Pain/Inflammation: Headache
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Overview
Everyone experiences a headache now and then. Headaches are a common cause of pain and one of the most frequent reasons for absences from work and school. According to the World Health Organization, an estimated 47% of individuals experience a headache at least once a year. Headaches are commonly categorized as primary or secondary. Primary headaches account for approximately 90% of headaches and are not related to an underlying illness. Examples include tension headaches, cluster headaches, migraine headaches, and medication overuse headaches (also known as rebound headaches). Secondary headaches result from an underlying condition such as head trauma, stroke, or viral and bacterial infection. Patients experiencing chronic headaches and secondary headaches should always be referred to their primary health care provider for further medical evaluation and treatment.

Signs and Symptoms
Although the signs and symptoms of headache may vary from person to person, they often include the following:
  • Dull and aching head pain
  • Tenderness across the scalp, neck, and shoulders
  • Tightening sensation or feeling of pressure across the forehead, sides of the head, back of the head, and neck
Causes/Common Triggers
The causes or triggers of headache vary in each individual, but the following factors are often considered causative:
  • Emotional or mental stress, anxiety
  • Brightness from computer screens and other electronic devices<
  • Excessive noise
  • Overexertion
  • Hormone fluctuations during menstruation or menopause
  • Overuse of analgesics
  • Changes in sleep and/or eating patterns
  • Adverse effect of some medications
  • Poor posture
  • Dehydration
Tests and Diagnosis
Although most headaches are mild and easily managed with self-treatment, individuals who experience chronic and/or secondary headaches should seek medical care to determine the cause. Your doctor will review your medical history, medication profile, and symptoms as well as conduct a physical and neurologic examination. Other tests may be ordered to rule out other medical conditions.

Prevention
You can often prevent headaches by:
  • Avoiding headache triggers when possible
  • Getting enough sleep
  • Limiting alcohol, caffeine, and sugar
  • Staying hydrated
  • Establishing a regular exercise routine
  • Reducing stress and using relaxation techniques
  • Taking frequent breaks when working on computers and other electronic devices
  • Maintaining good posture when sitting for long periods of time
Management
Headaches can be managed effectively in several ways:
  • Take an appropriate pain relief medication as soon as a headache starts.
  • Manage your stress level.
  • Rest when needed.
  • Use an ice pack to provide relief.
  • Take a hot bath or shower to relax.
  • Keep a headache diary to identify possible triggers.
Treatment and Care
Treatment for a headache depends on the severity, the symptoms, and the cause of the headache. Treatment may include the use of OTC or prescription analgesics. Your doctor will determine the best treatment to suit your individual needs.

Homeopathic and Alternative Remedies
Many patients who experience headaches rely on alternative forms of treatment, including herbal remedies and homeopathic medicine. Alternative remedies may include the following:
  • Herbal remedies (butterbur and feverfew)
  • Supplements such as riboflavin and coenzyme Q10
  • Relaxation techniques
  • Biofeedback
  • Acupuncture
To prevent harmful drug interactions or contraindications, it is very important to check with a pharmacist or physician before taking any supplements.

Self-Care
A host of OTC products can provide relief from headache pain, including acetaminophen, aspirin, ibuprofen, and naproxen. These medications should be taken as directed because overuse may actually cause a type of headache known as a rebound headache or medication overuse headache. To prevent drug interactionsor adverse reactions, it is important to discuss the use of these products with a doctor or pharmacist before using them. A pharmacist can counsel you regarding the proper use of these products and can provide advice or recommendations based on your preferences and symptoms.

Educational Resources
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