from Anti-inflammaatory to build a stronger Improves mental performance in high-pressure situations to advice on treating cataracts. Anti-inflammatory remedies for headaches other headache Lentils and mashed potatoes, tension headaches headwches not caused by a Ani-inflammatory condition but by triggers such as:. My podcast changed me Can 'biological race' explain disparities in health? Burstein R, Collins B, Jakubowski M. The pain usually goes away within a few minutes. Neurology ; Our team thoroughly researches and evaluates the recommendations we make on our site.

Anti-inflammatory remedies for headaches -

Advil tablets. Aleve dosage. Haag G, Diener HC, May A, et al. Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migraine and Kopfschmerzgesellschaft DMKG , the Deutsche Gesellschaft für Neurologie DGN , the Österreichische Kopfschmerzgesellschaft ÖKSG and the Schweizerische Kopfwehgesellschaft SKG.

doi: Moore N, Pollack C, Butkerait P. Adverse drug reactions and drug—drug interactions with over-the - counter NSAIDs. Therapeutics and Clinical Risk Management. Excedrin Extra Strength.

Lipton RB, Diener H-C, Robbins MS, Garas SY, Patel K. Caffeine in the management of patients with headache. Moore AR, Derry S, Wiffen PJ, Straube S, Bendtsen L. Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments.

Centers for Disease Control and Prevention. Patient education: Nonsteroidal anti-inflammatory drugs NSAIDs Beyond the Basics. Ashina S, Mitsikostas DD, Lee MJ, et al.

Tension-type headache. Nat Rev Dis Primers. Johns Hopkins Medicine. Tension headaches. Diener HC. Headache: insight, understanding, treatment and patient management. Int J Clin Pract Suppl. Taylor FR. Tension-type headache in adults: Acute treatment.

By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Use limited data to select advertising. Create profiles for personalised advertising.

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Table of Contents View All. Table of Contents. Tylenol vs. Risks of OTC Pain Relievers. Choosing an OTC Pain Reliever. If OTC Pain Relievers Don't Work. When to Talk With a Healthcare Provider. How to Treat Headache at Home.

Advil vs. Aleve Aleve naproxen is another NSAID that can be for headaches. How Is Advil Different From Aleve? What the Location of a Headache Means. Can OTC Painkillers Cause Headaches? Can You Take Tylenol and Advil Together? Natural Remedies for Tension Headaches. Show references Jankovic J, et al.

Headache and other craniofacial pain. In: Bradley and Daroff's Neurology in Clinical Practice. Elsevier; Accessed July 3, Kellerman RD, et al. Nonmigraine headache. In: Conn's Current Therapy Togha M, et al.

Tension-type headache. In: Headache and Migraine in Practice. Kang W-L, et al. Acupuncture of tension-type headache: A systematic review and meta-analysis of randomized controlled trials.

Frontiers of Neurology. Headache classification committee of the International Health Society HIS. The international classification of headache disorders, 3rd edition. National Institute of Neurological Disorders and Stroke. Taylor FR. Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis.

Ropper AH, et al. Headache and other craniofacial pains. In: Adams and Victor's Principles of Neurology. McGraw Hill; Loscalzo J, et al. Migraine and other primary headache disorders. In: Harrison's Principles of Internal Medicine.

Headaches: What you need to know. National Center for Complementary and Integrative Health. Tension-type headache in adults: Preventive treatment.

Goldman L, et al. Headaches and other head pain. In: Goldman-Cecil Medicine. Related Headaches and stress Relieving tension-type headaches. Associated Procedures CT scan MRI. News from Mayo Clinic 6 tips for headache relief Dec. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press.

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Show the heart some love! Give Today. More patients achieved pain freedom with nVNS compared with sham, but the difference was not significant at minutes 30 versus 20 percent. The most common adverse effects in the nVNS group were discomfort at the application site and nasopharyngitis.

