Got a Headache? Read This Before You Reach for That Painkiller

Not all headaches are created equal. Learning what’s behind yours is the first step to easing the pain.

Headaches come in all shapes and sizes. When figuring out how to best treat yours, you’ll need to figure out what’s causing it first. Read on to learn the most common types of headaches — and the most reliable treatments.

Tension headache

You’re behind on meeting your sales quota for the month, not to mention you have a to-do list a million miles long. Your neck and shoulders are tense, and then you start to feel it — that nagging ache in your head. Tension headaches are typically mild to moderate and feel like a band is tightening all over your head.

To treat a tension headache, try an over-the-counter (OTC) pain reliever such as aspirin, Ibuprofen or naproxen. If one of those doesn’t work, try an OTC product specifically meant for headaches that contain a combination of aspirin, acetaminophen and caffeine, such as Excedrin.

Call for an Appointment
(800) USC-CARE (800-872-2273)

Alternative medicine, including acupuncture and massage, also may be helpful at reducing stress and muscle tension that causes headaches. If none of these put an end to the pain, speak with your doctor about prescription treatments that can ease headache pain and/or prevent headaches altogether.

Cluster headache

You wake up only a few hours after you went to bed with a crushing headache on one side of your head. After a couple of hours, the pain subsides as quickly as it came on, but then you wake up the next night at the exact same time with the exact same headache.

Chances are you’re experiencing a cluster headache. Episodes of cluster headaches last from six to 12 weeks, and the onset of the headache is generally at night, one to two hours after you fall asleep.

Cluster headaches differ from other headaches in that they aren’t usually triggered by an outside factor, such as stress or a specific food. Men are more likely than women to have cluster headaches, and they are most common in people 20 to 50 years old.

If you experience cluster headaches, you should see a doctor to find the best treatment for you. Options to treat the pain include prescription injections of sumatriptan, octreotide or dihydroergotamine. These also are available as nasal sprays but may not be as effective or as fast-working.

Preventative medications can help when you’re experiencing a bad bout of cluster headaches. These include calcium-channel blockers, corticosteroids and lithium carbonate. Each comes with its own side effects, cautions and interactions with other drugs; your doctor will work with you to find the best option for you.

Migraine headache

A day ago you felt a little off — maybe you couldn’t stop yawning, had trouble going to the bathroom or had frequent mood changes. Then, today, it hits — an intense, throbbing pain on one side of your head, and you feel like you’re about to throw up and can’t handle bright light. The feeling lasts for up to three days.

Women are three times as likely to experience migraines, thanks to fluctuations in estrogen. Migraines also can be triggered by stress, a change in the weather, alcohol, and foods and food additives (processed food, aspartame and MSG are top culprits).

If your migraine is mild, you may find that an OTC pain reliever (aspirin, ibuprofen, naproxen or a combo therapy like Excedrin Migraine) is enough to ease the pain. For more severe pain, speak to your doctor about a prescription migraine medication. These include triptans, which are available as pills, injections and nasal sprays. If your nausea is severe, you may also need to take an anti-nausea medication.

“Treating migraine is a challenge because it involves not only triggers that are easy to control, like different foods and hydration, but
also other, internal triggers (stress, pulse rate) and external triggers (light, sound, pacing),” Soma Sahai-Srivastava, MD, professor of clinical neurology at Keck School of Medicine of USC and director of the Headache and Neuralgia Program at Keck Medicine of USC, told Women magazine.

For those who have four or more migraines a month, a preventive medication can be helpful. These include beta blockers, antidepressants and anti-seizure medicine. Botox injections into the forehead and scalp also have shown to be effective at reducing the severity and frequency of migraines.

Alternative therapies including acupuncture, massage, biofeedback and cognitive behavioral therapy also may effectively combat migraines. And vitamins and supplements including vitamin B2, magnesium, feverfew and butterbur may help, but it’s important to speak to your doctor before taking any of these.

Are you a migraine sufferer? See your primary care physician to find out what the most effective treatment options are for you.

For those suffering more complex issues with headaches, the USC Headache and Neuralgia Center at Keck Medicine of USC in Los Angeles offers an interdisciplinary approach. This includes the country’s only Lifestyle Redesign program, which consists of weekly sessions viewing key parts of a patient’s daily life, including diet, stress, posture and ergonomics. Learn more here.

If you are in the Los Angeles area and are looking for a new primary care physician, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting

By: Anne Fritz