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Headache Treatment.

Why does it fail? What might actually work?

Headache treatment options are countless.

If you continue to have headaches despite following a doctors advice, you may well wonder why you still have headaches?

So why did your headache treatment fail?

In a nutshell here's the reasons why your treatment did not give you any satisfaction:

You were scared to use medication and left the bottle unopened
You took the headache medicine at too low a dose or not often enough or not for long enough
The drug was taken at the correct dose, but not for long enough
Your other medication caused a headache medicine not to work properly

This is the BIG one. You have a 50-75% chance of significantly reducing chronic migraine, if you can stop frequent painkiller use.

Sometimes there is more than one headache disorder present, and both need treated
There are important lifestyle adjustments that you can still make
Your expectations of what modern medical practice can deliver are, unfortunately, unrealistic
You have other health complaints that work against successful headache relief
Apart from medication, there are physical or psychological treatments you have yet to try
You have a complex headache disorder that needs highly technical specialist intervention (this is really rare)
You have a truly refractory headache disorder, there is literally nothing else that will work (this is really, reallly rare)

In general, there are several ways of treating headaches, not just medication.

Here's a list of Headache Treatments that might work:

A Headache Friendly Lifestyle which pays careful attention to hydration, sleep, exercise, an enjoyable diet and stress minimisation, can pay for itself.
This is especially if you have migraine that has not yet evolved into chronic migraine.

Of course there are dozens of different Headache Medications most of which should only be used after discussion with a pharmacist or doctor.
In deciding which medication to use it is important to be aware that the scientific evidence for some drugs is a lot better than for others.
The choice of drug is usually determined by a combination of scientific proof, potential side-effect profile and what other health issues you may have.

Physical Treatments like physiotherapy to the cervical spine, have been used for years and years.
However, not all headaches are referred from neck joints. Cervicogenic headache, which is due to pain from facet joints in the neck can be helped significantly.

Injections - like Botox for Migraine or Occipital Nerve Anaesthetic Injections ("occipital nerve blocks") do have a role in specific situations.
Botox is now licensed for use in Chronic Migraine.
Occipital Nerve Blocks can offer temporary relief (for days to weeks) in almost any headache. Occipital Nerve Blocks containing steroids can be used as a treatment for Cluster Headache.

Intravenous Infusions for Refractory Migraine like IV Dihydroergotamine, or IV Chlorpormazine for Sustained Severe Migraine Attacks can be helpful in very specific situations, but they are not without some side-effect risk.

Implantable Occipital Nerve Stimulators, are being tested in migraine and cluster headache with some success.

Deep Brain Stimulation - it's role not yet fully established. It has been used in the most severe forms of chronic cluster headache.
Deep Brain Stimulation is brain surgery that carries small but catastrophic risks, which is why it's role remains highly restricted.

Lastly there is - Doing Nothing. Yes that's right. It's not a typo! There are some people who feel exhausted by medical intervention.
Eventually they seem to come to terms with headaches when they stop all headache treatment. They cope better using their own strategies.
This is best discussed with your own doctor first as many long term medications will need to be withdrawn carefully to avoid a complication of medication withdrawal.
There is always the option of going back to some ordinary medication down the line if needed.