There are four general types of headaches:

Tension headaches

  • Causes: anxiety, eyestrain, caffeine overload, neck problems, or teeth grinding during sleep.
  • Characteristics: a dull, persistent pain, like a tight band around one's neck.
Migraine headaches
  • Causes: unknown, possibly due to the constriction and swelling of blood vessels; possibly due to genetic or neurological factors.
  • Characteristics: intense, throbbing pain (usually starting on one side of the head) and nausea, sometimes preceded by warning signs like flickering dots of light, blind spots, numb limbs, or strange scents.
Cluster headaches
  • Causes: unknown, but may be related to nerves around the eyes. They are more common in men and are sometimes triggered by heavy smoking, alcohol consumption, and certain foods. They tend to occur in groups over several days.
  • Characteristics: stabs of pain, usually centered on one red, watering eye.
Sinus headaches
  • Causes: allergies, hay fever, colds, the flu.
  • Characteristics: congestion in the sinus cavities, pain behind the face (around the nose, behind the eyes, in the forehead).
Conventional Approach
by Dr. Brown
& Alternative Approach

by Dr. Dillard
The best defense against headaches is a healthy lifestyle that includes exercise and proper nutrition, but even that is no guarantee against stress or other headache triggers. In addition, a headache may be an indication of serious health problems. If your headache is severe, sudden, nausea-inducing, long lasting, accompanied by high fever, and/or unlike anything you've ever experienced, consult your doctor immediately. Otherwise, if you suffer from chronic headaches, consider discussing some of the following treatments with your doctor.

Tension headaches remedies
Over-the-counter remedies (aspirin, acetaminophen, ibuprofen) can relieve tension headaches. In severe cases, antidepressants can be prescribed. (Note: Avoid giving aspirin to children under the age of 19. This can lead to Reye's syndrome, a rare but dangerous illness involving inflammation of the brain and liver.)

Migraine headache remedies
Mild attacks can be treated with over-the-counter analgesics such as aspirin, acetaminophen, and non-steroidal anti-inflammatory drugs. There are a variety of prescription medications for moderate to severe attacks, such as ergotamine and sumatriptan. Preventive medications include beta-blockers, calcium channel blockers, and antidepressants.

Cluster headache remedies
Corticosteroids, methysergide maleate, ergotamine, calcium channel blockers, lithium carbonate, and sumatriptan have all been used for these headaches. Also, inhaling pure oxygen may reduce the pain of cluster headaches. Prevention involves cessation of any known precipitating substances.

Sinus headache remedies
Over-the-counter decongestants can alleviate the pain caused by congestion. In severe cases, prescription antibiotics can treat the infection behind the headache.

Ronald C. Brown, MD, FACP., is the Vice President of Medical Programs for Oxford Health Plans. He is a graduate of Yale University School of Medicine and was trained in internal medicine at Roosevelt Hospital in New York City. Dr. Brown is a board-certified internist.
  Relaxation techniques are the foundation of many alternative headache therapies because they address the stress and tension that are at the root of many headaches. These therapies include deep-breathing exercises, meditation, and visualization therapy. Also, for migraines, a licensed nutritionist can offer advice about aromatherapy and herbal therapies. There are additional approaches for tension headaches and sinus headaches.

Acupressure remedies
Techniques that may alleviate headache pain include:

  • Pressing the indent spots at the bottom of your cheekbones (directly below your pupils) for a minute, then repeating three times.
  • Breathing deeply while pressing the tip of your middle finger against the spot at the top of your nose, directly between your eyebrows, for two minutes and repeating three to five times.
  • Putting the tips of your middle fingers at the hollows at the base of the skull, near the spine, and pressing firmly for a minute.
Chiropractic remedies
Bad posture can create unnecessary muscle strain, which can cause tension headaches. Through spinal or cervical manipulation and realignment, a chiropractor can soothe aching muscles and relieve the resultant headache.

Massage remedies
For headaches caused by muscle tension, massage is ideal for easing the pain. Gently and slowly massaging your own scalp, from your hairline to the crown of your head, can relieve surface tensions. Neck massages, together with neck exercises and other stretching drills, can reduce the stress that causes headaches. As with treatment for other conditions, discuss alternative therapies for headaches with your primary care physician. In particular, there are certain herbal medications that might not interact well with prescription drugs, so be sure to make your physician aware of any herbal remedies or tonics that you may be using.

James Dillard, MD, DC, CAc, is the founding Medical Director for Oxford Health Plans' Complementary and Alternative Medicine program and is chairman of the Oxford Chiropractic Advisory Board. He is a board-certified medical doctor, a doctor of chiropractic, and a certified medical acupuncturist.

This column is offered for your interest and information. It is not intended as advice and should not replace your doctor's recommendation or treatment plan. Comments on this column can be e-mailed to or mailed to:

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