Headaches have plagued humans for thousands of years. Ancient human remains with evidence of an early form of neurosurgery known as “trepanation” have dated back as early as 7000 BC.1  Trepanation involved removing a portion of bone from the skull. A common belief during this time was that headaches and other neurological disorders like seizures were caused by evil spirits trapped inside the head. The hole presumably allowed the spirit to escape. This procedure was recommended as a treatment for migraines as recently as the 1600s.1

Today, many people think a headache is just a headache, but for some, they are much more than that. Headaches are an incredibly common condition, in fact, they are the most common form of pain.2 Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks.3 Nearly everyone has either had a headache themselves or knows someone who has. They can be extremely debilitating, and may impact the ability to live and work normally. Headaches are a major reason why people miss work or school or visit a health care provider.2

Not all headaches are the same. Differences exist in everything about them including what triggers them, the type of pain one feels, the location of the pain, and what makes them better or worse. As always, the goal of a naturopathic physician is to treat the cause so there is no single approach to the treatment of headaches or migraines. Instead, naturopathic medicine has many treatment options to offer when managing headaches and migraines that enable the naturopathic physician to tailor the protocol to the individual patient and the cause of the problem.

Common Headache and Migraine Triggers

  • Stress
  • Emotional distress
  • Hormonal imbalance
  • Certain foods or food allergies
  • Environmental exposures,
  • Infection
  • Constipation
  • Blood pressure issues
  • Drugs and Alcohol
  • Fatigue
  • Eyestrain
  • Nutritional deficiencies.

Types of headaches and clinical features

Tension Headache: These are the most common type of headache experienced by adults and older children/teens. Also known as stress headaches, they tend to come on slowly and can be episodic appearing only every now and then or chronic appearing more than 15 days per month for months on end. They are typically non-progressive, involving mild to moderate pain and a tightness similar to the sensation of a band around the head. The pain is typically dull and diffuse effecting both sides of the head and may be accompanied by tenderness of the scalp, neck, or shoulders. They can be brief lasting less than an hour to extended, with pain lasting a week.

Cluster Headache: Cluster headaches are less common than tension headaches or migraines but are the most severe headache type.4 They are typically characterized by intense, piercing, burning, sudden-onset pain often localizing behind one eye. Cluster headaches, as the name implies, are likely to occur in groups over a period of time from weeks to months and may occur daily or even multiple times per day with the pain pattern tending to recur in the same manner each time. They can last from one-three hours and there may be months or even years between cluster episodes.

Migraine Headache: Migraines are the third most prevalent illness in the world, impacting around 1 billion men, women, and children worldwide.3 Migraines are much more than just a really bad headache – they are a neurological condition accompanied by extremely debilitating neurological symptoms. More than 90% of sufferers are unable to work or function normally during their migraine.3 Migraines typically occur only on one side of the head (though in around 33% of cases both sides are affected) and involve severe, throbbing pain that is often accompanied by other symptoms such as visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face.3 Migraines can last anywhere from a few hours to several days and can occur in both episodic and chronic patterns. Around 85% of chronic migraine sufferers are women.3 Migraines may also involve a genetic component. A child who has one parent with migraine has a 50% chance of inheriting it, and if both parents have migraine, the chances rise to 75%.3

Naturopathic Management of Headaches and Migraines


Riboflavin: A prominent member of the B-vitamin family, riboflavin (vitamin B2) has been investigated for its role in the prevention or headaches, particularly migraine type headaches. Multiple clinical trials have shown the benefit of riboflavin for migraine prophylaxis.5 Riboflavin use has been associated with reduction in frequency of migraine attacks as well as reduction in the use of anti-migraine medications.6

Magnesium: Low levels of magnesium have been detected in those suffering from a variety of headache types.7 Magnesium has a long history of effective use in migraine prevention. Additionally, magnesium has been shown to be effective as an acute treatment option for headaches including migraines, tension- type headaches and cluster headaches, particularly when administered via IV to those with low blood levels.7

