taking ibuprofen for tension headaches

December 31, 2012 7:29 PM

How many days in a row can you take ibuprofen for headaches before it becomes unhealthy?

I have been suffering for the past 3 days from dull headaches. I'm 99% sure that they are tension headaches, because lately I've been even more intensely stressed out (and depressed) than I usually am.

Stress has been an issue for me for a very long time (thanks to having to deal with multiple jobs, grad school, and family issues!) but this is the first time that I've had to deal with day after day of headaches. My neck and shoulders also hurt. I've been taking two tablets ibuprofen every day for the past 3 days, sometimes twice a day. I've had a headache for the past 4 or 5 hours, but I'm trying to ignore it because I'm worried about taking ibuprofen so often.

Is it okay to keep taking ibuprofen for these headaches? Is there anything else I can do to make them go away? I feel better for an hour or so after napping, after which the headaches return, but I can't keep napping. I have things to do! I guess "stop stressing" would be a good idea... :/

Thanks for the advice in advance!

posted by joyeuxamelie to health & fitness (25 answers total)

Two tabs a day? That's not only under the maximum dosage, it's probably not enough to do anything useful for you. According to my bottle, the max is 6 in 24 hours, for up to 10 days. (Those are for 200 mg tablets, which are I believe the most common size, but do double-check.) I know I need to take close to that for about a day before I see much relief at all.
posted by restless_nomad at 7:39 PM on December 31, 2012 [3 favorites]

If Advil, stretching/posture maintenance, drinking water, staying in the cool/dark/quiet for the most part, and eating healthily haven't improved continuous headaches after 48 hours, I call my doctor. If the headache doesn't respond to 800mg (four tabs) taken in six to eight hours, I generally call the very next day or even that night, because that's extremely unusual for me. Same with "pain so bad it interferes with sleep." (I honestly think the extremely unusual for me bit is the important part.)

I've never had muscle pain/aches/etc. (that actually responded to Advil or any other OTC product) that lasted so long as to bring up "am I taking this for too long" issues. The continuous pain I had a few years ago was bad enough that I went to urgent care after about ten hours - by bad enough I mean "can't see straight, can't eat."

If it's daily headaches that come and go, I wait till it's been seven to ten days (ten days is what it says on the Advil website.)

Chronic daily headache is defined as 15 or more days per month. Don't freak out too much at this point. Treat these like migraines (be gentle with yourself, basically) and they'll probably go away.
posted by SMPA at 7:50 PM on December 31, 2012 [1 favorite]

Anacdata: my surgeon prescribed 300mg 4x/day for *six weeks*. Granted, I'm sure that wasn't great for my liver, but I needed it to keep post-surgery swelling down. I think you're totally fine.

In terms of what to do for the headaches: get plenty of sleep, take a hot bath now and then, get some gentle exercise, meditate for 20 minutes a day, drink about twice as much water as you think you should, and be nice to yourself.
posted by Specklet at 7:51 PM on December 31, 2012

You're fine, and could definitely increase the dose. Ibuprofen is only effective for about four hours. 500mg several times a day is usual. I've been prescribed 600mg pills for back pain, so the over the counter dosage is well below the actual limit you can take per dose.
posted by catatethebird at 7:51 PM on December 31, 2012

I broke T-12 in 2005. At my doctor's direction, I took 4 tablets of Ibuprofen and 2 tablets of Tylenol every six hours for 3 months straight. I remember saying 'won't that kill my liver or my intestines, or something like that?' and him responding something along the lines of a Louis CK skit (the whole thing is the explanation, 2:14 is the start of the actual pain medication advice). His actual advice was that I could basically take as much ibuprofen as necessary, but that the Tylenol was at the absolute edge of what was okay.
posted by Nanukthedog at 8:16 PM on December 31, 2012

You are taking less than the recommended dosage. Don't worry!
posted by Perplexity at 8:34 PM on December 31, 2012

With tension headaches that I can tell originate in my neck/shoulders, I have more luck slathering on one of those stinky lotions/ointments for pain relief. Tiger Balm, Tylenol's pain relieving cream, Bengay, whatever. They're smelly, but they loosen up my neck and shoulders enough to let the Aleve or ibuprofen work.
posted by yasaman at 8:39 PM on December 31, 2012 [1 favorite]

I've been going to burn an Ask about alieve, which works just one heck of a lot like ibuprofen, exact same type drug, non-steroidal anti-inflammatory drugs. My doc cleared me on it, cautiously, said hey just don't go overboard with it and I haven't. NSAID drugs are not only for pain, they promote healing by (drum roll) reducing inflammation. (duh) And even though my doc cleared me, I still like to run stuff past everybody here; a bright crowd.

I only take Tylenol when I'm really, really hurting and then take it one half pill at a time, till it grabs the pain down managable. Tylenol also reduces inflammation but it is harsh stuff, I'm really scared of t, moreso than NSAID drugs, that's for sure. (Tylenol does kick the shit out of a fever though, so there's that.)

