Headache

The most common headache, felt as a bilateral band-like pressure of mild to moderate intensity. It is driven by pericranial muscle tightness, stress, poor posture, and central pain sensitization. It typically does not worsen with routine activity and lacks nausea.

A neurovascular disorder involving trigeminal activation and cortical spreading depression, producing throbbing, often one-sided pain lasting 4–72 hours. It is commonly accompanied by nausea, light and sound sensitivity, and sometimes visual aura. Triggers include hormonal shifts, sleep disruption, skipped meals, and certain foods.

Reduced fluid volume and falling blood glucose alter cerebral blood flow and sensitize pain pathways. Abrupt caffeine cessation causes rebound cerebral vasodilation and a dull, diffuse ache within 12–24 hours. These headaches resolve quickly once the trigger is corrected.

Taking analgesics or triptans more than 10–15 days per month can transform episodic headaches into near-daily pain. The brain's pain-modulating systems downregulate, so the headache returns as each dose wears off. Treatment requires supervised withdrawal of the overused drug.

Inflamed sinuses create pressure pain over the cheeks and forehead that worsens on bending forward. Uncorrected refractive error, jaw clenching (TMJ), and neck joint dysfunction refer pain to the head via shared trigeminocervical pathways. Treating the underlying structure resolves the headache.

Ibuprofen 400–600 mg or naproxen 500 mg works well for tension-type and mild migraine by blocking prostaglandin-driven pain; acetaminophen 1000 mg is an option if NSAIDs are contraindicated. Limit to fewer than 15 days per month to avoid medication-overuse headache. Avoid NSAIDs with peptic ulcer disease, kidney impairment, or anticoagulant use.

Sumatriptan, rizatriptan, or eletriptan are serotonin 5-HT1B/1D agonists that abort migraine attacks by reversing trigeminal activation and vasodilation. They work best taken early in the attack and are far more effective than simple analgesics for moderate-to-severe migraine. They are contraindicated in coronary artery disease, uncontrolled hypertension, and prior stroke.

When attacks occur 4+ days per month, doctors prescribe daily preventives such as propranolol, amitriptyline, topiramate, or candesartan, which reduce migraine frequency by roughly half in many patients. Amitriptyline is also effective for chronic tension-type headache. Each requires 6–8 weeks at a therapeutic dose before judging benefit.

Monoclonal antibodies (erenumab, fremanezumab, galcanezumab) and gepants (rimegepant, ubrogepant, atogepant) block calcitonin gene-related peptide signaling central to migraine. They are well tolerated and useful when conventional preventives fail or are contraindicated. These are prescription specialty drugs and typically require prior authorization.

Antibiotics or intranasal corticosteroids for bacterial sinusitis, corrective lenses for eye strain, dental splints for bruxism/TMJ, and physiotherapy for cervicogenic headache address the source rather than masking pain. Botulinum toxin injections are licensed for chronic migraine (15+ headache days/month). Accurate diagnosis by a clinician determines which applies.

A cold pack or frozen gel wrap on the forehead and temples constricts vessels and numbs trigeminal pain — best for migraine. A warm towel or heating pad on the neck and shoulders relaxes tight muscles and suits tension-type headache. Apply 15–20 minutes with a cloth barrier to protect skin.

Drink 500–750 ml of water, or water with a pinch of salt and a squeeze of lemon, over 30 minutes. This directly reverses dehydration headaches and helps after alcohol, heat exposure, or illness. Relief usually begins within an hour.

Lying in a dark, silent room reduces sensory input that amplifies migraine pain through a sensitized brain. A 20–60 minute nap frequently aborts a migraine entirely. This targets migraine's photophobia and phonophobia directly.

Diluted peppermint oil (a few drops in a carrier oil) rubbed on temples and forehead produces a cooling menthol effect with evidence comparable to acetaminophen for tension headache. Combine with firm circular massage of the temples, jaw, base of the skull, and trapezius muscles. Keep oil away from eyes and avoid in young children.

Every 30–45 minutes, look 20 feet away for 20 seconds, roll the shoulders back, and tuck the chin to lengthen the neck. This relieves cervicogenic and tension headaches caused by forward-head posture and sustained eye focus. Raising the monitor to eye level prevents recurrence.

These are over 90% water plus potassium and magnesium, correcting the mild dehydration and electrolyte loss that commonly trigger headaches. The natural sugars also stabilize blood glucose if a meal was skipped. Eating them regularly helps prevent recurrent dehydration headaches.

Omega-3 fatty acids EPA and DHA are converted into anti-inflammatory resolvins that dampen trigeminal pain signaling. Trials of high-omega-3 diets have shown reductions in monthly migraine hours. Aim for two servings weekly as part of migraine prevention.

These are among the richest food sources of magnesium, a mineral often low in people with migraine and needed to stabilize neuronal excitability. They also supply riboflavin and folate, both linked to fewer migraine days. A daily serving supports long-term prevention.

