Providing treatment options for your patient with headaches

Increase treatment success by knowing the options and setting reasonable goals for your patients with headaches.
Last update26th Nov 2020

In order to devise a treatment plan for your patient, first you must help your patient set goals for treatment. What are reasonable goals?

There are three reasonable goals for a treatment plan for your patient with headaches:

  1. To reduce use of abortive treatments and increase their efficacy
  2. To reduce headache disability
  3. To establish pain control and lower stress

Your patient may indicate a preference for pharmacological or non-pharmacological therapy. You may find many patients are not receptive to prescription drugs and become overwhelmed by potential side effects, preferring instead to at least try remedies that they consider more natural. These may be supplements and / or lifestyle alteration.

If your patient does not wish to try a pharmaceutical intervention, there are many non-pharmacologic treatments that you can recommend:

  1. Get adequate sleep
  2. Practice yoga / meditation
  3. Attend therapeutic massage treatments
  4. Use essential oils such as peppermint oil
  5. Exercise
  6. Wear sunglasses
Figure 1. Non-pharmacologic treatments for headache include adequate sleep, yoga / meditation, therapeutic massage, essential oils, exercise and wearing sunglasses.

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Recommended reading

  • Blumenfeld, AM. 2018. Botox for chronic migraine: Tips and tricks.  Practical Neurology. 17: 27–36. https://practicalneurology.com
  • Halker Singh, RB, Starling, AJ and VanderPluym, J. 2019. Migraine acute therapies. Practical Neurology. 17: 63–67. ttps://practicalneurology.com
  • Krel, R and Mathew, PG. 2019. Procedural treatments for headache disorders. Practical Neurology. 17: 76–79. https://practicalneurology.com
  • Mauskop, A. 2012. Nonmedication, alternative, and complementary treatments for migraine. Continuum (Minneap Minn). 18: 796–806. PMID: 22868542
  • Motwani, M and Kuruvilla, D. 2019. Behavioral and integrative therapies for headache. Practical Neurology. 17: 85–89. https://practicalneurology.com
  • Natekar, A., Malya, S., Yuan, H. & Nahas, S.  2018. Migraine Preventative Therapies in Development Practical Neurology. 17: 54–57.
  • Parikh, SK and Silberstein, SD. 2018. Calcitonin gene-related peptide monoclonal antibodies. Practical Neurology. Feb: 20–22. https://practicalneurology.com
  • Rizzoli, PB. 2012. Acute and preventative treatment of migraine. Continuum (Minneap Minn). 18: 764–782. PMID: 22868540
  • Tepper, SJ and Tepper, DE. 2018. Neuromodulation and headache. Practical Neurology. 17: 42–45. https://practicalneurology.com

About the author

Robert Coni, DO EdS
Robert is Neurohospitalist, Medical Director, and Coordinator at the Grand Strand Medical Center, and Clinical Assistant Professor at the University of South Carolina.
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