptly (within a few seconds)
• a migraine that has lasted several days, or even weeks
• any new symptoms you haven’t previously experienced along with the headache (disorientation, loss of vision or vision changes, fatigue, or fever)
• kidney, heart, or liver disease with a headache
• a severe or ongoing headache in pregnancy, which could indicate complications like preeclampsia
• HIV or another immune system disorder along with a headache
• headache associated with fever and stiff neck

There are multiple conditions that can cause a persistent headache that lasts for more than a day. Some of those include:

Rebound headaches

Regularly taking over-the-counter (OTC) pain medication for your headaches can actually cause your head to hurt between doses. While this type of headache often doesn’t hang around, it can recur over the course of a day or more.

Migraine

Migraine can be a severe type of headache that can last for days, or even weeks, at a time. They start with a feeling of general illness that takes hold one or two days before the headache begins. Some people experience aura, or bright, flashing vision changes before the pain begins.

Then, there’s the headache itself, with symptoms that may include:

• throbbing pain on either side (or both sides) of your head
• pain behind your eyes
• nausea
• vomiting
• light and sound sensitivity
• sensitivity to odors and fragrances

After your migraine lifts, you may experience a hangover-like feeling of fatigue and exhaustion.

Headaches related to stress or mood disorders

Anxiety, stress, and mood disorders can trigger headaches that linger for more than a day. Specifically, those with panic disorder or generalized anxiety disorder tend to experience prolonged headaches more often than those without.

Cervicogenic headaches

Sometimes your headaches actually aren’t coming from your head at all. They’re coming from your neck.

In cervicogenic headaches, pain is referred to your head from an area in your neck. You may not even realize where it’s originating from. And if the underlying cause — the problem in your neck — isn’t treated, your headache won’t go away.

Cervicogenic headaches can be caused by injuries, arthritis, bone fractures, tumors, or infection. Your posture or falling asleep in an awkward position could cause a cervicogenic headache. It’s also possible that disc-related wear can also cause these types of headaches.

Concussions and other head injuries

If you’ve recently experienced a concussion or similar head injury, you could be dealing with an ongoing headache. This is called post-concussion syndrome, and it’s a mild injury to your brain caused by the initial trauma. It can last for months after a concussion — possibly up to a year.

Symptoms of post-concussion syndrome include:

• recurrent or ongoing headaches
• fatigue
• dizziness
• periods of irritability
• difficulty concentrating
• short-term memory issues
• anxious feelings
• ringing sensation in your ears
• difficulty sleeping
• sensitivity to sound and light
• blurred vision
• sensory disturbances like a lessened sense of smell and taste

A variety of treatment options, including home treatments and medical care, can help relieve symptoms of a prolonged headache.

Rebound headaches

Overusing OTC pain medications can actually cause headaches. These headaches are known as rebound or medication overuse headaches.

If you’re experiencing ongoing rebound headaches, you can start addressing your symptoms at home by reducing the amount of OTC medications you take.

You shouldn’t take medicine for pain for more than 15 days out of every month, and prescription pain medications shouldn’t be used for more than 10 days out of every month.

Your doctor or pharmacist can guide you regarding medication ingredients and potential side effects.

If you continue to experience chronic headache pain, your doctor may be able to help. Make an appointment to speak with them about preventative medicines.

Ask your healthcare professional for alternative treatment options for headaches and migraine, like antidepressants for headaches caused by chronic tension.

Waiting until your headache starts could keep you in a cycle of OTC treatment, so prevention is key.

Migraine

To address your migraine symptoms at home consider building a predictable schedule that minimizes stress and keeps you in a routine. Focus on adhering to regular mealtimes and a solid sleep schedule.

Exercise can help prevent migraine attacks, but be sure to warm up slowly before diving right in, as too much strenuous exercise can cause a headache.

Prescriptions containing estrogen, like the birth control pill, could also contribute to your migraine. You might need to speak with your doctor about stopping or changing those medications.

Your doctor may prescribe medications specifically for migraine that can prevent the headaches from occurring. They may also prescribe pain medications that are stronger than OTC options to stop your symptoms once they’ve begun.

Anti-nausea medication or corticosteroid treatments are sometimes prescribed by physicians for migraine symptoms as well.

Headaches related to stress or mood disorders

Work to reduce stress and promote relaxation in your environment. Self-massage or massage therapy may help ease the tension that causes ongoing headaches. You may also benefit from reducing stimuli and resting in a dark, quiet room.

