A variety of drugs have been used to help treat headache pain. Aspirin, ibuprofen, and naproxen all are NSAIDs, which work by blocking natural enzymes and proteins that contribute to pain and swelling. And prescription triptans, including Imitrex, act on the neurochemicals that cause pain. But experts say there are other options.

Alternative remedies:
Biofeedback: This form of relaxation training teaches you to read your body’s responses to stress. As you become more aware of your own signals—a clenched jaw, shallow breathing, a tight neck—you learn to control them, and this results in fewer and less-severe headaches. This nondrug treatment may teach you a useful lifelong skill, but it can be a bit pricey. Formal training, which is offered at many headache clinics, can run as much as $850 for 10 sessions; some insurance programs will cover a portion of the cost. Home systems are available for as little as $100.

Acupuncture: In a huge German study, researchers looked at more than 15,000 people with migraine and tension-type headaches. Results showed that those treated with both acupuncture and regular medical care improved significantly more than those who had regular medical care alone.

Botox: Widely known as a beauty procedure, Botox is also used off-label to treat migraines. Injections are given in the forehead, around the eyes, at the temples, or on the back of the neck. Treatment costs $700 to $1,200, and studies show that it can relieve headaches for up to three months.

Supplements: Magnesium, co-enzyme Q10, vitamin B2, feverfew, and butterbur all have been shown in studies to help ease headaches. Talk to your doctor before taking them. Upside: These treatments are all-natural and relatively inexpensive. Downside: It may take a few months to see results.

The new meds:
Treximet: This Rx, which became available last year, combines the existing migraine medicine Imitrex with naproxen to treat migraines. Studies show the two-drug combo can be more effective than taking either medication alone, and a single dose has a longer effect.

Migralex: Just out this spring, this over-the-counter pain reliever combines aspirin and magnesium. The magnesium relieves headaches on its own and may also help the stomach absorb and tolerate aspirin. On the downside, aspirin may upset some people’s stomachs, and magnesium can sometimes cause diarrhea, says Merle Diamond, MD, a headache specialist at the Diamond Headache Clinic in Chicago.

Coming soon:
Telecagepant: This drug blocks the receptor of calcitonin gene-related peptide (CGRP), a substance that’s released during migraines. Doctors often prescribe triptans to deal with CGRP, but some people can’t take them. Telecagepant is about a year away from receiving approval.

Transcranial Magnetic Stimulation (TMS): Used as a depression treatment, this technique may work on headaches, too. A device would deliver a powerful—but painless—electromagnetic pulse to zap headache-related electrical activity in your head.

This article was first published in Health magazine, May 2009.

Could it be something you ate? Not enough sleep? Want to know what could be causing your headache? Our comprehensive list just might help you out.

1. Your weight
In a recent study, researchers found that women with mild obesity (a body mass index of 30) had a 35 percent greater risk of headaches than those with a lower BMI. Severe obesity (BMI of 40) upped the chances to 80 percent.

2. Your personality
Certain traits, including rigidity, reserve, and obsessivity may make you headache-prone. If that sounds like you, it could be time to sign up for relaxation training.

3. The big O
In one survey, 46 percent of headache sufferers said sex had triggered a headache. Usually, this is an overexertion headache (like joggers and weight­lifters sometimes get); you may feel a dull pain that builds during foreplay or get a sudden headache around orgasm (more likely in men). In rare cases, such an intense headache could be caused by a tumor or aneurysm. For most folks, though, sex headaches are harmless.

4. That three-day vacay
Weekend or “let-down” headaches can happen when you take a break from your routine, says Alexander Mauskop, MD, founder and director of the New York Headache Center and co-author of What Your Doctor May Not Tell You About Migraines. Ease into the change by keeping your sleep time as normal as possible—you’ll end up feeling more rested than if you stay in bed until noon.

5. Your bathroom paint job
It’s not just arguing over paint colors that can give you a headache; fumes from traditional paints can trigger pain. Many companies now make nearly odorless, low-VOC (volatile organic compound) formulas, like Benjamin Moore’s Natura line or Devoe’s Wonder Pure.

6. Dehydration
You don’t have to drink gallons of water to stay hydrated, says John La Puma, MD, author of ChefMD’s Big Book of Culinary Medicine, “I’d love it if people got more water from eating fruits and vegetables because then they’d get all the other good things that come with them.”

7. Skipping meals
We know you’re busy, but hunger is a common headache trigger.

Take the Migraine Quiz: Find out what really triggers that debilitating pain in your head.

8. Too much caffeine
A little can help headaches, but too much can trigger them, New York City neurologist Audrey Halpern, MD, says. If caffeine is causing your pain, gradually cut back until you have caffeine no more than two days a week.

9. Inactivity
A recent Swedish study showed that those who were inactive were more likely to get headaches than those who worked out. Aim for 20 to 30 minutes of cardio a day, five days a week, to relieve stress, send blood to the brain, and get feel-good endorphins flowing. Exercise may be a trigger for some people, so consult your doc first.

10. Sleep deprivation
One large study says those who slept an average of six hours a night tended to have significantly more severe and more frequent headaches than those who got more zzz’s.

Don’t feed your headache
Everyone reacts differently, but some foods are known to trigger headaches for many people—and others (especially those rich in magnesium) seem to help prevent them.

Take the Migraine Quiz: Find out what really triggers that debilitating pain in your head.

This article was first published in Health magazine, May 2009.