How to Treat Different Types of Headaches: An Australian Guide to OTC Relief
At a Glance
Most headaches respond well to simple OTC pain relievers such as paracetamol or ibuprofen — but choosing the right one depends on the type of headache. Tension headaches suit paracetamol or ibuprofen. Migraines respond best to ibuprofen, aspirin, or a paracetamol-plus-caffeine combination taken early. Sinus headaches need a decongestant alongside a pain reliever. If you are getting headaches on 15 or more days per month, see your GP.
Panadol Rapid (Paracetamol 500mg) for tension headaches; Nurofen Migraine Pain for migraines
Generic ibuprofen 200mg from your pharmacy — same active ingredient as Nurofen at a lower cost
Why the Type of Headache Matters
Headaches are one of the most common health complaints in Australia, affecting around 87% of Australians at some point. But 'headache' is not a single condition — it is an umbrella term covering many different types, each with different causes, symptoms, and treatments. Taking the wrong approach can mean the treatment does not work, or in some cases, makes things worse. This guide covers the five most common headache types and the best way to treat each one using products available over the counter in Australian pharmacies.
1. Tension Headaches
Tension-type headaches are the most common headache, accounting for roughly 70% of all headaches. They feel like a dull, constant pressure or tightness on both sides of the head — often described as a band squeezing around the forehead. The pain is mild to moderate and does not usually stop you from carrying on with daily activities.
How to identify a tension headache
- •Dull, aching pain on both sides of the head
- •Feeling of tightness or pressure across the forehead or around the back of the head and neck
- •Tenderness in the scalp, neck, and shoulder muscles
- •No nausea or vomiting (unlike migraines)
- •Not made worse by physical activity
- •Duration: 30 minutes to several hours, sometimes days
Best OTC treatments for tension headaches
Simple analgesics are the first-line treatment. Paracetamol (500mg to 1000mg) is the gentlest option and works well for most tension headaches. Ibuprofen (200mg to 400mg) is an alternative, particularly if there is any muscle or neck tenderness contributing to the pain. Take at the first sign of the headache — do not wait for it to become severe.
Panadol Rapid (Paracetamol 500mg)
Fast-acting pain relief. Gentle on the stomach. Suitable for headaches, fever, and general aches.
Nurofen (Ibuprofen 200mg)
Fast, effective pain relief with anti-inflammatory action. Ideal for period pain, back pain, and inflammation.
Non-medicine approaches
For tension headaches, non-drug strategies can be just as effective as tablets. Try applying a cold or warm compress to your forehead or neck, taking a break from screens, practising slow deep breathing, or gently stretching your neck and shoulders. A short walk in fresh air can also help.
2. Migraines
Migraines are much more than a bad headache. They are a neurological condition causing moderate to severe throbbing pain, usually on one side of the head. Migraines often come with nausea, vomiting, and extreme sensitivity to light and sound. Some people experience an 'aura' before the pain starts — visual disturbances such as flashing lights, zigzag lines, or temporary blind spots. Migraines affect around 12% of Australians and are more common in women.
How to identify a migraine
- •Moderate to severe throbbing or pulsing pain, usually on one side
- •Nausea and/or vomiting
- •Sensitivity to light (photophobia) and sound (phonophobia)
- •Pain worsened by physical activity such as walking or climbing stairs
- •Some people get aura: visual disturbances, tingling, or speech difficulty before the headache
- •Duration: 4 to 72 hours if untreated
Best OTC treatments for migraines
Timing is critical with migraines. Take your OTC pain reliever as early as possible — ideally at the first sign of symptoms or during the aura phase. Delaying treatment significantly reduces effectiveness because migraine slows down stomach emptying, meaning tablets are absorbed more slowly as the attack progresses.
Ibuprofen (400mg) is one of the most effective OTC options for migraines and is supported by good clinical evidence. Soluble aspirin (900mg) is another evidence-based choice — the soluble form is preferred because it is absorbed faster than standard tablets. Paracetamol combined with caffeine (such as Panadol Extra) can also be effective; the caffeine improves absorption and has a mild pain-relieving effect of its own.
Nurofen Migraine Pain (Ibuprofen 200mg)
Specifically formulated for migraine headache relief. Contains ibuprofen 200mg in a soft capsule for fast absorption.
Aspro Clear (Aspirin 300mg)
Soluble aspirin for fast relief of headaches, migraines, pain, and fever. Dissolves quickly for rapid absorption.
