Updated 10 February 2016

Preventing headaches

There are two approaches to preventative treatment for headaches. An expert explains.

There are two approaches to preventative treatment. One entails reducing the sensitivity of the migraine generator by means of drugs, and the other focuses on reducing the number of impulses reaching the migraine generator. 

All drugs have side effects and this approach is only recommended if all else fails. In addition, the drugs used to prevent primary headaches are often not effective.

It is preferable to make every effort to diagnose where abnormally high numbers of impulses are coming from and why, and to treat the cause or causes. In most primary headache sufferers, it is possible to achieve effective prevention without the use of drugs.

The best way to get to the root of the problem is by a “multidisciplinary” approach. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. 

For this reason, the expertise of different specialists who would normally treat headache patients in isolation, is combined and integrated into a single more comprehensive body of knowledge. This makes it possible to provide a coordinated treatment plan, so that all the contributing factors are addressed.


There are several common-sense courses of action that may well prevent headaches by removing the triggering factors: A change in lifestyle that reduces stress may be enough – although for the majority of people, changing one’s lifestyle is in practice impossible.

Some sufferers notice that certain situations or habitual patterns of behaviour are likely to trigger headache. Avoiding certain trigger foods and chemical compounds (perfumes, smoke) may be helpful in the management of migraine. 

Getting regular exercise, avoiding excessive caffeine and alcohol, stopping smoking and ensuring adequate hydration may also be helpful in some individuals – and these steps have many other benefits.

Preventative medications

Prophylactic medications are taken daily and are directed towards preventing the headache from developing in the first place. They are not pain medications.

Read more:

Treating headaches

Causes of headaches

Diagnosing headaches

Reviewed by Dr Elliot Shevel, BDS, Dip MFOS, MB, BCh, Maxillo-facial and Oral Surgeon and Medical Director, The Headache Clinic, Johannesburg and Cape Town, February 2015.

Previously reviewed by Dr Andrew Rose-Innes, MD, Department of Neurology, Yale University School of Medicine, New Haven


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Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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