Your doctor can help you address your stress, anxiety, or mood disorder through a combination of cognitive behavioral therapy and medication.

Your doctor may prescribe antidepressants or anti-anxiety medications that can help relieve the tension and stress causing your prolonged headaches. Some medications for anxiety also work to reduce the number or intensity of headaches.

Cervicogenic headaches

Because cervicogenic headaches can be caused by injuries or issues in the neck, the underlying cause must be addressed to relieve your headache. Your doctor will examine you to rule out other types of headaches arising from other sources, like tension headaches.

Once the cause of pain is identified, your doctor may prescribe pain medication or nerve blocks to manage pain. They may also recommend physical therapy or a therapeutic exercise routine for pain management.

Concussions and other head injuries

While post-concussion syndrome does not have a specific treatment regimen, your doctor will work with you to address your specific symptoms. You can also take comfort measures at home to reduce your pain, like resting and limiting stimuli when you’re hurting.

Your doctor might advise you to take OTC medication for mild pain, or they may prescribe stronger pain management medication for headaches.

However, remember that overuse of pain medication can contribute to rebound headaches. So discuss with your doctor if you feel you’re taking too much.

Unexplained or general headaches

For unexplained, ongoing headaches, you may be able to manage or ease your symptoms at home through comfort measures, rest, and responsible use of medication.

Massage therapy can ease muscle tension that contributes to headaches, or you can perform self-massage techniques at home.

Managing your stress can help reduce your pain. Also, consider reducing the intensity of your exercise schedule or focusing on your form while exercising.

If your headache continues to persist, see your doctor. You may have an underlying condition that they can diagnose. With proper treatment, you’ll be able to address your persistent headache pain and return to your normal quality of life.

You may be able to prevent persistent headaches before they begin by taking a few steps every day. These include:

• drinking plenty of water to avoid dehydration
• exercising regularly
• avoiding environmental triggers
• getting needed support for your mental health
• seeking hormonal support, particularly if you’re premenopausal or experiencing menopause
• reducing stress

Headaches that won’t go away are alarming, but they usually aren’t serious. It’s important to discuss your symptoms with your doctor.

With the appropriate diagnosis and the right approach to treatment, you can get relief from your persistent headache and return to your usual quality of life.

What type of headache do you have?

Headaches are familiar to nearly everyone: in any given year, almost 90% of men and 95% of women have at least one. In the vast majority of cases, however, the pain isn’t an omen of some terrible disease. The three most common types of headaches are tension, sinus, and migraine. The most common headache triggers are stress, fatigue, lack of sleep, hunger, and caffeine withdrawal.

Mixed headaches

As understanding of the different types of headaches has evolved, researchers have altered some of their beliefs about migraine and tension headaches and the relationship between the two. This is largely because of the realization that some headaches don’t neatly fit either category. “Mixed” headaches have characteristics of both types, and because they’re hard to classify, treatment can be challenging.

For instance, the more intense a tension headache gets, the more it resembles the sharp, throbbing pain of a migraine headache. Likewise, when a migraine headache becomes more frequent, its pain begins to feel like that of a tension headache. Symptoms of headaches fall along a continuum ordered by their characteristics: the occasional tension headache is at one end and the classic migraine headache is at the other. In between are chronic daily headaches, which can start with features typical of either tension or migraine headache.

Headache caused by a medication or illness

Some headaches are actually symptoms of another health problem. Many non-life-threatening medical conditions, such as a head cold, the flu, or a sinus infection, can cause headache. Some less common but serious causes include bleeding, infection, or a tumor. A headache can also be the only warning signal of high blood pressure (hypertension). In addition, certain medications, such as nitroglycerin and female hormones (prescribed for a contraception or menopausal symptoms) are notorious causes of headache.

Because the following symptoms could indicate a significant medical problem, seek medical care promptly if you experience:

• a sudden headache that feels like a blow to the head (with or without a stiff neck)
• headache with fever
• convulsions
• persistent headache following a blow to the head
• confusion or loss of consciousness
• headache along with pain in the eye or ear
• relentless headache when you were previously headache-free
• headache that interferes with routine activities.

Always take children who have recurring headaches to the doctor, especially when the pain occurs at night or is present when the child wakes in the morning.

