Headache treatment

Many headaches have a treatable cause. This type of headache is therefore called a secondary headache. Examples are headaches with fever, after head trauma, with acute high blood pressure or after excessive alcohol consumption.

However, for primary headaches such as chronic tension-type headaches, migraines and cluster headaches, targeted treatment by specialists is advisable. The therapies, which we often use in combination, are suitable either for the prevention of headache attacks or for the treatment of acute pain attacks.

Headaches: treatment with general measures

There are a few well-known tips that you can use to tackle or prevent headaches yourself:

  • Drink plenty of fluids. We recommend 1.5 to 2 liters per day, even more on hot days. It is best to choose low-calorie drinks such as water or unsweetened teas.
  • Eat regularly throughout the day, don’t skip a meal – several small meals a day are good as they put less strain on the body.
  • Exercise regularly, preferably in the fresh air: running, hiking or swimming are considered healthy. But a brisk walk can also banish a headache.
  • Don’t drink too much alcohol – otherwise you could end up with a grumpy head and a hangover the next morning.
  • Also give up smoking and watch your caffeine intake.
  • Adopt strategies for coping with stress Take regular time-outs, take breaks in your daily routine, learn to delegate and relax in between. Relaxation techniques such as autogenic training or yoga are also effective.
  • Make sure you get enough sleep, but also good quality sleep. The amount of sleep alone is not enough.
  • Pay attention to your posture – especially if you spend a lot of time sitting down at work. Stand up every now and then and walk a few steps.
  • Stretching exercises loosen the muscles in the back, neck and shoulders. They counteract tension, which is often a cause of headaches.
  • A massage (e.g. temples, forehead, neck) can also relax and relieve headaches.
  • Acupuncture can help people with headaches.
  • Physical treatment: Heat relieves pain in the muscles. Cold helps with headaches, for example in the form of a cold compress over the forehead.
  • Apply peppermint oil to the forehead, temples or back of the neck.

Headaches: treatment with painkillers

There are a number of effective painkillers (analgesics) that are available in low doses over the counter (without a prescription) from pharmacies or online. However, you should not use pain medication for a long period of time without consulting your doctor. Frequent use can also trigger headaches itself(drug-induced headache).

Some examples of active ingredients that have a pain-relieving effect:

  • Acetylsalicylic acid (ASS)
  • Ibuprofen
  • Naproxen
  • Paracetamol

Under no circumstances should you take several painkillers at the same time, but only one preparation at a time. Otherwise unpleasant side effects may occur. The long-term use of painkillers is also not recommended. Always talk to the doctor treating you.

Migraine and cluster headache: special medication

For people with migraines and cluster headaches, there are special medicines that are specifically tailored to these types of headaches. They are available in various dosage forms, such as tablets, nasal spray, injections or suppositories.

  • Migraine: triptans, ergotamines, metamizole, anti-nausea medication (e.g. metoclopramide, domperidone).
  • Beta-blockers (e.g. metoprolol or propranolol), calcium antagonists (flunarizine) or antiepileptic drugs (valproic acid, topiramate) are suitable for migraine prophylaxis. CGRP antagonists are now available for treatment-resistant headaches. Non-drug therapies can also be helpful (e.g. transdermal electrostimulation).
  • Cluster headache: oxygen therapy (breathing mask and oxygen cylinder), two triptans (sumatriptan as a pen for injection under the skin, zolmitriptan as a nasal spray), special local infiltration with anesthetics.

Responsible professionals

Heiko Pohl, MHD, PD Dr. med.

Attending Physician, Department of Neurology

Tel. +41 44 255 55 11

For patients

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For referrer

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University Hospital Zurich
Department of Neurology
Headache department
Frauenklinikstrasse 26
8091 Zurich

Tel. +41 43 254 03 00
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Responsible Department

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