Living with headaches

The basics

  • Keep a headache calendar/diary. This is very important. Bring it to your next appointment. Mark down when you get a headache, how bad it is on a 1 to 10 scale, and what you took to help the pain. To download a headache calendar you can use, click here.
  • Obtain a headache book and learn as much as you can about your condition. Click here to view a list of books.
  • Try to keep current with medication refills. Having medications on hand avoids having to scramble for refills during an acute headache attack.
  • Migraine is a threshold disorder. Much of what is recommend is intended to raise the threshold, i.e. make it harder to get a headache.

Non-drug treatment

  1. Stick to a regular schedule. Try to eat, sleep and wake at approximately the same time each day.
  2. Try to identify headache triggers (food, alcohol, prolonged hunger, sleep deprivation, etc.) and avoid these triggers whenever possible.
  3. Learn acupressure (finger acupuncture) for headaches. It is simple and often effective for mild to moderate headaches. Click here for easy acupressure steps you can use.
  4. Try to make a concerted effort to regularly reduce stress in your life. Learn and practice relaxation techniques (click here for more information). Biofeedback can be very helpful for headache sufferers.
  5. Associated medical conditions such as depression, anxiety, insomnia and substance overuse/abuse (nicotine, alcohol, caffeine) should be discussed with your doctor. Successful headache treatment requires that these associated conditions be treated effectively.

Drug therapy

  1. Treat headaches early and aggressively.
  2. Do not take immediate relief medications more than two days per week or else rebound headaches may occur. If applicable, take your preventative medications on a daily basis.
  3. Treat nausea aggressively. Reglan (metoclopramide) is usually the best choice. Even if you do not have nausea, Reglan allows headache medications to be absorbed better, especially if taken 15 to 20 minutes before the other headache medications. Reglan should be taken at the first sign of a significant headache.

Goals

Remember your treatment goals:

  • Eliminate emergency room visits for acute headache treatment.
  • Have a home program that is well tolerated and works.
  • Minimize impact of headache on work and family activities.

Follow-up

If you have an appointment scheduled, be sure to keep it. If the headache pattern worsens, call your doctor.