CoQ10: CoEnzyme Q10, also known as ubiquinone, is used by the cells to generate energy. CoQ10 is naturally present in the human body but can also be taken in supplement form. It has potent antioxidant properties and is well known for its cardiovascular benefits. Studies of the use of CoQ10 in headache management have yielded positive results. A 2017 study suggests that CoQ10 might reduce the frequency of headaches, and may also make them shorter in duration, and less severe, with a favorable safety profile.8


Butterbur: Butterbur (Petasites hybridus) Butterbur is a shrub that grows in Europe and parts of Asia and North America, typically in wet, marshy ground.9 Historically, butterbur has been used to treat many ailments from the plague to skin wounds. Studies have validated the use of butterbur in the prevention of migraines. In a randomized clinical trial, a standardized extract of butterbur was shown to decrease the frequency of migraines by up to 60% with no adverse events reported.10

Note: Butterbur that is raw and unprocessed contains chemicals known as pyrrolizidine alkaloids or PAs. These chemicals can be harmful and may cause liver damage or result in serious illness. Commercial butterbur products have typically been processed to remove PAs and are labeled as PA-Free. These are the only types that should be used.

Feverfew: Feverfew (Tanacetum parthenium) is a member of the daisy family and is native to the Balkan Peninsula. It has yellow—green leaves and yellow tubular florets with numerous small white flowers that resemble those of chamomile (with which it is often confused). It has a long history of use as a treatment for headaches, particularly migraines. Research shows that consuming feverfew reduces the frequency of migraine headaches and headache symptoms, including pain, nausea, vomiting and sensitivity to light and noise.11


Diet plays a major role with nearly all medical conditions; headaches migraines are no different. The mechanisms though which diets may precipitate headache include their effects on neuropeptides, neuro-receptors and ion channels, inflammation, sympathetic nervous system, release of nitric oxide, vasodilation, and cerebral glucose metabolism.12 Substances found in foods such as caffeine and MSG can be related to headaches. Withdrawal of caffeine or administration of MSG have produced very strong and reproducible results in terms of resulting in headaches.13 Other foods such as those containing gluten and histamine as well as alcohol are all well-known headache triggers. Food allergies may also play a role. Multiple randomized controlled trials reported that an elimination diet of IgG positive foods significantly decreased frequency of headaches and migraines.13


Acupuncture is a therapeutic technique often used in Traditional Chinese Medicine. It involves the insertion of very thin needles into various points on the body. It is not painful and has extremely low risk of side effects. Acupuncture has been investigated for its benefits in pain management in multiple clinical trials with good success. A systematic review of 22 clinical trials found evidence that acupuncture reduces the frequency of headaches by 50% in over half of the participants.14 This effect is similar to that seen with preventive medications.

Environmental Medicine

Exposure to environmental toxins, including pollution, smoke, chemicals-based cleaning products, perfumes, air fresheners, as well as off gassing from household goods may lead to headaches. Avoiding these exposures is an effective means of preventing headaches that are due to environmental exposure. Eliminating personal and household use of scented products such as dryer sheets, perfumes, air fresheners, and scented candles can go a long way towards minimizing exposure. Utilizing fewer toxic methods of cleaning such as steam, vinegar, or essential oils can also be helpful

Other Therapies

Other therapeutic options such as biofeedback, mind-body therapies, physical medicine, craniosacral therapy, naturopathic adjustment techniques, massage, stress management, meditation, yoga, tai chi, as well as energetic therapies like reiki and homeopathy may also be included in a naturopathic headache protocol.

Having your case reviewed by a clinically trained naturopathic physician is the best way to determine which naturopathic therapies might be of the most benefit for your specific circumstances. Because each person is unique and naturopathic physicians are more concerned with the individual versus the diagnosis, they focus on the specifics of the individual and what they are experiencing in order to develop a comprehensive plan to address the root cause of the issue and resolve the problem for good.

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