- OTC analgesics such as aspirin, paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Nurofen) or naproxen (Aleve) can temporarily relieve most tension-type headaches. Acupuncture, physical therapy, cognitive behavioural therapy and relaxation techniques may also help with frequent headaches.
Aspirin, paracetamol or NSAIDs (including ibuprofen, naproxen or diclofenac) can often successfully treat mild migraines. Your doctor may prescribe triptans, anti-emetics or ergotamine compounds for more severe migraines. Opioids (such as codeine or pethidine) are not recommended.
There are several prescription medicines that, taken daily, may help reduce the frequency and/or severity of migraines. Your doctor can determine what’s likely to help you, with options including beta blockers, some anti-depressants, anti-epileptic medications and calcium channel-blockers.
A specific headache diagnosis is the best way to obtain the right treatment. If a prescribed treatment hasn’t been successful, see your doctor again for a different prescription - or seek a second opinion.
Can painkillers really 'target pain'?
You may believe there are specific painkillers for different parts of the body: tension headache, migraine, back pain, neck pain, period pain and osteoarthritic pain.
But a closer look at the ingredients reveals they are often identical from product to product. For example, Nurofen Migraine Pain contains 200mg of ibuprofen, the same as Nurofen Back Pain, Nurofen Period Pain, Nurofen Tension Headache Pain and regular Nurofen Tablets. Panadol Back + Neck Pain contains the same 500mg of paracetamol as regular Panadol tablets, while the eight-hour sustained-release Osteo and Back+ Neck products both contain 665mg.
Different types of painkiller will act differently on pain:
Aspirin and other NSAIDs stop or reduce the production of prostaglandins – hormone-like substances that can trigger pain signals to the brain. They act in both the brain and the painful area to reduce pain and inflammation.
Paracetamolreduces the production of prostaglandins in the brain and central nervous system rather than at the site of pain, and has no anti-inflammatory effect.
Opioids, such as codeine, affect the brain’s responses to the pain message, rather than act on prostaglandins.
Painkillers act systemically rather than locally, so the drug is absorbed into your bloodstream and accesses most tissues in your body, not just the site of pain.
Alternative therapies for migraine
Feverfew and butterbur are herbal remedies that have been found to reduce the incidence of migraines – as have riboflavin (vitamin B2), magnesium (oxide or chelated) and coenzyme Q10 supplements. Our sister organisation in the US, Consumers Union, has put compiled a summary of supplements for migraines on its Consumer Reports on Health website.
A recent review of 22 studies found consistent evidence that acupuncture is also useful for treating acute migraine attacks and appears to be at least as effective as, or possibly more so than, preventative drug treatment, with fewer adverse effects.