Have a throbbing headache? It can be difficult to diagnose head pain, especially if there's not an obvious culprit (such as too many drinks the night before).
Use this step-by-step chart to find out what's really causing your headache and determine if you're suffering from a tension headache, cluster headache, migraine, or PMS headache. Then find the right remedy to treat your pain with this guide.
Tension headache
Over-the-counter painkillers—ibuprofen, naproxen—can dull the sensation. But to avoid these headaches, you'll want to address possible triggers, such as stress, tension in the face and neck muscles, poor posture, or clenching or grinding your teeth.
Try stress-reduction techniques such as meditation, biofeedback, and cognitive behavioral therapy (CBT), says Richard B. Lipton, MD, professor of neurology at Albert Einstein College of Medicine and director of the Montefiore Headache Center in New York City. If the headaches strike 15 or more days per month, they're considered chronic; see your doctor for stronger pain relief and/or prevention meds.
Migraine
While two or three ibuprofen might stop the throbbing for some people, if you get migraines 15 or more days a month, go to your doctor for bigger guns. Top Rx treatments include a class of drug called triptans, which constrict blood vessels in the brain.
Drugs that may help stave off migraines include beta-blockers, antiseizure medication, antidepressants, calcium channel blockers, and, for chronic migraine only, Botox injections. For natural remedies, coenzyme Q10, vitamin B2, magnesium, and the herbs butterbur and feverfew may help; check with your doctor before trying them.
Then there's the high-tech stuff: Cefaly, an FDA-approved device that stimulates the trigeminal nerve branches above the eyes to prevent pain, and transcranial magnetic stimulation, which delivers magnetic pulses to the back of the head to relieve migraine with aura.
And, of course, it's crucial to pinpoint and avoid your personal triggers, which might include stress, missed meals, sleep changes, chemicals and preservatives (such as MSG or nitrates) in food and drink, caffeine (too much or less than you're use to), changing weather patterns, and hormonal flux. Stress-busting methods that make a difference include yoga, mindfulness meditation, CBT, and biofeedback.
Cluster headache
Cluster headaches aren't usually linked to triggers—they may be related to abnormalities in the hypothalamus. When they hit, oxygen therapy (inhaling high-flow oxygen through a mask) and injections of the pain medication sumatriptan can stop the agony. Doctors may use meds such as calcium channel blockers and corticosteroids, as well as nerve block injections, to ward off future attacks.
PMS headaches
Do you get headaches before or during your period? You're not alone. "One of the strongest triggers of migraine headaches is hormonal change, mostly dropping estrogen," explains Jack Schim, MD. While the exact connection between hormones and headaches isn't clear, it could have to do with links between estrogen and inflammation, which can contribute to pain.
One fix: Birth control. Take the active pills continuously—skip the sugar pill week. "If you don't get the hormone drop, you don't get headaches," notes Lauren Streicher, MD, clinical associate professor of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine.
Not on the pill or don't want to start? Consider an Rx for low-dose estrogen (a patch, gel, or pill). Use it for up to a week, starting three days before your period. "It's a much lower dose of hormone than what's in the pill, just enough to keep estrogen levels from dropping so precipitously," says Dr. Streicher. You'll still get your period, but it will be lighter than usual (bonus!).
