The first thing a neurologist would do is order a CT scan or MRI to rule out potentially serious causes such as a tumor, aneurysm, or stroke, says Marc Sharfman, MD, director of the Headache and Neurological Treatment Institute in Longwood, Florida. If those are ruled out, then, besides the nondrug treatments above, Sharfman might suggest biofeedback: He connects patients to devices that monitor muscle tension, blood pressure, and heart rate, then has them practice breathing patterns to identify what helps them relax. Drugs—over-the-counter and prescription—are part of a neurologist's arsenal, but Sharfman notes that patients do best by combining nondrug approaches with minimal medication use.
A primary goal for an acupuncturist is to wean the patient off prescription and over-the-counter painkillers that can trigger rebound headaches (people who regularly take these medications can suffer a headache as soon as the pills wear off), says Daniel Hsu, a practitioner of traditional Chinese medicine and founder of New York AcuHealth, an acupuncture clinic. Acupuncture can help patients relax as well as transition off medications; what's more, a recent review of research found that the technique could halve the number of days a month a person experiences head pain.
Along with prescribing a remedy for the headache, a homeopath will typically offer advice on improving diet or, say, reducing exposure to chemicals in the environment, says Dana Ullman, who runs Homeopathic Educational Services in Berkeley. Because homeopaths believe the body's response to an illness is the correct one, they give heavily diluted substances—often the herbs nux vomica and belladonna for headaches—that are supposed to mimic the patient's symptoms, thereby helping the body defend and heal itself. (Though these two herbs are poisonous, the doses contain no toxins.) Often, the patient can begin to feel much better after one treatment, Ullman says.