A headache is a signal, and most signals have a cause. The trouble is that the quickest answer, a painkiller, can become a cause of its own.
Painkillers taken often for headaches can bring on a headache that arrives almost every day. It has a name, medication overuse headache, and an older, plainer one: the rebound headache. It is one of the common reasons that an occasional headache turns into a daily one. The pills that ease today's pain help set up the next one, and so on, round and round. From the inside, the loop looks just like relief.
That is not a reason to suffer through a bad headache. It is a reason to know what else relieves the pain without medication, so the pills stay for the days that truly need them.
When the pills become the problem
The rebound headache tends to build in people who already get migraines or tension headaches. As the pills are taken more and more often, the headaches come more and more often too, until they arrive most days.
For simple painkillers, the line is usually drawn at 15 or more days a month for more than three months. For some stronger headache drugs it is lower. If you are near that line, the remedies below matter twice: they ease the pain, and they help you need the pills less.
Stopping brings a rough patch of its own. For a few days, usually two to ten, the headaches can get worse, with nausea, poor sleep and restlessness. A pill eases it, which is exactly how the loop keeps going, and up to 45% slip back into the old pattern. So if you take painkillers on most days, get advice on how to cut down, and expect the first days to be the hardest.
1. Water and salt
Dehydration is a real trigger. 7 Fun and Tasty Ways to Stay Hydrated Without the Boredom, linked below, has the 25 young women who lost just over 1% of their body weight in water: their mood dropped, their concentration slipped, and headaches came on.
But water is not a cure-all, and the best test of it is worth knowing. In 102 people with recurrent headaches who drank little, half were asked to drink more water every day for three months. They rated their headache-related quality of life higher, and 47% felt much better, against 25% of the others. The number of days with a real headache, though, did not change. Water helped people feel better about their headaches, if not have fewer of them. That is still worth a glass.
So drink steadily, and use the colour of your urine as a guide: pale yellow is right, dark means drink more. Do not overdo it. Too much water dilutes the salt in your blood, and that brings on headache, confusion and tiredness too.
Salt matters as much as the water. A pinch in a glass, or a mug of salted bone broth, puts back what sweat takes out. Magnesium can come from the glass too. What to Drink Instead of Plain Water — and What the Popular Alternatives Do to Your Body has why natural mineral water varies so much, and why the label is worth reading.
2. Peppermint oil
For the tight, band-like tension headache, peppermint oil has the best evidence of any oil. Rubbed into the skin of the forehead and temples, it works better than a placebo, and about as well as a standard dose of aspirin or paracetamol. It cools the skin and seems to act on the pain from several directions at once.
Dilute it in a plain carrier oil before it touches your skin. Keep it well away from your eyes, and away from the faces of young children. comes undiluted, so a little lasts a long time.
Lavender and eucalyptus smell lovely and may help you relax, but neither has this kind of result behind it for headaches.
3. Ginger
Ginger is an old remedy with one modern test worth knowing. In 100 people with migraine, ginger powder taken during an attack eased the pain as well as sumatriptan, a standard migraine drug, two hours later, and with fewer side effects.
It is one test, and it needs repeating. Still, ginger is cheap, it is a traditional remedy for nausea, and a strong tea from grated fresh root is easy to make. Few medicine cabinets are as cheap to stock as a spice rack.
4. Feverfew and butterbur
These two are the herbs most often sold for migraine prevention, and they deserve a straight answer each.
Feverfew takes its name from the Latin febrifugia, "fever-chaser". For migraine, it has a small effect at best. In the largest good test, with 218 people, attacks fell from 4.8 to 2.9 a month on feverfew, and from 4.8 to 3.5 on placebo. That is 0.6 fewer attacks a month, or roughly one fewer migraine every couple of months. Two other careful tests found no difference at all. Side effects were mild, mostly stomach upsets and mouth ulcers.
Butterbur worked better in its main test: over four months, 245 people with migraine had 48% fewer attacks on the stronger extract, against 26% on placebo. But the plant naturally contains compounds that can damage the liver. Only products processed to remove them, sold as "PA-free", should even be considered, and rare cases of liver injury have been reported even with those. Swapping a headache for a liver problem is a poor bargain.
5. Magnesium and riboflavin
Two nutrients have stood up in migraine tests.
Magnesium. In 81 people with migraine, those who took magnesium for 12 weeks had 41.6% fewer attacks by the end, against 15.8% on placebo. The most common side effect was diarrhoea, in almost one in five.
Riboflavin, also called vitamin B2, did well in a smaller test. Over three months, 55 people took riboflavin or a placebo, and 59% of the riboflavin group halved their headache days, against 15% on placebo.
Both take weeks to show an effect, so give either one a fair run. Patience is part of the remedy. Why Most Stress Supplements Fail (And the 9 Worth a Look), linked below, has how to choose a bottle that holds what it says, and why to start one supplement at a time. carries an independent NSF certificate.
An Epsom salt foot bath in the evening is a pleasant way to wind down. Whether much magnesium gets through the skin is another matter, so enjoy it for the warmth and the calm.
6. Move
Regular exercise is one of the best-tested ways to have fewer migraines. In 91 people with migraine, three months of regular exercise cut attacks by as much as relaxation training did, and by as much as a daily preventive drug, topiramate. The bicycle has fewer side effects.
Start gently. Brisk walking or cycling, built up slowly, is enough. Hard exercise can set off an attack in some people, so ease into it.
7. Relax the body
Tension builds in the jaw, the neck and the shoulders long before it turns into pain. The jaw is often the first to clench and the last to notice. Relaxation training did as well as the drug in the same migraine test, and there are several ways to learn it.
