UPMC Headache Center in Pittsburgh, Pa.

Migraines cause throbbing pain on one or both sides of your head. You may have nausea and vomiting and be sensitive to light, sounds, and smells.

A migraine attack can last 4 to 72 hours.

Cluster headaches cause intense piercing pain around the eye or one side of your head. Attacks come in groups with pain that wakes you up at night.

They can last 15 minutes to 3 hours.

Tension headaches are dull, aching pain on both sides of your head or stiff muscles behind your head and neck.

The pain is typically mild or moderate, steady, and non-throbbing, without nausea or light sensitivity.

Sinus headaches come with pain, congestion, and pressure around your nose, cheeks, and forehead.

They're usually linked to a sinus infection so you may have yellow or green drainage and a fever.

With a whole-person treatment approach, our headache clinic:

• Shares lifestyle, food, and supplement choices for headache remedies.
• Works with you to design a plan based on your symptoms and health history.

Your doctor will have you stop taking over-the-counter pain medicine if it no longer helps.

Prescription-strength non-steroidal anti-inflammatory drugs (NSAIDs) may be the next step. NSAIDs reduce inflammation and pain.

UPMC neurologists study the newest advances in prescription medicine.

Your doctor may prescribe medicine to stop the pain, prevent it, or both. They may also prescribe anti-nausea drugs.

Some migraine medicines were initially made to treat other health issues:

• Beta-blockers (to lower blood pressure).
• Antidepressants (to treat depression).
• Antiepileptics (to treat seizures).

Migraine medicine to stop or prevent your headache pain may include:

• Triptans. These drugs balance chemicals in the brain and block pain in the brainstem. They come in a tablet, nasal spray, or shot.
• Calcitonin gene-related peptide (CGRP) receptor antagonists. These drugs reduce pain by turning off an inflammation-causing compound in the brain called CGRP. They also work as a migraine prevention tool.

Your doctor may suggest medicine to prevent headaches, such as:

• CGRP monoclonal antibodies. This drug can prevent migraine and treat cluster headaches. They work by blocking CGRP from causing inflammation and sending pain signals.
• BOTOX^® shots. The FDA approved Botox shots as a chronic migraine treatment in 2010. It reduces the strength and frequency of migraine attacks. Doctors use them to treat chronic migraines that occur more than 15 days per month. You'll get a series of shots, mainly in your scalp, with a tiny needle every three months.

The goal of a nerve block is to block pain signals coming from the nerves of the head and neck.

Pericranial nerve blocks are for migraine and cluster headaches. The shots target the seven main branches of the pericranial nerves in the scalp.

Doctors mostly use nerve block shots as needed, but some people get them every three months. The shots are less invasive, quick, and safe.

Trigger point shots treat migraine, cluster, and tension headache pain from the muscles. With shots at UPMC, your doctor tailors the dose and placement for your pain.

They will:

• Inject an anesthetic, which numbs the pain.
• Sometimes combine corticosteroids with the trigger shots.
• Often use the same solution as a nerve block so that you can get both during the same visit.

Cycle breaker drugs can break the pain of a headache that won't stop for days.

Your doctor can call or send in a prescription for various drug options. These drugs will break the headache cycle and keep you out of the ER.

An oxygen tank and face mask at home can relieve a cluster headache. When you inhale pure oxygen, it reduces blood flow to the brain. This works quickly to stop the pain.

At the UPMC Headache Center, we may use oxygen therapy with a sumatriptan shot for quick pain relief.