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Headache – causes, symptoms and diagnosis, indications for visiting a doctor

Perhaps there is no such person in the world who has not had a headache at least once in his life, and about 20% of people suffer from chronic pain. Mentions of this problem are found in ancient manuscripts – the works of doctors and literary works of ancient Egyptian, Greek, Babylonian, Chinese authors. Even then, doctors were trying to find patterns in which pain in the head occurs, and treatment options. In ancient Egypt, there were even special priests who dealt only with the problem of headaches. A panacea has not been found so far, but modern medicine has made significant progress. Now there are effective methods of assistance, and high-precision diagnostic equipment will help to understand the causes of the problem.

Sometimes a completely healthy person can have a headache, and in some cases a headache can be the only practical symptom of some dangerous diseases. Why does pain arise, how to help yourself at home, when you need a doctor’s help, and when there is nothing to worry about – we will consider these issues in more detail with the doctors of the Kutuzovsky Medical Center.

Types and causes of headaches

We feel a headache in those areas where there are pain receptors. It can be different in strength, duration, accompanying symptoms and character. The manifestations and symptoms of a headache are different: someone has a headache in the temples, others complain of frequent headaches in the forehead. Consider the main options.

Migraines

This is an intense headache in the temples on one side of the head, mostly of a throbbing character. The patient exacerbated and painfully reacts to bright light, loud sounds, smells. The attack lasts from several hours to three days, may be accompanied by nausea (in 90% of cases) and vomiting (in 30% of cases). Unpleasant sensations are aggravated by physical exertion, especially sharp ones. Often the whole right side of the head (or left) hurts, and not just the temple.

Migraine is a primary headache, that is, it is not a symptom of any other disease. The cause of migraine is the appearance of inflammatory substances around the nerves and vessels of the head, which provoke pain. Why such a mechanism is activated is not known for certain. An attack can be provoked by mental or physical overstrain, stress, changes in weather, diet, hormonal drugs.

Migraines can be hereditary, women are twice as likely to suffer from them. Several genes have been identified that are responsible for migraines.

Seizures recur periodically throughout life – from several times a week to several times a year. Migraines begin during puberty (less often in childhood).

15-60 minutes before a migraine attack, some people may notice the appearance of a migraine precursor – an aura. This is a neurological phenomenon in which short-term visual disturbances appear (flickering, fogging, narrowing of the field of vision), dizziness, sensory symptoms – tingling, loss of sensation in the hands, nasolabial folds. After an attack for a day or more, the patient may experience general weakness, a weaker headache in the temples than during the acute phase, a state of “hangover”, confusion of thoughts.

Tension pains

This is a pain that “compresses” the head. She is often described as having a tight helmet over her head. There is a headache in the temples, the back of the head, on the forehead, the crown of the head – unpleasant sensations can be, both throughout the head, and in some part. This is the most common type of headache. Feelings are usually moderate, there is no acute pain (as with migraines).

Among the causes that cause this pain are muscle tension due to the same type of work, mental and visual stress, uncomfortable postures, stress, weather changes, non-compliance with the regime of work and rest. An attack can last up to several days. Tension pain is more common in people prone to deep emotional experiences, depression, stress.

Cluster headaches

Most intense pain with severe attacks. They last from 20 minutes to one hour with several attacks per day. In some cases, they may occur daily for a long time (up to several weeks).

During an attack, the head hurts in the forehead or eyes, lacrimation, swelling in the nose, drooping of the eyelids may begin. Middle-aged men are six times more likely to suffer from cluster pain, and about 0.5% of people are familiar with the problem.

These are the main three types of primary headache. Less common, but may be pain from physical or sexual activity, medication.

There is also a secondary headache – it is a symptom of some disease. These include pain associated with:

• Traumatic brain injury. Their other symptoms: dizziness, irritability, memory impairment.
• Injuries or diseases of the cervical spine (osteochondrosis and others). With them, the head hurts in the back of the head, visual acuity and hearing may decrease.
• Pathologies of cerebral vessels – stratification of the walls, atherosclerosis, aneurysms, strokes and other vascular changes.
• Arterial hypertension – high or low blood pressure. With hypertension, the back of the head hurts, with hypotension, there is weakness, and the head is spinning.
• Infections – encephalitis, meningitis, and other infectious lesions.
• Tumors in the head or neck.
• Diseases and injuries of the ears, sinuses, jaws and teeth, eyes and other structures of the skull. Where and how it will hurt depends on the root cause. So, with glaucoma, a headache is a pain in the eyes that radiates to the forehead.
• Mental illness.
• Excessive use of painkillers, including for headaches.