Progressive muscle relaxation. Tense each muscle group for a moment, then let it go, working from your feet up to your head.
Biofeedback. Sensors show your muscle tension or skin temperature on a screen, so you can see it fall as you relax, and learn to do it without the screen. Across 53 sets of findings on tension headaches, biofeedback had a medium-to-large effect that held for about 15 months on average. It did better than relaxation alone, best of all when the two were combined, and especially well in children and teenagers.
Meditation and guided imagery. Sit quietly and follow your breath, or picture a calm, specific place in detail. Recordings help if you want structure.
Stretch the tight spots. Chin tucks for a head that juts forward from a screen, gentle neck stretches, and a deliberate unclenching of the jaw. Hands-on work helps too: a 2012 review found that manual therapy, massage included, may reduce how often and how badly chronic tension headaches strike.
Acupuncture. Pressure points are often suggested for headaches. The needles have the better evidence. Across 22 tests with 4,985 people with migraine, headaches at least halved in 41% of those given acupuncture against 17% of those given none. Against sham needling, the edge was small: 50% against 41%.
Cold or warm. A cold pack on the back of the neck numbs a throbbing migraine. A warm compress loosens tight muscles in a tension headache. Use whichever feels better. A set of does both: into the freezer for one, warm water for the other.
8. Food
Food matters, and one result stands out.
In 96 overweight women with migraine, those put on a very-low-calorie ketogenic diet for a month went from 2.9 attacks a month to 0.71. Their headache days fell from 5.11 to 0.91, and the pills they took from 4.91 to 0.51. A standard low-calorie diet helped less. A ketogenic diet is built around meat, fish, eggs and natural fats, with very few carbohydrates.
Fish helps in its own right, and seed oils seem to work against it. In 182 adults with migraine, a diet with more of the omega-3 fats from fish cut headache days by 2.0 a month over 16 weeks, compared with a usual diet. The same diet with linoleic acid, the main fat in seed oils, kept low brought headache days down by 4.0, twice as much. Headache hours fell too, though the scores for quality of life did not improve by much.
Even without going that far, steady meals help. Skipping meals and riding the blood sugar swings of sugar and refined starch are common triggers. Build each meal around protein, and put fatty fish such as salmon, sardines and mackerel on the plate often.
Food triggers are personal. Aged foods, alcohol and processed meats bother some people and not others. Rather than cutting out a long list, keep a diary for a few weeks and look for your own pattern.
And mind the caffeine. A headache that arrives when you have missed your usual coffee is withdrawal. How to Quit Coffee: Getting Through Caffeine Withdrawal has the timetable and two ways through it.
9. Sleep
Too little sleep and too much can both set off headaches, and so does an irregular pattern. Keep the same bedtime and waking time every day, weekends included. Simple sleep habits can make a real difference: in 43 women with chronic migraine, those taught a few of them had fewer and milder headaches than those given dummy instructions, and by the end, 48.5% had gone back from near-daily to occasional migraine. A long lie-in at the weekend can bring the headache with it. The body likes its timetable kept, holidays and all.
The first hour
When a headache starts, match what you do to the kind it is. A tension headache is usually on both sides of the head, pressing or tight rather than throbbing, mild to moderate, no worse for walking or climbing stairs, and comes without nausea. A migraine is more often on one side and throbbing, gets worse when you move, and brings nausea and a dislike of light or sound.
A tension headache, tight like a band around the head: drink some water, rub diluted peppermint oil into your forehead and temples, do a few chin tucks and neck stretches, unclench your jaw, and breathe out slowly.
A sinus headache, heavy behind the face: a warm compress over the nose and cheeks, steam from a bowl of hot water, and plenty of fluid.
A migraine, a word that began as the Latin hemicrania, "a pain in one half of the head", from the Greek for half and skull: move to a quiet, dark room, drink water, put a cold pack on the back of your neck, and try ginger tea if nausea allows.
When it is more than a headache
Get medical help straight away if a headache is sudden and the worst you have ever had, or if it comes with fainting, weakness, numbness, difficulty speaking, a stiff neck, a fever, or changes in your vision.
And if headaches keep coming despite your best efforts, or you are reaching for painkillers on most days, get them checked.
Fewer headaches, fewer pills
Go back to the rebound headache. The painkiller is the right tool for a bad day. Relief, used every day, stops being relief.
The remedies with the best evidence are mostly plain ones: water and salt, peppermint oil, ginger, magnesium, riboflavin, regular exercise, a relaxed jaw and neck, steady meals and steady sleep. None works for everyone, and the only way to find yours is to watch.
For the next two weeks, write down every headache, what came before it and what you tried, and look for your pattern.
Bored of plain water? 7 Fun and Tasty Ways to Stay Hydrated Without the Boredom — seven ways to drink more without forcing it, and why thirst is a poor alarm.
Wondering which supplement is worth it? Why Most Stress Supplements Fail (And the 9 Worth a Look) — which ones have evidence behind them, which are marketing, and how to buy one that holds what it says.
Know someone who keeps a packet of painkillers in every bag? Send them this, and ask what they reached for last week.
Disclaimer: This article is general information. For advice about your own health, talk to a qualified health professional. If you are pregnant, take regular medication or have a liver condition, get advice before trying a herb or supplement.
Affiliate Disclosure: This article contains affiliate links. As an Amazon Associate, All For Life earns from qualifying purchases, at no extra cost to you. We only link to products we would recommend without the commission.
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