There are many strategies for managing headaches without medication. For many people, these work better than standard medication regimens. The first step in managing your headaches is to be sure to follow the treatment plan you and your doctor decide on. Avoid taking medicines that have not been ordered by your doctor, and do not take over-the-counter pain medicines more than twice a week. If you don't feel your treatment plan is working effectively, contact your doctor.
Beyond medication, these techniques may help control your headaches:
Reduce emotional stress. Force yourself to take time away from stressful situations. Learn deep breathing and progressive muscle relaxation. Counseling or cognitive therapy may also help you recognize and relieve stress.
Reduce physical stress. Proper rest and sleep will better equip you to face the stressors of the day. When sitting for prolonged periods, get up and stretch periodically. Relax your jaw, neck, and shoulders.
Exercise regularly. Get at least 20 minutes of exercise three times a week. Exercise alleviates stress and can reduce the frequency and severity of your headaches. It also increases the levels of beta-endorphins, your body's natural stress reliever. If you already have a headache, exercise can help relieve the pain.
Keep a regular schedule. Eat well-balanced meals and snacks at about the same times every day, get at least eight hours of sleep per night, and take short breaks during the day to relax.
This section contains more information on:
- Self-treatment for headaches
- Managing headaches in children
- Managing migraines
- Alcohol and cigarette smoke
- Managing stress
Here are some ways you can cope with headaches yourself, without medicine:
- Take breaks from activities that trigger or provoke headaches, such as using the computer for long periods of time or exercising strenuously.
- Apply an ice pack to the painful area of your head. Try placing it on your forehead, temples, or the back of your neck.
- Apply gentle, steady rotating pressure to the painful area of your head with your index finger or thumb. Maintain pressure for seven to 15 seconds, then release. Repeat as needed.
- Take a warm bath or shower.
- Take a walk.
- Rest, sit, or lie quietly in a low-lit room. Close your eyes and try to release the tension in your back, neck, and shoulders.
- Ask someone to rub your neck and back, or treat yourself to a massage.
- Stretch and relax the muscles. For patients who have excessive muscle contractions in the neck, physical therapy exercises performed daily are often helpful.
Children who suffer from migraines and other types of headaches may benefit from keeping a headache diary, so that they learn to identify and avoid headache triggers such as caffeinated foods and beverages, aged cheeses, pizza, luncheon meats, sausage, and hot dogs. They will want to follow a regular schedule, making sure to eat all meals (especially breakfast) and get eight hours of sleep nightly. It's important to limit a child's use of over-the-counter medications to no more than two doses per week, since overuse can actually worsen headaches.
At the first sign of a headache, a child should take the maximum allowable dosage of recommended medications. These will not include aspirin, which can be dangerous to children. Then it can be helpful to:
- Seek rest in a quiet, comfortable location
- Use relaxation strategies and other methods to reduce stress
- Apply a cold compress
Identifying and then avoiding migraine triggers should reduce the frequency of your migraine attacks. Recalling what was eaten prior to an attack may help you identify chemical triggers and make the necessary dietary changes to avoid these triggers in the future.
Stress management and coping techniques, along with relaxation training, can help prevent or reduce the severity of the migraine attacks. Migraine sufferers also seem to have fewer attacks when they eat on a regular schedule and get adequate rest. Regular exercise can also help prevent migraines.
Women who get migraines during their menstrual periods typically find relief during pregnancy and after menopause. Hormonal treatment of migraines has not been satisfactory, however. Generally, becoming aware of the menstrual cycle patterns as they relate to the onset of the headaches can help you take preventive action to try to reduce the severity of the attacks.
Blood flow to your brain increases when you drink alcohol, increasing headache pain. Some scientists blame some headaches on impurities in alcohol or on byproducts produced as your body metabolizes alcohol.
