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Behavioral and Other Nonpharmacologic Treatments for Headache

Medicines provide our chief means of treating headaches – so much so that many people have difficulty thinking of any other strategy. Plenty of nondrug techniques can ease head pain, such as massage, applying cold or heat, rest, and avoiding headache triggers. In fact, people have relied on these and other “alternative therapies” for head pain management for centuries. Early alternatives included faith healing, incantations and superstitious rituals, bloodletting, poultices, and many more. Today, we are fortunate to have a host of proven prescription and nonprescription medications at our disposal that can be quite effective for treating headaches. So why use nonpharmacologic alternatives? Nondrug therapies often are well suited for those who experience side effects with medications, have other medical conditions that prohibit medications, or have an inadequate response to medications. Some people have preference for nondrug treatment, and women who are pregnant, planning pregnancy, or nursing should limit or avoid medication use. People with medication overuse or highstress levels also benefit from nondrug approaches that emphasize lifestyle and behavior changes. When discussing nondrug treatments, we often prefer the term complementary therapies to highlight that nondrug therapies need not be used in place of medications. Rather, drug and nondrug treatments should be combined for added benefit. Headache is not merely a problem of the body or the mind but rather a biopsychosocial disorder – a physical disorder subject to psychological, social influences, and environmental stressors. Moreover, chronic headache is a complicated problem that involves pain and suffering and can interfere with family, social, vocational, and emotional functioning. Frequent and severe headaches are especially likely to cause these problems. So it is important to apply multiple forms of intervention to completely address the problems caused by headache.