The nVNS device used in this trial is approved for marketing in the United States and European Union. The most important contraindications to peripheral nerve blocks include known allergy to a local anesthetic, open skull defect, and overlying skin infection; pregnancy is a relative contraindication.

See "Headache during pregnancy and postpartum". The primary outcome of headache freedom at 30 minutes was achieved by 4 of 13 31 percent treated with bilateral greater occipital nerve blocks, and none of 15 patients 0 percent who received sham therapy.

There were no differences in adverse effects between the treatment groups. However, anatomic research has shown that the SPG is not as close to the nasal mucosa as previously believed, raising doubt that SPG blockade can be accomplished through intranasal application of local anesthetic [ ].

Nevertheless, limited data suggest benefit of SPG blocks for treatment of acute migraine. One early trial randomly assigned patients in a ratio to intranasal 4 percent lidocaine or saline placebo; a 50 percent reduction in headache intensity at 15 minutes was achieved by 29 patients 55 percent treated with lidocaine compared with 6 patients 21 percent who received placebo [ ].

A later parallel-arm, randomized pilot trial enrolled patients with chronic migraine and randomly assigned them in a ratio to repetitive SPG blocks twice weekly for six weeks with either 0.

With efficacy data for 38 patients, pain rating scores were lower at 15 minutes, 30 minutes, and 24 hours postprocedure for patients treated with bupivacaine compared with those treated with saline [ ].

However, patients treated bupivacaine had only a marginal absolute reduction in average pain intensity 1 to 1. In addition, the use of opioids is complicated by their potential for tolerance, dependence, addiction, and overdose [ 15,20 ].

See "Chronic migraine" and "Medication overuse headache: Etiology, clinical features, and diagnosis". SOCIETY GUIDELINE LINKS — Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately.

See "Society guideline links: Migraine and other primary headache disorders". These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are written at the 10 th to 12 th grade reading level and are best for patients who want in-depth information and are comfortable with some medical jargon.

Here are the patient education articles that are relevant to this topic. We encourage you to print or e-mail these topics to your patients. You can also locate patient education articles on a variety of subjects by searching on "patient info" and the keyword s of interest.

For patients who present with significant nausea or vomiting, a nonoral eg, intravenous [IV], intramuscular [IM], or subcutaneous agent may be preferred. Adjunctive preventive medications may be warranted when headaches are frequent or unresponsive to acute therapies to reduce the risk of medication overuse headache.

See 'Approach to treatment' above. See 'Mild attacks' above and 'Simple analgesics' above. For patients unresponsive to nonopioid analgesics, we add a triptan table 2.

The combined use of an NSAID with a triptan is more effective than either agent alone. See 'Triptans with NSAIDs' above and 'Antiemetics' above and 'Simple analgesics' above. Several triptans are available in a variety of formulations table 2. All the triptans are effective for the acute treatment of migraine and the combined use of a triptan and a nonopioid analgesic appears to be more effective than using either class alone.

See 'Moderate to severe attacks' above and 'Triptans' above and 'Triptans with NSAIDs' above. Alternative options include calcitonin gene-related peptide CGRP antagonists, lasmiditan , an antiemetic drug, and dihydroergotamine.

See 'CGRP antagonists' above and 'Lasmiditan' above and 'Antiemetics' above and 'Ergots' above. See 'Triptans' above and 'Antiemetics' above. See 'Antiemetics' above. See 'Abortive therapy plus parenteral dexamethasone' above.

See 'Dihydroergotamine' above and 'Sodium valproate' above and 'Simple analgesics' above. See 'Status migrainosus' above. Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you.

Select the option that best describes you. View Topic. Font Size Small Normal Large. Acute treatment of migraine in adults.

Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. View in. Language Chinese English. Authors: Todd J Schwedt, MD, MSCI Ivan Garza, MD Section Editor: Jerry W Swanson, MD, MHPE Deputy Editor: Richard P Goddeau, Jr, DO, FAHA Contributor Disclosures.

