Welcome back to Just Curious, Strong Women’s weekly series exploring all the random health and fitness questions you’ve always wondered about but never got the answers to.

This week, we’re looking into why certain headaches seem to be resistant to pain medication, and how to deal with these types of headaches when they strike.  

There’s nothing quite like an out of the blue headache to ruin your day – you know, those behind-the-eyes ones that strike without warning and make it hard for you to concentrate.

But if there’s one thing worse than surprise headaches, it’s surprise headaches which don’t respond to pain medication. Dealing with a headache is bearable when you know a couple of ibuprofens will take the edge off, but there’s nothing worse than taking pills and still being forced to retreat to a dark, quiet room for the rest of the day to cope with the pain.

There seems to be very little rhyme or reason as to why these headaches seem impenetrable. But is there an explanation for all this? We asked Dr Luke Powles, associate clinical director at Bupa Health Clinics, to share some insight.

Whether or not a headache will respond to pain medication largely depends on the type of headache you’re experiencing. There are more than 150 different types of headaches in total, although some are a lot more common than others. A few of the most common types include tension, migraines, exertion and hormonal.

Tension headaches – the most common type – are most likely to respond to over-the-counter medication, Dr Powles explains. Exertion headaches also tend to respond well to pain medication, while others – like cluster headaches – don’t respond at all. Having two types of headaches at the same time can also make them less likely to respond to medication.

Migraines can be tricky too. “Usually, migraines need specific medication designed to be taken as soon as the first symptoms of migraine are felt,” he says. That doesn’t mean that ibuprofen or paracetamol won’t take the edge off – in some cases, they can be effective. However, overusing painkillers can make the situation worse. In these cases, headaches may become resistant to medication simply because of overuse.

“If you use painkillers too frequently, the medication itself may cause your headaches,” he adds. “Rebound headaches, also known as medication overuse headaches, are diagnosed when you’ve been taking headache medication for more than 10-15 days a month for at least three months. This tends to be the most common reason that headaches don’t improve with pain medication.”

In situations like this, experts believe the effectiveness of pain medication begins to wane over time, leading to shorter periods of pain relief which result in repetitive chronic headaches. 

If your headache doesn’t get better with medication, it’s important to look into other ways of dealing with your pain. Using over-the-counter pain relief for over two days a week can increase your risk of rebound headaches, so you need to be careful about how you use it.

Dr Powles explains: “Always use it as instructed on the box’s label. It can also be handy to take the medication at the first sign of a headache rather than waiting for it to get worse and then taking it.”

Other things you can do to ease your headaches include looking at your lifestyle to see if there’s any way to prevent them in the first place (are you drinking enough water, eating the right food and getting enough sleep?) and using self-care techniques.

“Resting in a cool, dark, quiet room is good for relieving migraines,” Dr Powles says. “Taking part in massage and relaxation therapy may help with tension headaches, as can experimenting with hot or cold compresses. Apply these compresses to your head and neck to see if they can provide relief.” 

If you’re suffering with headaches on a regular basis – more than once a month every month for at least three months – or you experience symptoms alongside your headaches like an increase in temperature, vomiting or a loss of vision, balance or speech, then it’s important to speak to a health professional.

You should also keep note (or ask those around you to note) of any changes in your behaviour, personality or ability to recall memories when you’re experiencing your headaches.

“Your health professional may ask you to keep a headache diary, including your sleep, eating, drinking and lifestyle habits, to see if there are any patterns or triggers to your headaches,” Dr Powles adds. “Regular headaches may be a sign of poor mental health, poor posture, eye strain, temporomandibular jaw disorder (TMJ), arthritis in your neck, high blood pressure, sinus infections or sleep disorders.” 

Images: Getty