Patient information
Migraine and headache: managing your headaches
Most headaches, including migraine, are not caused by anything serious. This leaflet explains how to treat attacks, how to avoid painkiller headaches, and when to get help.
My headache plan
Name:
Headache type:
For an attack I take:
My preventer (if any):
Review date:
Treating an attack
- Take your treatment as early as possible once the headache starts. If you get an aura, wait until the headache begins before taking a triptan.
- Combining a triptan with ibuprofen, naproxen, aspirin or paracetamol often works better than either alone.
- An anti-sickness tablet can help your painkiller work, even if you don't feel sick.
- Codeine and other opioids are not recommended for migraine – they can make headaches worse.
Avoid painkiller (medication overuse) headaches
Taking painkillers or triptans on more than 2–3 days a week can make headaches more frequent. If this is happening, talk to us – stopping the overused painkillers usually helps within a few weeks, although headaches may be worse at first. Cutting down caffeine helps too.
Preventing migraine
- If you have 4 or more bad headache days a month, a daily preventer may help. They start at a low dose and are increased slowly; side effects often settle in 2–4 weeks.
- Give each preventer at least 3–4 months at the right dose before deciding whether it works.
- Keep a headache diary – note headache days, how bad they were and what you took. It's the best way to see what's working.
- Regular sleep, meals, fluids and exercise, and managing stress, can reduce attacks.
- If you could become pregnant, ask about contraception – some preventers are not safe in pregnancy.
Get urgent help (call 999 or go to A&E) if you have
- a sudden, severe "worst ever" headache that peaks within minutes
- headache with fever, stiff neck, a rash or confusion
- new weakness, numbness, slurred speech, loss of vision or a fit
- a headache after a head injury
Contact your GP soon if headaches are new and getting steadily worse, are worse when lying down or coughing, if you are over 50 with a new headache and scalp tenderness or jaw pain when chewing, or if your eye is red and painful.
More help: NHS: migraine · The Migraine Trust · National Migraine Centre