Diagnosis and treatment

Why does my head hurt and what should I do? The answer to this question will help to give modern diagnostic techniques. This does not mean that the doctor can conclusively find the only “culprit” – the root cause. Especially when it comes to primary headaches (migraine, tension and cluster pain). The physiological processes of their occurrence are not fully understood, although medicine knows a number of factors that provoke an attack.

The main task is to determine the type of headache: primary or secondary. The first – although they deliver a lot of discomfort to the patient, interfere with the ability to work, but are not dangerous to health. The pain will go away on its own or after taking medication.

Management of primary headaches:

• Relief of an attack with pain medications: analgesics or other drugs.
• Prophylaxis with drugs that reduce the frequency or intensity of seizures.
• Avoidance of precipitating factors – overwork, certain foods, periodic breaks in work, sufficient sleep and others.

The situation is different with secondary headaches. To help the patient, you need to determine the symptom of what disease is the headache. And treat him. This is especially important for serious pathologies that threaten life or health. Stroke, meningitis, brain tumors – these and other diseases are manifested by headaches.

Help in finding the cause:

• Examination by a neurologist, competent collection of complaints and anamnesis. This is the most important thing in diagnosing headaches.
• Laboratory diagnostics – determination of the main indicators of the body’s work: the level of cholesterol, glucose, leukocytes and other parameters.
• Instrumental diagnostics: MRI of the brain, vessels, neck, dopplerography or duplex examination of the vessels of the brain and neck, radiography.
• Examinations – electroencephalogram, examination by an ophthalmologist, measurement of blood pressure and others.

The main doctor who treats headaches is a neurologist. When it comes to secondary headaches, an ENT doctor, an ophthalmologist, a therapist, and some other specialized specialists may be needed.

Medical center “Kutuzovsky” – a medical center where they will help to deal with the causes of headaches and the right treatment.

It is beneficial to contact us for many reasons:

• The clinic has all the doctors of all necessary specialties who will work together to solve the problem.
• We have high-precision diagnostic equipment – you do all tests and examinations in the center, in a short time.
• Our prices are affordable, there is a bonus program, you can get treatment under VHI.

Our center has developed several comprehensive diagnostic programs, among which is the Headache Diagnosis. This is an opportunity to undergo a comprehensive examination for those who value time and money. Examinations and consultations will take only a few hours, and the cost of services included in the program, individually, is higher than the cost of complex diagnostics.

The headache is excruciating and can be dangerous. It prevents us from leading our usual way of life, productive work and rest. No need to endure, wait for it to pass by itself, endlessly drink painkillers. It’s time to find out why your head hurts, and act on the problem purposefully!

Video: Live on the topic: “Headaches. Modern approaches in diagnosis and treatment”

Publication checked:

Tsarev Vyacheslav Yurievich

Experience:
11 years old

Neurologist, reflexologist, functional diagnostics doctor

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Tension-type headache – treatment, symptoms, causes, diagnosis

Tension-type headache is usually diffuse, mild to moderate in intensity, and is often described as a “tight band” feeling around the head. Tension-type headache (THT) is the most common type of headache, and yet the causes of this type of headache are still not well understood.

The treatment of tension headache is quite effective. Tension-type headache management is often a balance between a healthy lifestyle, the use of non-drug treatments, and the administration of adequate medication.

Symptoms

Symptoms of tension headache include:

• Dull, aching headache
• Feeling of “tightness” or pressure in the forehead or on the sides of the head and in the back of the head
• Soreness of the scalp, neck and shoulder muscles

Tension headaches fall into two main categories – episodic and chronic.

Episodic tension headaches

Episodic tension headaches can last from 30 minutes to a week. Episodic tension headaches occur on less than 15 days per month for at least three months. Frequent episodic tension headaches can become chronic.

Chronic tension headaches

This type of tension headache lasts several hours and may be continuous. If headaches occur 15 days or more per month for at least three months, they are considered chronic.

Tension headaches and migraine

Tension headaches are sometimes difficult to distinguish from migraines. In addition, if a patient has frequent episodic tension-type headaches, they may also have migraines.

