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Chronic daily headaches can interfere with your job, your relationships and your quality of life. But you can cope with the challenges.

* Take control. Commit yourself to living a full, satisfying life. Work with your doctor to develop a treatment plan that works for you. Take good care of yourself. Do things that lift your spirits. Set aside time for your loved ones — and yourself — every day.
* Seek understanding. Don’t expect friends and loved ones to instinctively know what’s best for you. Ask for what you need, whether it’s time alone or less attention focused on your headaches.
* Check out support groups. When your head is throbbing, companionship may be the last thing on your mind — but perhaps it’s just what you need. A support group can put you face to face with people who share your physical symptoms and emotional responses. You may learn useful coping strategies — or help others by sharing some of your own.
* Consider counseling. A counselor or therapist can help you manage stress and maintain your emotional balance. Through therapy, you can learn to change behavior that’s not good for you and reinforce behavior that’s helping you manage your headaches.

Complementary and alternative therapies

For many people, complementary or alternative therapies offer welcome relief from headache pain. It’s important to be cautious, however. Not all complementary or alternative therapies have been studied as headache treatments, and others need further research.

* Acupuncture. This ancient technique uses hair-thin needles to promote the release of natural painkillers and other chemicals in the central nervous system. There is some evidence that it can help control headaches and other conditions that cause chronic pain.
* Biofeedback. With this relaxation technique, you can learn to control headaches by producing changes in bodily responses such as muscle tension, heart rate and skin temperature.
* Meditation. During meditation, you focus on a simple activity, such as breathing or repeating a single word or phrase. The practice creates a deeply restful state in which your breathing slows and your muscles relax — which can help you manage pain and reduce the stress that can trigger or worsen a headache.
* Massage. Massage can reduce stress, relieve tension and promote relaxation. Although its value as a headache treatment hasn’t been determined, massage may be particularly helpful if you have tight, tender muscles in the back of your head, neck and shoulders.
* Herbs, vitamins and minerals. Some dietary supplements — including magnesium, feverfew and butterbur — seem to help prevent or relieve some types of headaches, but there’s only modest scientific support for these claims. If you’re considering using supplements to treat headaches, check with your doctor. Some supplements may interfere with the effectiveness of prescription or over-the-counter drugs or have other harmful effects.
* Chiropractic care. Spinal manipulation can effectively treat some types of pain, but studies don’t support claims that chiropractic care relieves headaches. Chiropractic manipulation of the neck has been associated with injury to the blood vessels supplying the brain. Rarely, this may cause a stroke.

If you’d like to try a complementary or alternative therapy, discuss the risks and benefits with your doctor.

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Nontraditional therapies may be helpful if you have chronic headache pain:

* Acupuncture. In this treatment, a practitioner inserts many thin, disposable needles into several areas of your skin. The penetration is so shallow and the needles are so thin that acupuncture generally causes little or no pain or discomfort. A number of clinical trials have found acupuncture may be helpful for headache pain, but evidence from these trials isn’t strong enough for experts to routinely recommend this treatment.
* Biofeedback. Biofeedback appears to be especially effective in relieving migraine pain. This relaxation technique uses special equipment to teach you how to monitor and control certain physical responses, such as muscle tension. This technique can be combined with preventive medications.
* Massage. Although massage is a wonderful way to reduce stress and relieve tension, its value in treating headaches hasn’t been fully determined. For people who have tight, tender muscles in the back of the head, neck and shoulders, massage may help relieve headache pain.
* Herbs, vitamins and minerals. There is some evidence that the herbs feverfew and butterbur may prevent migraines or reduce their severity. A high dose of riboflavin (vitamin B-2) also may prevent migraines by correcting tiny deficiencies in the brain cells. There is also some evidence that coenzyme Q10 supplements may be helpful in some individuals. Oral magnesium sulfate supplements may reduce the frequency of headaches in some people, although studies don’t all agree on this issue. In addition, infusions of magnesium sulfate seem to help some people during an acute headache, and they seem to relieve migraine pain in people with magnesium deficiencies. Ask your doctor if these treatments are right for you. Don’t use feverfew or butterbur if you’re pregnant.
* Cervical manipulation. There are no scientifically valid studies that prove that chiropractic or other spine-manipulation treatments are effective in the treatment of migraine.

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Caffeine is contained in many food products (cola, tea, chocolates, and coffee) and OTC analgesics. Caffeine in low doses can increase alertness and energy, but caffeine in high doses can cause insomnia, irritability, anxiety, and headaches. The over-use of caffeine-containing analgesics causes rebound headaches. Furthermore, individuals who consume high levels of caffeine regularly are more prone to develop withdrawal headaches when caffeine is stopped abruptly.

Chocolate, wine, tyramine, MSG, nitrites, aspartame and migraine

Chocolate has been reported to cause migraine headaches, but scientific studies have not consistently demonstrated an association between chocolate consumption and headaches. Red wine has been shown to cause migraine headaches in some migraine sufferers, but it is not clear whether white wine also will cause migraine headaches. Tyramine (a chemical found in cheese, wine, beer, dry sausage, and sauerkraut) can precipitate migraine headaches, but there is no evidence that consuming a low-tyramine diet can reduce migraine frequency. Monosodium glutamate (MSG) has been reported to cause headaches, facial flushing, sweating, and palpitations when consumed in high doses on an empty stomach. Nitrates and nitrites (chemicals found in hotdogs, ham, frankfurters, bacon and sausages) have been reported to cause migraine headaches. Aspartame, a sugar-substitute sweetener found in diet drinks and snacks, has been reported to trigger headaches when used in high doses for prolonged periods.

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