All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jan This topic last updated: Nov 27, Evidence of efficacy is limited mainly to small, low-quality trials. Multispecialty consensus on diagnosis and treatment of headache.

Neurology ; Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache an evidence-based review : report of the Quality Standards Subcommittee of the American Academy of Neurology.

Ashina M, Buse DC, Ashina H, et al. Migraine: integrated approaches to clinical management and emerging treatments.

Lancet ; Lipton RB, Stewart WF, Stone AM, et al. Stratified care vs step care strategies for migraine: the Disability in Strategies of Care DISC Study: A randomized trial. JAMA ; MacGregor EA. In the clinic. Ann Intern Med ; ITC5.

Becker WJ. Acute Migraine Treatment in Adults. Headache ; Raskin NH. Repetitive intravenous dihydroergotamine as therapy for intractable migraine. Rozen TD. Emergency Department and Inpatient Management of Status Migrainosus and Intractable Headache. Continuum Minneap Minn ; Iljazi A, Chua A, Rich-Fiondella R, et al.

Unrecognized challenges of treating status migrainosus: An observational study. Cephalalgia ; Marmura MJ, Hou A. Inpatient Management of Migraine. Neurol Clin ; Marmura MJ, Goldberg SW. Inpatient management of migraine.

Curr Neurol Neurosci Rep ; Taylor FR, Kaniecki RG. Symptomatic treatment of migraine: when to use NSAIDs, triptans, or opiates. Curr Treat Options Neurol ; Kelley NE, Tepper DE.

Rescue therapy for acute migraine, part 1: triptans, dihydroergotamine, and magnesium. Rescue therapy for acute migraine, part 2: neuroleptics, antihistamines, and others.

Rizzoli PB. Acute and preventive treatment of migraine. Acute migraine treatment in emergency settings. Comparative Effectiveness Review Summary Guides for Clinicians.

Agency for Healthcare Research and Quality. Rescue therapy for acute migraine, part 3: opioids, NSAIDs, steroids, and post-discharge medications. Friedman BW, Garber L, Yoon A, et al. Randomized trial of IV valproate vs metoclopramide vs ketorolac for acute migraine. Orr SL, Aubé M, Becker WJ, et al.

Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: the american headache society evidence assessment of migraine pharmacotherapies.

Colman I, Rothney A, Wright SC, et al. Use of narcotic analgesics in the emergency department treatment of migraine headache. Friedman BW, West J, Vinson DR, et al. Current management of migraine in US emergency departments: an analysis of the National Hospital Ambulatory Medical Care Survey.

Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force.

Eur J Neurol ; Loder E, Weizenbaum E, Frishberg B, et al. Choosing wisely in headache medicine: the American Headache Society's list of five things physicians and patients should question. McCarthy LH, Cowan RP. Comparison of parenteral treatments of acute primary headache in a large academic emergency department cohort.

Croop R, Lipton RB, Kudrow D, et al. Goadsby PJ, Dodick DW, Ailani J, et al. Lancet Neurol ; Moreno-Ajona D, Pérez-Rodríguez A, Goadsby PJ. Gepants, calcitonin-gene-related peptide receptor antagonists: what could be their role in migraine treatment? Curr Opin Neurol ; Kirthi V, Derry S, Moore RA.

Aspirin with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev ; :CD Biglione B, Gitin A, Gorelick PB, Hennekens C. Aspirin in the Treatment and Prevention of Migraine Headaches: Possible Additional Clinical Options for Primary Healthcare Providers.

Am J Med ; Rabbie R, Derry S, Moore RA. Ibuprofen with or without an antiemetic for acute migraine headaches in adults. Law S, Derry S, Moore RA. Naproxen with or without an antiemetic for acute migraine headaches in adults. Derry S, Rabbie R, Moore RA. Diclofenac with or without an antiemetic for acute migraine headaches in adults.

