Vanquish® Headache Center


Nearly everyone has an occasional headache. Usually it is mild and brief although some headaches may last a long time or feel very severe or recurrent, happening several times a week. Headaches have many causes and are not often associated with serious medical problems. Safe and effective treatments allow most people suffering from a headache to resume their normal activities within a short period of time. It is important to understand what causes a headache and how it might be possible to avoid one.

Irritation of nerve endings from different parts of the head and neck can produce the unpleasant sensation that we recognize as a headache. These pain-sensitive nerves can be stimulated by stress, muscular tension, dilated blood vessels, and inflammation. Although the pain can sometimes feel as though it originates from deep inside the head, the brain tissue itself lacks pain-sensitive nerves and does not cause this kind of discomfort.

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3 Common Headache Types

  • Tension headaches are the most common form of headache and will affect two out of three people at some point in their lives.i The pain is often described as ‘a tight band’ or ‘vise’ felt on both sides of the head. It is usually mild or moderate in intensity and typically lasts 4 to 6 hours. Muscles of the neck and shoulders may also feel sore.
  • Migraines, another type of headache, are characterized by severe pain on one side of the head, nausea, and sensitivity to light, sound, or movement. About 20% of migraines are preceded by an “aura” such as flashing lights or decreased vision.ii The onset of pain is gradual and most migraines last between 4 and 72 hours. Women are 3 times more likely than men to experience a migraine headache.iii  Migraine symptoms are often treated with prescription products.
  • Cluster headaches are less common than migraines. These headaches are characterized by brief recurring episodes of intense pain on one side of the face and are associated with tearing of the eyes or a runny nose.
  • Rarely, headaches are caused by irritation or swelling of structures in the face, skull, or brain. These conditions are associated with more serious underlying medical problems and often require prompt evaluation by a doctor. For example, bacterial meningitis causes a severe headache that is accompanied by a high fever, neck stiffness, and sensitivity to bright light. Sinus headache pain is felt in the cheeks and forehead. It may become more intense when bending forward or lying down. The headache of temporal arteritis can be associated with scalp tenderness and decreased vision.iv

Sourced From i Prevalence of headache in Europe: a review for the Eurolight project Stovner LS, Andree CJ Headache Pain 2010 11:289-299 iii Migraine prevalence, disease burden, and the need for preventive therapy. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF, AMPP Advisory Group Neurology. 2007;68(5):343. ii Migraine aura. Cutrer FM, Huerter K; Neurologist. 2007;13(3):118. iv Giant Cell Arteritis: Suspect it, treat it promptly Villa-Forte A. Cleveland Clinic Journal of Medicine. 2011; 78(4): 265-270
NEXT Causes of Headaches

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Primary Causes of Headaches

Tension headaches can be caused by tight muscles in the shoulders, neck, scalp, and jaw. Often, they are related to stress, irregular meals, poor posture, inadequate sleep, or anxiety.

Migraine headaches are thought to result from abnormal function of the brain’s blood vessels or vascular system. They are often provoked by certain activities, foods, or behaviors, referred to as “triggers” in susceptible individuals. The most common triggers are alterations in sleep patterns, stressors in everyday life, menstrual periods in women, irregular meals, changes in weather, and travel.

Some foods and additives may contribute to the development of a migraine headache.


  • Caffeine-containing products such as chocolate or coffee. Headaches may also occur when people who regularly use caffeine try to cut back.
  • Monosodium glutamate (MSG), a flavor enhancer
  • Alcohol, red wine in particular
  • Artificial sweeteners, a low calorie sugar substitute
  • Tyramine, a naturally-occurring chemical sometimes found in aged cheeses
  • Nitrates and nitrites, preservatives sometimes found in cured meats


  • Common viral illnesses such as the flu
  • Clenching or grinding your teeth
  • Excessive physical exercise
  • Dehydration
  • Holding your head in one position for a long time
  • Poor body position during sleep
  • Medications such as nitrates for chest pain or high blood pressure, anti-viral drugs, and medications used for erectile dysfunction are just a few
  • Overuse of headache medications can lead to “rebound headaches” when they are stopped
Sourced from:
v Tension-type headache Loder E, Rizzoli P BMJ 2008; 336:88-92 vii The triggers or precipitants of the acute migraine attack. Kelman L 2007;27(5):394
vi Migraine and cardiovascular disease Bigal ME, Kurth T, Hu H, Santello N, Lipton RB Neurology 2009; 72: 1864-1871 x Diagnosing and Managing Migraine Headache Mueller LL JAOA 2007; 107(11) ES10-16
NEXT Diagnosis of Headaches

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General Headache Information

Your doctor can often obtain all the necessary information to  diagnose and treat a headache from a detailed series of questions and a careful physical exam. Occasionally, other diagnostic tests are helpful. These include: a CT scan of the head, brain MRI, sinus x-rays, or a lumbar puncture.

