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Your 7-Step Plan for Curing Headaches and Migraines

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    Step 2: Track Your Pain

    Pinpointing the triggers of a throbbing head isn't easy. That's why experts suggest keeping a pain journal for at least a month or two. Include the days and times your head hurts, but also jot down severity and how long the pain lasts, where you feel it, your stress level and any pain medications you are taking. And don't just note the major ones. "Every ache counts—even a mild one," says Audrey Halpern, M.D., director of Manhattan Headache and Neurology and clinical assistant professor of neurology at New York University School of Medicine. Share this diary with your doctor to help determine what factors are setting off your headaches or migraines.

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    Step 3: Watch Your Diet for Potential Triggers

    Though certain foods like aged cheese or cured meats are often linked to migraines, experts say food is rarely the sole culprit. "Often, foods are triggers only when they are combined with other things: You're worried about layoffs at work, your parents keep asking when you're going to come visit, and your sick kid kept you up all night. You then had a hot dog at lunch, and now your head's killing you," says Dr. Halpern. Still, limit your consumption of potential offenders like caffeinated or artificially sweetened beverages, citrus fruits, sourdough breads, and foods high in additives, including those containing monosodium glutamate. You should also stick to a low-fat diet. Research suggests that cutting back on dietary fat significantly reduces the number and severity of migraines.

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    Step 4: Find Healthy Releases for Stress

    Almost all the women—97%—who participated in a 2009 Journal of Clinical Sleep Medicine study blamed stress for their tension headaches, which are brought on when muscles in your neck and scalp contract. (Sleeping in an awkward position and logging long hours in front of the computer are common culprits.) Not surprisingly, stress is also the cause of many migraines. Release tension and reduce head pain by incorporating relaxation exercises, yoga, deep breathing, and physical activity into your everyday routine.

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    Step 5: Get Help for Fluctuating Hormones

    Women prone to migraines are more likely to have them during their menstrual periods than at any other time—and often the pain is particularly intense, says Elizabeth Loder, M.D., chief of the headache and pain division at the department of neurology at Brigham and Women's Hospital in Boston. Because sensitivity to falling estrogen levels is often to blame, taking oral contraceptives containing estrogen that stop your periods may help. If taking birth control pills doesn't improve symptoms or worsens your migraines, try 360 milligrams of magnesium daily starting on day 15 of your cycle and continuing until the onset of your period.

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    Step 6: Go Easy on Pain Pills

    In some circumstances when you're using meds too often, headaches actually start to occur even more frequently; these are known as boomerang or rebound headaches. "When used in excess, either over-the-counter or prescription painkillers may interfere with pain regulators in the brain," explains Dr. Halpern. You'll need to stop the meds for a few weeks, which can be difficult, so talk to your doctor about substituting a different type of treatment or medication. The good news: 45% of participants in a recent study reported fewer headaches and migraines two months after reducing their reliance on pain pills.

  • Step 7: Catch Enough (but Not Too Many) Zzz's

    If your head pounds after a late night or after you've slept in, you probably suffer from what's called weekend headaches. Nearly 60% of women with tension headaches who participated in a 2009 study said too little or too much sleep can leave them in agony. Migraine sufferers are equally susceptible, with fatigue considered a top trigger. "In people prone to headaches and migraines, the brain may respond to changes in sleep patterns by switching on pain centers," says Merle Diamond, M.D., associate director of the Diamond Headache Clinic in Chicago and a National Headache Foundation board member.

    Oversleeping also throws your entire body clock off schedule: You're hungry because breakfast's delayed and you're going through caffeine withdrawal because you haven't had your morning coffee. You'll enjoy more pain-free weekends and vacation days by going to bed and getting up at the same time every day. And though it may be tempting to crawl into bed when your head pounds, that same study suggests this often backfires: Napping makes it more difficult to fall asleep at night, upping your chances of developing another headache. What you should aim for is seven hours (eight or nine is even better) of shut-eye every night.

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    Treatment for Tension Headaches or Mild Migraines

    Anti-inflammatories: OTC nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen (Motrin) or naproxen sodium (Aleve) are considered the first line of treatment for head pain.

    Combination meds: The painkilling properties of acetaminophen and aspirin work best when combined with caffeine (try Excedrin Migraine). But be careful: Combo meds are more likely to cause rebound headaches.

    Antidepressants: Daily tricyclic antidepressants, such as Pamelor, prevent head pain by stabilizing the levels of serotonin in your brain.

    You may need to test out several remedies before finding the most effective one.

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    Treatment for Severe Migraines

    Triptans: Take these prescription pain medications (Imitrex, Maxalt) at the first sign of a migraine to dull pain-processing signals to the brain. Triptans narrow heart arteries, so don't take them if you're at risk for heart disease.

    Anti-seizure meds: Taken daily, these preventive drugs (Topamax, Depakote) ward off migraines by soothing the central nervous system.

    Heart medications: Beta blockers and calcium-channel blockers relieve stress on the heart and blood vessels and have been shown to prevent migraines when taken daily.

    You may need to test out several remedies before finding the most effective one.

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    Alternative Therapies for Headaches and Migraines

    Biofeedback: Studies suggest this relaxation technique can reduce headaches or migraines by up to 60%—or nearly 80% when you combine it with medications like beta blockers.

    Acupuncture: A review of 22 acupuncture studies found that headache and migraine sufferers treated with acupuncture had fewer headaches than those taking pain medications.

    Botox: About 75% of migraine sufferers in a University of California, San Francisco, study were migraine-free for four to six months after receiving Botox injections.

    You may need to test out several remedies before finding the most effective one.

    Originally published in the April 1, 2010, issue of Family Circle magazine.

    All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.


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