Vécsei L, Gallacchi G, Sági I, et al. Diclofenac epolamine is effective in the treatment of acute migraine attacks. A randomized, crossover, double blind, placebo-controlled, clinical study. Myllylä VV, Havanka H, Herrala L, et al. Tolfenamic acid rapid release versus sumatriptan in the acute treatment of migraine: comparable effect in a double-blind, randomized, controlled, parallel-group study.

Lipton RB, Munjal S, Brand-Schieber E, et al. Mainardi F, Maggioni F, Pezzola D, et al. Dexketoprofen trometamol in the acute treatment of migraine attack: a phase II, randomized, double-blind, crossover, placebo-controlled, dose optimization study. J Pain ; Gungor F, Akyol KC, Kesapli M, et al.

Intravenous dexketoprofen vs placebo for migraine attack in the emergency department: A randomized, placebo-controlled trial. Taggart E, Doran S, Kokotillo A, et al. Ketorolac in the treatment of acute migraine: a systematic review. Diener HC, Montagna P, Gács G, et al. Efficacy and tolerability of diclofenac potassium sachets in migraine: a randomized, double-blind, cross-over study in comparison with diclofenac potassium tablets and placebo.

Derry S, Moore RA. Paracetamol acetaminophen with or without an antiemetic for acute migraine headaches in adults. Lipton RB, Baggish JS, Stewart WF, et al. Efficacy and safety of acetaminophen in the treatment of migraine: results of a randomized, double-blind, placebo-controlled, population-based study.

Arch Intern Med ; Lipton RB, Stewart WF, Ryan RE Jr, et al. Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain: three double-blind, randomized, placebo-controlled trials. Arch Neurol ; Pope JV, Edlow JA. Favorable response to analgesics does not predict a benign etiology of headache.

Tfelt-Hansen P, De Vries P, Saxena PR. Triptans in migraine: a comparative review of pharmacology, pharmacokinetics and efficacy. Drugs ; Bartsch T, Knight YE, Goadsby PJ. Ann Neurol ; Pringsheim T, Becker WJ. Triptans for symptomatic treatment of migraine headache.

BMJ ; g Smith LA, Oldman AD, McQuay HJ, Moore RA. Eletriptan for acute migraine. Eletriptan relpax for migraine. Med Lett Drugs Ther ; Havanka H, Dahlöf C, Pop PH, et al.

Efficacy of naratriptan tablets in the acute treatment of migraine: a dose-ranging study. Naratriptan S2WB Study Group. Clin Ther ; Mathew NT, Asgharnejad M, Peykamian M, Laurenza A. Naratriptan is effective and well tolerated in the acute treatment of migraine.

Results of a double-blind, placebo-controlled, crossover study. The Naratriptan S2WA Study Group. Stark S, Spierings EL, McNeal S, et al. Naratriptan efficacy in migraineurs who respond poorly to oral sumatriptan.

Winner P, Mannix LK, Putnam DG, et al. Pain-free results with sumatriptan taken at the first sign of migraine pain: 2 randomized, double-blind, placebo-controlled studies.

Mayo Clin Proc ; Oldman AD, Smith LA, McQuay HJ, Moore AR. Pharmacological treatments for acute migraine: quantitative systematic review. Pain ; Derry CJ, Derry S, Moore RA. Sumatriptan subcutaneous route of administration for acute migraine attacks in adults.

Sumatriptan oral route of administration for acute migraine attacks in adults. Sumatriptan intranasal route of administration for acute migraine attacks in adults. Sumatriptan all routes of administration for acute migraine attacks in adults - overview of Cochrane reviews.

Pfaffenrath V, Cunin G, Sjonell G, Prendergast S. Efficacy and safety of sumatriptan tablets 25 mg, 50 mg, and mg in the acute treatment of migraine: defining the optimum doses of oral sumatriptan. Tfelt-Hansen P. Efficacy and adverse events of subcutaneous, oral, and intranasal sumatriptan used for migraine treatment: a systematic review based on number needed to treat.