A quarter cup provides roughly 40% of daily magnesium along with vitamin E and healthy fats, directly addressing the magnesium deficiency associated with migraine susceptibility. They also provide steady energy that prevents hypoglycemia-related headaches. Keep a small portion as a mid-afternoon snack.

Gingerols inhibit prostaglandin synthesis and have antiemetic action, and one trial found ground ginger comparable to sumatriptan for acute migraine relief. It is especially useful when nausea accompanies the headache. Steep fresh grated ginger in hot water for 10 minutes.

Slow-digesting complex carbohydrates keep blood glucose steady, preventing the fasting-related headaches that follow skipped or late meals. Whole grains also supply magnesium and B vitamins involved in neuronal energy metabolism. A bowl of oatmeal is a good headache-preventive breakfast.

Calcium and vitamin D status correlate with migraine frequency, and low-fat dairy is a reliable source of both plus riboflavin. The protein content also prevents blood sugar dips. Choose plain varieties, since aged cheeses are a separate trigger.

Protein breakdown during aging produces tyramine, a vasoactive amine that triggers noradrenaline release and can provoke migraine in susceptible people. The longer the aging, the higher the tyramine content. This is one of the best-documented dietary migraine triggers.

Nitrites and nitrates used as preservatives are converted to nitric oxide, a potent vasodilator that activates trigeminal pain pathways. The classic "hot dog headache" appears within minutes to an hour. Cured meats also carry tyramine from fermentation.

Alcohol causes vasodilation and a diuretic effect that dehydrates, while red wine additionally contains histamine, sulfites, and tannins. Many migraineurs react within hours of even a single glass. Hangover headache reflects dehydration plus acetaldehyde toxicity.

More than roughly 200–400 mg daily can cause rebound headaches as each dose wears off, and stopping suddenly triggers withdrawal headache within 12–24 hours through cerebral vasodilation. Inconsistent intake is worse than a steady modest amount. Taper gradually rather than quitting abruptly.

Monosodium glutamate can provoke headache in sensitive individuals, likely via glutamate-mediated neuronal excitation and nitric oxide release. Very high sodium loads also raise blood pressure and promote fluid shifts. Instant noodles, soup bases, and some restaurant dishes are common sources.

Aspartame has been reported in controlled studies to increase headache frequency in some migraine sufferers, possibly through phenylalanine effects on neurotransmitters. Diet sodas and sugar-free gum are common sources. A two-week elimination trial can reveal personal sensitivity.

Chocolate contains phenylethylamine and some tyramine and is a frequently reported trigger, though cravings may actually be an early migraine symptom. Refined sugar causes a glucose spike followed by a reactive dip that provokes headache. Pairing any sweets with protein blunts the swing.

Magnesium stabilizes neuronal membranes and blocks cortical spreading depression; evidence for migraine prevention is moderate-to-good and it is recommended by several headache societies. Typical dose is 300–600 mg daily of elemental magnesium, taken for at least 8 weeks. The main side effect is diarrhea (less with glycinate), and dose reduction is needed in kidney disease.

High-dose riboflavin improves mitochondrial energy metabolism in neurons and has reduced migraine frequency in randomized trials — evidence is moderate. The studied dose is 400 mg daily for at least three months. It is very safe, harmlessly turns urine bright yellow, and interacts with few drugs.

CoQ10 supports mitochondrial ATP production and showed roughly 50% reduction in attack frequency versus placebo in small trials; evidence is moderate but limited by study size. Typical dosing is 100 mg three times daily or 300 mg of a high-bioavailability form. It may reduce the effect of warfarin, so inform your doctor.

Standardized butterbur extract has the strongest trial evidence of any herbal migraine preventive at 75 mg twice daily. However, unprocessed butterbur contains hepatotoxic pyrrolizidine alkaloids and cases of liver injury have led several countries to restrict it. Use only PA-free certified products and only under medical supervision with liver monitoring.

Feverfew inhibits platelet serotonin release and prostaglandin synthesis; evidence for migraine prevention is mixed and considered limited. Typical dose is 50–150 mg daily of standardized extract containing parthenolide. Avoid in pregnancy, in people allergic to ragweed family plants, and alongside anticoagulants; stopping abruptly can cause rebound headache.

Melatonin 3 mg at bedtime performed comparably to amitriptyline for migraine prevention in one randomized trial and also helps cluster headache; evidence is promising but limited. It works partly by regularizing sleep, a major headache trigger. Side effects include morning grogginess and vivid dreams; avoid combining with sedatives without advice.

Low vitamin D status is associated with more frequent headaches, and supplementation has reduced migraine days in deficient individuals, though evidence overall is limited. A common dose is 1000–2000 IU daily, ideally guided by a blood level. Do not exceed 4000 IU daily long-term without monitoring, as excess causes hypercalcemia.