Symptoms of a Headache

Concerning features of a headache that may prompt your physician to order one of these tests include:

  • Sudden onset of the worst headache of your life
  • Acute change in your typical pattern of headaches
  • New severe headache in someone over the age of 50
  • Headache that is associated with a seizure or recent head trauma
  • Headache that occurs in the context of a fever, neck stiffness, confusion, weakness, numbness, sensitivity to light, or problems with coordination
  • “Whooshing” or pulsating sounds that are heard with a headache
  • Headaches that vary with changes in head or body position
  • Headaches that occur in people with medical problems such as cancer or AIDS
  • Headaches that are not responding to proper types and amounts of medications

Diagnostic Tests for Headaches

Diagnostic tests that may be performed include the following:

  • A head CT scan is a quick and painless test in which X-rays are passed through the body at various angles to produce images of the skull and brain. It is sometimes used to look for an area of bleeding, swelling, mass, or abnormalities in the skull and sinuses. Although a CT scan can provide a quick and useful assessment of the brain’s overall anatomy, it is not a very detailed test. People with claustrophobia usually do not mind undergoing a head CT. This test involves a relatively low level of exposure to radiation, slightly more than a chest x-ray.
  • A brain MRI, or magnetic resonance imaging, uses magnets and radio waves to create highly detailed pictures of the brain. Significantly more information is revealed than with a CT scan. An MRI takes much longer than a CT scan, sometimes up to an hour. It is necessary to lie still in a narrow tunnel during the entire study. For people with claustrophobia, this may be difficult. If available, “open MRI’s” are a good alternative. If an open MRI is unavailable, a sedating medication may be helpful. People with pacemakers, some metal heart valves, and brain clips need special consideration before undergoing an MRI.viii
  • Sinus x-rays are useful to identify fluid or inflammation of the maxillary (cheek) and frontal (forehead) sinuses, a condition known as sinusitis that can sometimes cause headaches.
  • A lumbar puncture, or spinal tap, is a procedure in which a small needle is inserted between two bones of the lower spine (lumbar vertebrae) to remove a sample of the fluid that surrounds the brain and spinal cord. A lumbar puncture can help determine if a headache is the result of an infection, such as meningitis, bleeding, or increased pressure in the brain.
Sourced from: viii MRI Safety Update 2008:Part 2, Screening Patients for MRI Shellock FG, Spinazzi A AJR 2008; 191:1140-1149
NEXT Treatment of Headaches

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Headache Relief

When a headache does occur, there are a few simple steps to take that may provide fast relief.

  • Act quickly. The earlier treatment for a headache is initiated, the less severe the headache will likely become.
  • Rest, relax, and minimize external stimuli. Lying down in a dark and quiet environment can allow the brain and muscles of the neck, face, and scalp to relax and recover.
  • A non-steroidal anti-inflammatory, and pain relieving over-the-counter (OTC) medication, such as Vanquish®, is a safe and effective choice, when used as directed to treat most headaches. When using these medications, it is important to use the least amount of medicine necessary. In general, use of the recommended dose of a medicine early in a headache will minimize the amount and type of medication that is needed.
    It is important to know what the active ingredient or ingredients are in your medications, as the same drug can be found in more than one medication. Always pay attention to the instructions on a medication’s label and check with your doctor or health care professional if you have any questions or concerns.
  • Prescription medicinesfor headaches are an appropriate choice when over-the-counter medicines fail to relieve the headache or OTC use is more frequent than recommended by your doctor.

NEXT Prevention of Headaches

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Preventive Headache Treaments

When headaches occur more than three times per month, preventive treatment is usually recommended by your doctor.ix Stress reduction, biofeedback, elimination of certain foods from the diet, and drug therapy are the most common methods of preventing and controlling recurring headaches. Some of the most common preventative measures are:

  • Get enough sleep – Most adults need at least 6 to 8 hours of uninterrupted sleep. When possible, try to go to sleep and wake up at consistent hours
  • Eat a healthy diet and stay well hydrated- dehydration and fluctuations in blood sugar can cause a headache
  • Eat meals at regular intervals
  • If you suffer from migraines, be mindful of certain dietary triggers such as cheese, chocolate, MSG, nitrates, artificial sweeteners, and alcohol.
  • Exercise regularly. This can reduce stress and decrease headache frequency. However, excessive physical exertion or inconsistent patterns of exercise may cause a headache
  • Use proper posture
  • Use relaxation techniques such as deep breathing, yoga, or meditation
  • Stop or decrease nicotine use
  • Stretch your neck and upper body, especially if your work involves typing or using a computer
  • If needed, eyeglasses or contact lenses should fit properly and contain an appropriate prescription

Sourced from: ix Pharmacologic Management of Acute Attacks of Migraine and Prevention of Migraine Headache Snow V, Weiss K, Wall EM, Mottur-Pilson C Annals of Internal Medicine 2002; 137(10) 840-852 x Diagnosing and Managing Migraine Headache Mueller LL JAOA 2007; 107(11) ES10-16