Smoking and secondhand smoke from cigarettes, cigars, and pipes can trigger headaches and make any headache, especially migraine headaches, worse. Nicotine, one of the components of tobacco, stimulates vascular activity in the brain. Smoking also stimulates the ganglion nerves in the back of the throat, contributing to headache pain. Usually, removing the nicotine provides relief. (Note that 85 percent of cluster headache patients are smokers. It is alcohol that frequently precipitates a cluster headache when the cluster period starts.)
Quitting smoking or reducing exposure to secondhand smoke is not especially helpful for those with cluster headaches, although one study found that headaches decreased 50 percent in those who reduced their tobacco use by less than one-half pack of cigarettes per day. Other studies have not confirmed this finding.
Everyone feels stress. Our bodies are designed to react to it: It keeps us alert and ready to avoid danger. We can't always avoid or change the sources of stress in our lives, and we may feel trapped and unable to cope. When stress persists, illnesses can occur. Because stress plays a role in making any headache worse, relaxation techniques might help you manage your headaches.
The key to coping with stress is identifying stressors in your life and learning ways to reduce their effect on you. It's important to remember that you can learn to control how you respond to stressful events. We all have our own ways of coping with change, so the causes of stress can be different for each person.
When you are not sure of the exact cause of your stress, it may be helpful for you to know the warning signs of stress. Once you can identify these signs, you can learn to recognize possible triggers and how your body responds to stress. Then you can take steps to reduce it. Talk to a friend, family member, religious professional, or healthcare professional if you need support in dealing with your problems. Counseling can help you recognize and release stress.
General steps in learning how to handle your stress:
- Become aware of your stress reaction and its early signs
- Learn a relaxation skill you can adopt as your own
- Learn to apply that relaxation skill when the first signs of stress develop
- Master the technique of breathing from your abdomen
- Practice at home with a video- or audiotaped relaxation or imagery program
- Practice using your stress management skills in real-life situations
- Develop behavioral strategies so you can avoid stress reactions
More detail about coping with stress is provided:
Your body sends out physical, emotional, and behavioral warning signs of stress.
Emotional warning signs include:
- Sleep disruption
- Inability to concentrate
- Unproductive worry
- Frequent mood swings
Physical warning signs include:
- Stooped posture
- Sweaty palms
- Chronic fatigue
- Weight gain or loss
- Physical symptoms that your doctor cannot attribute to another condition
Behavioral warning signs include:
- Acting on impulse
- Using alcohol or drugs
- Withdrawing from relationships
- Changing jobs often
- Feeling agitated most of the time
Here are 10 suggestions to help you free yourself from stress:
- Eat and drink sensibly. Alcohol, drug, and food abuse may seem to reduce stress, but they actually add to it.
- Assert yourself. You do not have to meet others' expectations or demands. It's OK to say "No." Remember, being assertive allows you to stand up for your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
- Stop smoking. Aside from the obvious health risks of cigarettes, nicotine acts as a stimulant and brings on more stress symptoms.
- Exercise regularly. Choose noncompetitive exercise and set reasonable goals. Aerobic exercise has been shown to release endorphins (natural substances that help you feel better and maintain a positive attitude). Your body can fight stress better when it is fit.
- Study and practice relaxation techniques. Deep relaxation and aerobic exercise together provide a sure way to protect your body from the effects of stress.
- Control what you can and leave behind what you cannot control.
- Reduce stressors. Many people find that life is filled with too many demands and too little time. Effective time-management skills involve asking for help when appropriate, setting priorities, pacing yourself, and taking time out for yourself.
- Examine your values and choose your actions and your activities accordingly. The more your actions reflect your beliefs, the better you will feel, no matter how busy your life is.
- Set realistic goals and expectations.
- When you are feeling overwhelmed, remind yourself of what you do well.
Cognitive therapy can give you insight into the sources of your stress. It involves three main steps. In the first step, counselors help patients recognize any negative thoughts associated with the stressors. Examples of negative thoughts could include "That rotten teacher made the exam too hard" or "My headache is never going to go away."