Unlike some forms of migraine, tension headaches are usually not accompanied by blurred vision, nausea, or vomiting. And if, with migraine, physical activity increases the intensity of the headache, then with a headache, stress loads do not have such an effect. Hypersensitivity to any light or sound can sometimes occur with tension headaches, but these symptoms are uncommon.

Causes

Causes of tension headache are not known. Medical experts believed that tension headaches are due to problems in the muscles of the face, neck and scalp, which in turn are due to strong emotions, excessive workload or stress. But studies show that muscle spasm is not the cause of this type of headache.

The most common theories are that people who have tension headaches and may have stress sensitivity are hypersensitive to pain. Increased muscle soreness, which is a common symptom of tension-type headache, may be the result of an increase in general pain sensitivity.

Triggers

Stress is the most common trigger that causes tension headaches.

Risk factors

Risk factors for tension headache include:

• Gender. Women are more likely to get this type of headache. One study found that almost 90 percent of women and 70 percent of men experience tension headaches during their lifetime.
• Mean patient age. The frequency of tension-type headaches peaks at age 40, although this headache can develop at any age.

Complications

Due to the fact that headaches can be quite frequent, this can significantly affect productivity and quality of life in general, especially if they become chronic. Frequent pain can disrupt the usual way of life and overall performance.

Diagnosis

Diagnosis of tension-type headache is primarily based on clinical history and symptoms and neurological findings.

Physicians may be interested in answers to the following questions:

• When did the symptoms start?
• Did the patient notice any triggers such as stress or hunger?
• Were the symptoms continuous or episodic?
• How severe are the symptoms?
• How often do headaches occur?
• How long did you have a headache for the last time?
• What does the patient think reduces symptoms and what makes symptoms worse?

In addition, the doctor is also interested in the following details:

• Characteristics of pain. Does the pain throb? Is the pain dull, constant, or sharp?
• Pain intensity. A good indicator of headache severity is the amount of time a patient can work during a headache attack. Can the patient work? Are there episodes in which the headache led to awakening from sleep or sleep disturbance?
• Localization of pain. Does the patient feel pain in the whole head, only on one side of the head, or just in the forehead or eye sockets?

Instrumental methods of examination

If the patient has unusual or severe headaches, the doctor may order an additional examination to rule out more serious causes of headaches.

The two most commonly used diagnostic methods, such as CT (computed tomography) and MRI, allow visualization of organs and tissues and detect morphological changes.

Treatment

Some patients with tension-type headache do not go to the doctor and try to treat the pain themselves. Unfortunately, repeated self-use of painkillers can itself cause severe headaches.

Medications

There is a wide variety of drugs, including over-the-counter medications, to relieve pain, including:

• Painkillers. Simple over-the-counter pain relievers are usually the first line of treatment for headaches. These include aspirin, ibuprofen (Advil, Motrin IB, others), and naproxen (Aleve). Prescription drugs include naproxen (Naprosyn), indomethacin (Indocin), and ketorolac (ketorolac tromethamine).
• Combination preparations. Aspirin or acetaminophen, or both, often combined with caffeine or a sedative in the same medication. Combination preparations may be more effective than single-drug preparations.
• Triptans and drugs. For people who have both migraine and tension headaches, triptans can effectively relieve the headache. Opioids, or narcotics, are rarely used because of their side effects and the high risk of addiction.

Preventive drugs

Other drugs may be prescribed to reduce the frequency and severity of attacks, especially if the patient has frequent or chronic headaches that are not relieved by pain medication.

Prophylactic drugs may include:

• Tricyclic antidepressants. Tricyclic antidepressants, including amitriptyline and nortriptyline (Pamelor), are the most commonly used drugs for preventing tension-type headache. Side effects of these drugs may include weight gain, drowsiness, and dry mouth.
• Other antidepressants. There is evidence that antidepressants such as venlafaxine (Effexor XR) and mirtazapine (Remeron) are effective in patients who are also not depressed.
• Anticonvulsants and muscle relaxants. Other drugs that may prevent tension headaches from developing are anticonvulsants such as topiramate (Topamax) and muscle relaxants.

Lifestyle adjustments and home remedies

Rest, ice packs or long, hot showers can often relieve headaches.

Non-pharmacological treatment

• Acupuncture. Acupuncture can provide temporary relief from chronic tension headache.
• Massage. Massage can help reduce stress and release tension. It is especially effective in relieving spasm in the muscles in the back of the head, neck, and shoulders.