Panadol Extra (Paracetamol 500mg + Caffeine 65mg)
Enhanced pain relief combining paracetamol with caffeine. Caffeine has been shown to improve paracetamol's pain-relieving effect for headaches.
What about prescription migraine medicines?
If OTC treatments are not controlling your migraines, ask your GP about triptans. Sumatriptan (brand name Imigran) is now available over the counter in some Australian pharmacies as a Pharmacist Only Medicine (Schedule 3). Your pharmacist can assess whether it is suitable for you. For frequent migraines (four or more per month), your GP may recommend preventive medication.
3. Sinus Headaches
True sinus headaches are caused by inflammation or infection of the sinuses (sinusitis). They produce a deep, constant ache in the cheekbones, forehead, or bridge of the nose. The pain usually worsens when you bend forward or lie down. Important note: research suggests that many headaches people believe are 'sinus headaches' are actually migraines. If your 'sinus headache' comes with nausea, light sensitivity, or throbbing pain, it may be a migraine and should be treated as one.
How to identify a sinus headache
- •Deep, constant pressure or ache in the forehead, cheekbones, or bridge of the nose
- •Pain that worsens with sudden head movement or bending forward
- •Blocked or stuffy nose with thick, discoloured nasal discharge
- •Reduced sense of smell
- •May be accompanied by fever (if infection is present)
- •Usually follows or accompanies a cold or upper respiratory infection
Best OTC treatments for sinus headaches
Sinus headaches require a two-pronged approach: relieve the pain and tackle the congestion. Paracetamol or ibuprofen will manage the pain. A nasal decongestant such as pseudoephedrine (Sudafed) helps reduce sinus swelling and drain the blocked sinuses. Saline nasal sprays or rinses (such as Fess) can help flush mucus and relieve congestion without medication. Steam inhalation is another simple, drug-free option.
Sudafed Nasal Decongestant
Effective relief from nasal and sinus congestion caused by cold, flu, or allergies.
Fess Saline Nasal Spray
Non-medicated saline nasal spray to help relieve nasal and sinus congestion. Drug-free and suitable for daily use.
Do not use nasal decongestant sprays for more than 3-5 days
Medicated nasal decongestant sprays (such as oxymetazoline) should not be used for more than three to five days in a row. Using them longer can cause rebound congestion, where the nose becomes even more blocked once you stop. Oral decongestants like pseudoephedrine and saline sprays do not have this problem.
4. Cluster Headaches
Cluster headaches are rare but extremely painful — often described as one of the most severe pain conditions known. They produce intense, burning or piercing pain behind or around one eye. Unlike migraines, cluster headaches tend to be short (15 minutes to 3 hours) but can occur multiple times a day, often at the same time each day, in 'clusters' lasting weeks or months. They are more common in men.
How to identify a cluster headache
- •Severe, sharp, or burning pain behind or around one eye
- •Pain is always on the same side during a cluster period
- •Eye on the affected side may water, become red, or have a drooping eyelid
- •Nostril on the affected side may become blocked or runny
- •Restlessness — people with cluster headaches often pace or rock during an attack (unlike migraine sufferers who prefer to lie still)
- •Attacks last 15 minutes to 3 hours, often occurring at the same time daily
Treatment for cluster headaches
Standard OTC painkillers are generally not effective for cluster headaches because the attacks are too severe and peak too quickly for oral medicines to take effect in time. If you suspect you are having cluster headaches, see your GP as soon as possible. Effective treatments exist — including high-flow oxygen therapy and fast-acting triptans — but these require a prescription or specialist referral.
When to see your GP about cluster headaches
If you are experiencing repeated episodes of severe, one-sided headache with eye watering or nasal congestion, book an appointment with your GP. Cluster headaches are often misdiagnosed as migraines or sinus headaches, so an accurate diagnosis is important to get the right treatment.
5. Medication-Overuse Headaches
This is a common but often overlooked problem. If you take headache medicines — including paracetamol, ibuprofen, aspirin, or combination painkillers — on 15 or more days per month for three months or longer, the medicines themselves can start causing headaches. It is sometimes called 'rebound headache'. The headache often develops as the previous dose wears off, prompting you to take another dose, creating a cycle that is difficult to break.
