What to Do When Headache Treatments Don’t Work

Medically Reviewed by Murtaza Cassoobhoy, MD on February 13, 2023
Written by Stephanie Booth
3 min read

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.

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.

 

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.

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

Immediate 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. Doctors might refer to this type of treatment as abortive therapy. Ibuprofen or naproxen may relieve migraines or tension headaches. But, for more severe migraines, prescription triptans are often recommended.

Preventive treatment: Prescription drugs 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:

 

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.

 

Most headaches can be treated at home. However, if you have any of the following symptoms, you should go to the ER:

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

They’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.