What to Do When Headache Treatments Don’t Work

Head won’t stop pounding? Don’t give up hope.

If you get one headache or migraine after another and over-the-counter (OTC) pain relief doesn’t help, you do have options.

Headaches are tricky. Most of the time, there isn’t a single cause. They result from many different things going on inside and around you. These can range from lack of sleep to foods you eat or changes in the weather.

It can take time to figure out what makes your head throb. Patience is key when it comes to finding a treatment that works. But you can get relief. A headache specialist can help.

When to See a Doctor

If your headaches get in the way of daily life, it’s time to talk to a doctor. You should also seek medical advice if:

  • Your headaches are severe or come on quickly.
  • Your headache never fully goes away.
  • You take pain relievers more than twice a week.
  • You take a higher dose of medicine than what’s advised on the label.
  • Actions like bending over, coughing, sneezing, or having sex bring on a headache or migraine.
  • Your head pain started after a head trauma.
  • You have new headache pain and are over the age of 50.

What Kind of Doctor Should You See?

Your primary care doctor is a good starting point, but headaches are complex.

Neurologists and headache specialists have special training to help them figure out the type of headache you have and its causes. They can come up with a treatment plan to manage your symptoms.

How Are Headaches Treated?

There isn’t a one-size-fits-all approach. Your doctor will likely suggest one or more of the following:

Acute treatment: Some drugs can put a quick end to a headache or migraine. Your doctor might have you inhale oxygen through a mask to relieve cluster headaches.

Preventive treatment: Daily medicine can stop pain before it starts. It can make what you do feel less severe.

Nondrug treatments: Many natural therapies can be useful, too. Your headache specialist may suggest:

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Lifestyle Changes Can Help

Small tweaks in your daily routine can lower the number of headaches or migraines you have:

  • Drink plenty of water.
  • Don’t skip meals.
  • Watch your caffeine intake.
  • Limit alcohol.
  • Manage other health problems. Conditions like anxiety or high blood pressure can trigger headaches if you don’t keep them under control.
  • Watch your use of medicines. Taking OTC pain relievers too often, or at a higher dose than advised, could cause more problems. Once the drug wears off, withdrawal symptoms start. This leads to more head pain and the need for more medicine. Doctors call this a rebound headache.
  • Stick to a sleep schedule. Too little or too much rest can trigger headaches.
  • Get to a healthy weight. A high body mass index (BMI) can lead to more migraines.
  • Track your headaches. Write down when you get one and what you were doing right before. Make sure to include what, if anything, helped ease your pain.

If You Go to the ER

Headaches and migraines are some of the most common reasons people go to the emergency room.

Don’t wait weeks -- or even days -- to go. Any symptoms that are new to you are good reasons to seek help. Look out for:

Remember, an ER doctor isn’t a headache specialist. His focus will be to rule out serious health issues that cause head pain, like meningitis or a stroke. He may suggest some imaging tests, such as a CT scan that takes a picture of the inside of your head.

He’ll probably give you a drug to ease your pain, but it may only work for a short time. See a headache specialist. It’s the best way to get your headaches under control and come up with a long-term treatment plan.

WebMD Medical Reference Reviewed by Lawrence C. Newman, MD on June 29, 2017

Sources

SOURCES:

Harvard Health Publications: “Most headache-related brain scans aren’t needed.”

National Headache Foundation: “When to See a Healthcare Professional.”

Mayo Clinic: “Migraine: Diagnosis and Treatment.”

American Migraine Foundation: “What is a Headache Specialist? Do I Need One? And How Do I Find One?” “When to Go to the Emergency Room for a Headache or Migraine.”

The Migraine Trust: “Other headache disorders.”

UpToDate: “Patient education: Headache treatment in adults (Beyond the Basics.)”

Migraine Research Foundation: “Migraine Treatment,” “Non-Drug Treatments.”

American Family Physician: “Hard-to-diagnose Headache: Practical Tips for Diagnosis and Treatment.”

Cleveland Clinic: “Rebound Headaches.”

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