How to identify a medication-overuse headache
- •Headaches present on 15 or more days per month
- •Regular use of headache medication for three or more months
- •Headaches have gradually become more frequent over time
- •The headache develops or worsens as each dose of painkiller wears off
- •Pain is often dull and persistent, similar to a tension headache, but may have migraine-like features
- •OTC pain relievers provide less and less relief over time
How to treat medication-overuse headaches
The only effective treatment is to stop the overused medication. This is best done with guidance from your GP, who can help you manage the withdrawal period (headaches typically worsen for one to two weeks before improving). Your GP may also prescribe a preventive medication to break the cycle. Do not attempt to suddenly stop all pain medication without medical advice, especially if you have been using combination products containing codeine.
The 10/15 rule
To avoid medication-overuse headaches, follow the 10/15 guideline: do not use simple pain relievers (paracetamol, ibuprofen, aspirin) on more than 15 days per month, and do not use combination or stronger painkillers (those containing codeine, caffeine combinations, or triptans) on more than 10 days per month. If you need pain relief more often than this, see your GP about a preventive strategy.
Headache Types at a Glance
| Feature | Tension | Migraine | Sinus | Cluster | Medication-Overuse |
|---|---|---|---|---|---|
| Pain type | Dull, pressing, band-like | Throbbing, pulsing | Deep, constant pressure | Sharp, burning, piercing | Dull, persistent |
| Location | Both sides, forehead, temples | Usually one side | Forehead, cheeks, nose bridge | Behind or around one eye | Varies (often widespread) |
| Severity | Mild to moderate | Moderate to severe | Moderate | Severe to excruciating | Mild to moderate |
| Nausea | No | Yes, often with vomiting | Uncommon | Uncommon | Sometimes |
| Light/sound sensitivity | Mild or none | Yes, significant | No | Possible light sensitivity | Mild |
| Duration | 30 min to several days | 4 to 72 hours | Days (while congested) | 15 min to 3 hours per attack | Near-daily, ongoing |
| Best OTC treatment | Paracetamol or ibuprofen | Ibuprofen, aspirin, paracetamol + caffeine | Decongestant + paracetamol or ibuprofen | See GP (OTC usually ineffective) | Stop overused medication (with GP guidance) |
Paracetamol vs Ibuprofen for Headaches: Which Should You Choose?
This is one of the most common questions Australians have about headache treatment. Both are effective, safe, and widely available — but they work differently and suit different situations.
| Paracetamol | Ibuprofen | |
|---|---|---|
| How it works | Reduces pain signals in the brain (exact mechanism not fully understood) | Blocks prostaglandins that cause pain and inflammation (an NSAID) |
| Best for | Tension headaches, mild to moderate pain, when you cannot take NSAIDs | Migraines, headaches with muscle tension or inflammation, moderate to severe pain |
| Onset | About 30 to 60 minutes | About 20 to 30 minutes |
| Take with food? | No (can be taken on an empty stomach) | Yes (take with food or milk to protect the stomach) |
| Stomach friendly? | Yes — gentle on the stomach | Can irritate the stomach, especially with regular use |
| Safe in pregnancy? | Yes (all trimesters, at recommended doses) | Avoid in the third trimester; use only with medical advice earlier in pregnancy |
| Key cautions | Do not exceed 4g per day. Check all other medicines for hidden paracetamol (common in cold and flu products) | Avoid if you have stomach ulcers, kidney problems, or are taking blood thinners. Not suitable for everyone with asthma |
Bottom line: for a standard tension headache, either will work well — choose paracetamol if you want the gentlest option, or ibuprofen if you want faster relief or there is any inflammatory component (such as neck stiffness). For migraines, ibuprofen has stronger evidence of effectiveness. You can also alternate between paracetamol and ibuprofen if one alone is not providing enough relief — they work by different mechanisms, so this is safe for short-term use. Ask your pharmacist for guidance on timing.