Cady RK, Munjal S, Cady RJ, et al. Randomized, double-blind, crossover study comparing DFN injection 3 mg subcutaneous sumatriptan with 6 mg subcutaneous sumatriptan for the treatment of rapidly-escalating attacks of episodic migraine.

J Headache Pain ; Treatment of migraine attacks with sumatriptan. The Subcutaneous Sumatriptan International Study Group.

N Engl J Med ; Prescribing information. Tosymra sumatriptan nasal spray. pdf Accessed on June 19, Bird S, Derry S, Moore RA.

Zolmitriptan for acute migraine attacks in adults. Rapoport AM, Ramadan NM, Adelman JU, et al. Optimizing the dose of zolmitriptan Zomig, C90 for the acute treatment of migraine. A multicenter, double-blind, placebo-controlled, dose range-finding study. The Clinical Trial Study Group.

Dahlöf CG. Infrequent or non-response to oral sumatriptan does not predict response to other triptans--review of four trials. Ferrari MD, Roon KI, Lipton RB, Goadsby PJ.

Thorlund K, Mills EJ, Wu P, et al. Comparative efficacy of triptans for the abortive treatment of migraine: a multiple treatment comparison meta-analysis. Johnston MM, Rapoport AM.

Triptans for the management of migraine. Pascual J, Cabarrocas X. Within-patient early versus delayed treatment of migraine attacks with almotriptan: the sooner the better. Klapper J, Lucas C, Røsjø Ø, et al. Benefits of treating highly disabled migraine patients with zolmitriptan while pain is mild.

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A double-blind, placebo-controlled trial of almotriptan. Christoph-Diener H, Ferrari M, Mansbach H, SNAP Database Study Group.

Predicting the response to sumatriptan: the Sumatriptan Naratriptan Aggregate Patient Database. Burstein R, Collins B, Jakubowski M.

Defeating migraine pain with triptans: a race against the development of cutaneous allodynia. Burstein R, Cutrer MF, Yarnitsky D.

The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine. Brain ; Pt 8 Dodick DW, Martin VT, Smith T, Silberstein S. Cardiovascular tolerability and safety of triptans: a review of clinical data.

Headache ; 44 Suppl 1:S Roberto G, Raschi E, Piccinni C, et al. Adverse cardiovascular events associated with triptans and ergotamines for treatment of migraine: systematic review of observational studies.

Hall GC, Brown MM, Mo J, MacRae KD. Triptans in migraine: the risks of stroke, cardiovascular disease, and death in practice. Jamieson DG. The safety of triptans in the treatment of patients with migraine. Liston H, Bennett L, Usher B Jr, Nappi J. The association of the combination of sumatriptan and methysergide in myocardial infarction in a premenopausal woman.

htm Accessed on November 18, Evans RW. Concomitant triptan and SSRI or SNRI use: what is the risk for serotonin syndrome? Wenzel RG, Tepper S, Korab WE, Freitag F. Ann Pharmacother ; Rolan PE. Drug interactions with triptans : which are clinically significant?

CNS Drugs ; Orlova Y, Rizzoli P, Loder E. Association of Coprescription of Triptan Antimigraine Drugs and Selective Serotonin Reuptake Inhibitor or Selective Norepinephrine Reuptake Inhibitor Antidepressants With Serotonin Syndrome.

New Anti-ihflammatory shows little risk of infection from prostate biopsies. Discrimination ror work is linked to Anti-inflammatofy blood Improves mental performance in high-pressure situations. Icy fingers and toes: Poor circulation or Raynaud's phenomenon? Everyone gets the occasional when-will-this-day-end headache. These headaches may even follow a certain pattern. Mine usually strike like clockwork if I miss my morning cup of French press coffee. But when is a headache cause for concern?

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