In the second step, the counselor helps the patient challenge beliefs about the thought. For instance, the counselor will help patients realize that all past headaches have gone away, so this one will, too.
The third and final step is to substitute positive thoughts for the negative ones and teach patients to distract themselves so that they think more pleasant thoughts. An example of a self-confidence-building statement might be, "I've had this type of headache before and I know how to handle it. I will beat this headache." Cognitive therapy teaches patients how to maintain a positive mood, a key to alleviating the negative effects of stress.
Because stress plays a role in aggravating any headache, relaxation techniques might help you manage your headaches and prevent them from getting worse.
If you have a headache, you should:
- Lie down and relax.
- Stretch and relax your muscles, especially your neck and shoulder muscles.
- Take breaks from activities that trigger or provoke headaches, such as using the computer for long periods of time or exercising strenuously.
Here are some ways you can relax whether or not your head is hurting:
Relaxation exercises can help you deal with the effects of stress. Try the ones described here, after making sure that you are prepared with:
- A quiet location that is free of distractions
- A comfortable position on a chair or sofa
- A worry-free, focused state of mind
Two-minute relaxation. Concentrate your thoughts on your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly.
Mind relaxation. Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful," or a short phrase such as "I feel quiet" or "I'm safe." Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.
Progressive muscle relaxation. This is a technique that teaches you to concentrate on relaxing every muscle in your body by deliberately applying tension to certain muscle groups and then stopping the tension. First, focus your mind on a muscle group, for instance, the muscles in your hand. As you inhale, squeeze the muscles in your hand (by making a tight fist) as hard as you can for about eight seconds. Now, as you exhale, quickly open your hand and let the pain and tightness go. Feel the muscles relax and become loose and limp as the tension flows away. Repeat this tension-relaxation process for all the major muscle groups in your body, beginning with the muscles in your feet and moving upward all the way to your face.
Many people like to perform their relaxation exercises with some favorite music in the background. Select music that lifts your mood or that you find soothing or calming. Or you might find it easier to relax while listening to specially designed relaxation audio tapes, which provide music and relaxation instructions. Ask your healthcare provider about the availability of these tapes.
In order to learn how to relax, you need to become familiar with your own breathing patterns. Your breathing pattern is often disrupted by changes in emotion. If you are anxious, you tend to hold your breath and speak in a high-pitched voice as you exhale. On the other hand, if you are depressed, you tend to sigh and speak in a low-pitched voice as you exhale. Below are a few breathing exercises that will help you change your patterns and relax.
Rhythmic breathing. Ratchet down the pace by taking long, slow breaths. Inhale slowly, then exhale slowly. Count slowly to five as you inhale, and then count slowly to five as you exhale. As you exhale slowly, pay attention to how your body naturally relaxes.
Deep breathing. Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.
Visualized breathing. Find a comfortable place where you can close your eyes and combine slowed breathing with your imagination. Picture relaxation entering your body and tension leaving your body. Breathe deeply but in a natural rhythm. Visualize your breath coming into your nostrils, going into your lungs, and expanding your chest and abdomen. Then, visualize your breath going out the same way.
Guided imagery, or mental imagery relaxation, is a form of focused relaxation that helps create harmony between the mind and the body. Someone who is practiced in guided imagery coaches you in creating calm, peaceful images in your mind—a "mental escape." Then you can use this escape on your own.
With guided imagery, a person imagines a pleasant experience or a particularly soothing environment. By concentrating on creating as much detail as possible, the mind becomes absorbed in this task, which, in turn, lessens the stressful or painful event.
Guided imagery provides a powerful psychological strategy that enhances a person's coping skills. Many people dealing with stress feel a loss of control, fear, panic, anxiety, helplessness, and uncertainty. Research has shown that guided imagery can dramatically counteract these effects. The technique has been shown to dramatically decrease pain and the need for pain medication, to enhance sleep, and to strengthen the immune system and enhance the ability to heal.
Last reviewed on 07/06/2006
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