How we treat head pain
Nearly everyone will experience head pain at some point during their lives, but for some people, head pain can become chronic. Chronic migraines and headaches can range in severity from annoying to debilitating. Thankfully, a wide range of treatment options are available for head pain, providing lots of potential options to try when managing head pain.
Oral medications are usually the first type of pain management attempted to treat head pain.
The most common reason that people purchase over-the-counter pain medications is head pain. These medications are non-steroidal anti-inflammatory drugs (nsaids), like aspirin, acetaminophen, or ibuprofen. These over-the-counter pain medications often fall short when it comes to treating severe or chronic head pain. For instance, nsaids are considered most effective for people who suffer episodic migraines ten or less days per month.
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For more severe types of head pain, a physician may prescribe an opioid, such as oxycodone. Anticonvulsant drugs are also sometimes effective when treating head pain. Different medications may be indicated depending on the type of head pain being experienced. Explain what type of pain you’re experiencing as clearly as possible to your physician so he or she can prescribe the right medication.
Oral medications generally provide short-term, as-needed pain relief. Some injected medications can provide short-term pain relief, as well. Sumatriptan in oral form is commonly used to treat migraines, but subcutaneous (injected) sumatriptan is used to provide short-term relief from cluster headaches.
Other types of injected medications can potentially provide medium-term pain relief, or pain relief that’s not permanent but could last for several weeks to months.
Nerve block injections can act both as pain management and as a diagnostic tool for head pain.
These types of injections deliver medications directly to the inflamed nerves causing head pain. The injections will typically include a local anesthetic to block pain. Corticosteroids might also be included to reduce inflammation.
The exact location of the injection will depend on which nerves are causing the head pain. To relieve chronic migraine or cluster headaches, for example, a nerve block injection will be applied to the trigeminal or occipital nerves.
The physician will determine which nerve location is most likely to provide relief. If the injection is delivered to the nerve that’s causing the head pain, relief can occur fairly quickly and may last for weeks or months. If the injection is delivered to the incorrect nerve, it will have very little effect. In this way, the injection can be used as a diagnostic tool to identify exactly which nerve or nerves are to blame for the head pain.
Once the nerves causing the head pain have been identified, other types of treatments can be applied directly to the nerves.
Radiofrequency ablation (RFA) can be used on nerves that have been identified as causing head pain, but it can also be used as a potential treatment for severe, persistent headaches that don’t respond to nerve block injections.
During RFA, a local anesthetic is applied. Then thin probes are passed through the skin until they reach the targeted nerve or nerve group. The probes emit radiofrequency, or electrothermal impulses, on the nerve or nerve group. This selectively damages the nerve, causing the formation of a lesion, which blocks the pain signals that the nerve conducts.
Another type of nerve therapy is spinal cord stimulation (SCS). During SCS, flexible, thin devices are implanted next to the spinal cord, close to the nerves causing the head pain. The devices are attached to external leads, which are attached to a control device that allows the patient to operate it. When the devices are activated, a mild electrical impulse is emitted. This impulse interrupts the pain signals being transmitted along the nerves. When head pain occurs, the patient can then control his or her own pain relief.
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Alternative and complementary therapies, used in conjunction with traditional therapies, may be effective in controlling head pain, too.
Acupuncture originated in traditional Chinese medicine. It involves the insertion of small, sterile needles into strategic places on the body. This is believed to cause the body to release endorphins, increase blood circulation, and reduce inflammation. Acupuncture can be effective when used in conjunction with other pain management techniques. In fact, for some people, acupuncture is more effective than traditional pain management therapies.
Chiropractic manipulation might also be an effective treatment for head pain. It involves the application of targeted force to correct the body’s spinal alignment. Massage therapy, which focuses on the release of muscle tension and stress, can potentially reduce head pain as well, especially when the myofascial muscles are massaged.
Another technique called biofeedback might be particularly effective at teaching patients how to control their own head pain. Readings are taken of brain activity, muscle tension, and galvanic skin response, all of which are impacted by headache triggers like stress. People with head pain can then study these measurements to understand the physiological effects linked to their headaches. This understanding can then be applied toward relaxation techniques to enhance control over the physiological effects linked to head pain.
Keeping a pain diary can also enhance understanding of the triggers behind head pain, as well as make it easier for a physician to decipher exactly which type of head pain is being experienced and how best to treat it.
To track head pain with a migraine or headache diary, take note of all the factors surrounding the head pain, such as:
- When the pain began and ended
- Intensity and location of the pain
- Food or drinks before the pain began
- Activities before the pain began
- Amount of sleep the night before the head pain
Although tracking all of this information won’t necessarily reduce head pain, it can shed light on what causes the pain. For instance, it might suddenly become clear that headaches worsen after drinking caffeine, or that migraines occur more frequently after a short night’s sleep. This clearer understanding of what can lead to or worsen head pain can allow you to avoid the things that trigger head pain.
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