How to Prevent Headaches
Prevention is always better than treatment. While you cannot avoid every headache, these evidence-based strategies can significantly reduce how often they occur:
- •Stay hydrated — dehydration is one of the most common and easily avoided headache triggers. Aim for at least 2 litres of water a day, more in hot weather
- •Maintain a regular sleep schedule — both too little and too much sleep can trigger headaches. Aim for 7 to 9 hours per night and try to go to bed and wake up at consistent times
- •Manage stress — regular exercise, deep breathing, yoga, or meditation can reduce stress-related headaches
- •Take regular screen breaks — follow the 20-20-20 rule: every 20 minutes, look at something 20 feet (6 metres) away for 20 seconds
- •Watch your posture — poor posture, particularly when working at a desk or looking down at a phone, puts strain on neck and shoulder muscles
- •Limit alcohol and caffeine — both can trigger headaches. If you regularly drink caffeine, avoid sudden withdrawal as this is a common headache cause
- •Keep a headache diary — tracking when headaches occur, what you ate, how you slept, and your stress levels can help identify your personal triggers
- •Do not skip meals — low blood sugar can trigger headaches, particularly migraines
Red Flags: When a Headache Needs Urgent Medical Attention
Most headaches are not dangerous. However, in rare cases a headache can be a sign of a serious medical condition. Call 000 or go to your nearest emergency department immediately if you experience any of the following:
Seek emergency medical help if you experience
These symptoms may indicate a serious underlying condition such as meningitis, stroke, or brain haemorrhage:
- •A sudden, severe headache that reaches maximum intensity within seconds — often described as the worst headache of your life (thunderclap headache)
- •Headache with fever, stiff neck, rash, confusion, or seizures — may indicate meningitis
- •Headache with sudden vision loss, double vision, difficulty speaking, weakness on one side, or loss of balance — may indicate stroke
- •Headache after a significant head injury, especially if accompanied by drowsiness, vomiting, or confusion
- •A new or different headache pattern in someone over 50 who has never had significant headaches before
- •Headache that progressively worsens over days or weeks and does not respond to any treatment
- •Headache that wakes you from sleep or is worse when lying down, coughing, or straining
You should also make a non-urgent appointment with your GP if your headaches are becoming more frequent, are not responding to OTC treatments, or are affecting your work or quality of life.
Frequently Asked Questions
Can I take paracetamol and ibuprofen together for a headache?
Yes, for short-term use in adults, you can take paracetamol and ibuprofen together or alternate between them. They work by different mechanisms, so combining them can provide better relief than either alone. However, do not do this regularly without speaking to your pharmacist or GP. Follow the recommended dose for each medicine individually — taking both does not mean you should exceed the maximum dose of either.
How often can I take painkillers for headaches?
For occasional headaches, take paracetamol or ibuprofen as directed on the pack (paracetamol every 4 to 6 hours, up to 4g daily; ibuprofen every 6 to 8 hours, up to 1200mg daily for OTC use). The key rule is to avoid regular use on more than 15 days per month for simple analgesics or more than 10 days per month for combination products, as this can lead to medication-overuse headaches.
Is it safe to take aspirin for a headache?
Aspirin is an effective headache treatment, particularly for migraines. Soluble aspirin (such as Aspro Clear) is absorbed quickly and has good evidence for migraine relief at a dose of 900mg. However, aspirin is not suitable for everyone: avoid it if you have a stomach ulcer, bleeding disorder, or aspirin-sensitive asthma. Aspirin must not be given to children or teenagers under 16 due to the risk of Reye's syndrome. Always read the label.
Why do I get a headache when I skip my morning coffee?
Caffeine withdrawal is one of the most common headache triggers. If your body is used to regular caffeine, skipping it causes blood vessels in the brain to widen, which can trigger a headache. This usually starts 12 to 24 hours after your last caffeine intake and can last one to two days. To avoid caffeine withdrawal headaches, reduce your intake gradually rather than stopping suddenly. Interestingly, small amounts of caffeine can also help treat headaches, which is why it is included in some headache products like Panadol Extra.
Are generic painkillers as effective as brand-name products?
Yes. In Australia, all medicines — generic and branded — must meet the same TGA standards for quality, safety, and effectiveness. A 200mg ibuprofen tablet from a pharmacy-own brand contains exactly the same active ingredient at the same dose as a branded Nurofen tablet. The main differences are in the inactive ingredients (binders, coatings) and the formulation (for example, liquid capsules may be absorbed slightly faster than standard tablets). For most headaches, a generic paracetamol or ibuprofen tablet will work just as well at a significantly lower cost.
When should I see a doctor about my headaches?
See your GP if your headaches are occurring on more than two days a week, are getting worse over time, are not adequately controlled by OTC medicines, are new and different from your usual headaches, or are affecting your ability to work or enjoy daily activities. You should also see a doctor if you need to take headache medicine more than two to three days per week to function normally.
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always read the label and follow the directions for use. If symptoms persist, talk to your health professional. See your pharmacist or GP for advice tailored to your situation.
Our Recommendation
For occasional tension headaches, paracetamol or ibuprofen is all most people need. For migraines, ibuprofen or soluble aspirin taken at the very first sign of symptoms gives the best OTC results. Sinus headaches require tackling the congestion as well as the pain. If headaches are frequent, worsening, or not responding to OTC medicines, see your GP — you may need a tailored prevention plan.