Bad bike wreck here in late October, I've been on aleive every day since, first for the broken bones, sometimes 3 but now mostly 2 a day, left arm/shoulder/back are still really racked up, I was riding again in two weeks but only just this past week been able to reach behind my back to tuck in my shirt. I'm working with my chiropractor and it's moving but damn. So alieve has been religion to me, a holy blue sacrament, I worship twice daily, take the blue host, maybe they'll make the shit into a wafer.

Also: ice. Ice is your friend. It's amazing how well it reduces pain, not only that it numbs you (me) but also it super reduces inflammation, and my chiropractor told me that once off the ice pack, as the area warms to normal it sucks in blood which also helps the healing, and that sounds woo-woo to me but hey, whatevs. Ice is kindof magic stuff

Here's the ice pack trick -- get some of those zipper-lok freezer bags (gotta be freezer bags, not just sandwich bags; freezer bags are tough), put alcohol and water 50-50 mix (though I think I went more alcohol than that), get all the air out and zip it closed, put that first bag inside a second and zip *that* closed, put it in the freezer, one hour away from a super-flexible ice-pack.

I have frostburned myself; always have something between your skin and the icebag, even only a shirt will do the deal.

I also use rice-bags, my sister sews me up these long bags and mails them to me, I put rice in them then sew them shut, toss them in the freezer and then, once they aren't cold enough on my shoulder anymore, toss them in the microwave a couple minutes and now they're heat bags -- hurray!

Happy New Year all!
posted by dancestoblue at 9:30 PM on December 31, 2012 [1 favorite]

I was prescribed 800mg tabs up to three times per day when I had a torn meniscus; I only took it 2x per day, but I did it for about a year. I realized once I had surgery and stopped taking it that it was giving me an eye twitch, but otherwise I was fine...
posted by clone boulevard at 9:35 PM on December 31, 2012

My wife experienced a serious herniated disc, and we tried out Alieve. The warnings on the package were pretty fucking freaky compared to Ibuprofen.

As for your headaches, you may have a cold, it may be stress, it may be a combination of the two. I typically get severe headaches when the weather changes suddenly (sudden change in temperature from warm to cold, or from cold and dry to humid). I take Ibuprofen which works. I asked my doctor about it (who, it turns out, has the same problem, but with his joints), and he said it was okay.

Taking Ibuprofen to manage stress for a long period of time is probably not wise. There is the chance it could cause a stroke (blood thinning). But for a few days or a week it should be okay, unless directed by your doctor.
posted by KokuRyu at 10:12 PM on December 31, 2012

Another person here who was told (by a rheumatologist in this case) to take 800 mg of ibuprofen times a day for an unlimited period of time and that it would be just fine. She had my liver function tests available to her, though, so.

Also, my headache guy says that undermedicating is a big mistake, because if you don't stay out ahead of the headache you're more likely to have an echo headache or relapse.
posted by Sidhedevil at 12:47 AM on January 1

You're fine.

I'm no Doctor, mind, but what you describe will probably benefit from stretching/yoga/walking and a massage. Salon Pas patches if you believe in that sort of thing and can trace the headaches into your upper neck/pack area.

So, basically what SMPA said.
But, also consider coffee too. It apparently does stuff to loosen the blood vessels and anecdata suggests it works a treat.
posted by Mezentian at 1:43 AM on January 1

Actually: "Caffeine constricts blood vessels in the head and neck, and increases the release of excitatory neurochemicals, so increases the rate of nerve firing."
posted by Specklet at 2:09 AM on January 1 [3 favorites]

Just a note to mention that though the major concern with tylenol (paracetamol) toxicity is the liver, for ibuprofen the kidneys and gastrointestinal tract are the organs most at risk. If you're taking it regularly make sure you don't take it on an empty stomach. If you have any existing kidney disease or a history of stomach ulcers you should consult a doctor and be very very cautious about taking ibuprofen. It's also recommended that asthmatics avoid it as in some poeple it can trigger asthma attacks.

The NHS Information sheet on ibuprofen gives a fairly thorough summary of the risks and side effects.
posted by *becca* at 3:34 AM on January 1 [7 favorites]

Interesting. Headaches being what they are, they're always difficult to diagnose causes, but 10 years of experience (from someone without a caffeine addiction) stands at odds with that data.

I suppose it's a thing to try, if all else fails. I'm not going to argue with a website with animated gifs.naturally
posted by Mezentian at 3:57 AM on January 1

Echoing that you're way below the kind of dosages that would cause any trouble (unless you've had kidney or stomach ulcer problems in the past, and even then you're still taking a pretty tiny dose).

I came in to mention that ibuprofen works great for me for muscle aches, but tylenol is the only drug that helps my tension headaches. They work in slightly different ways, so it might be worth trying a different medication if you're not getting relief from the one you're using. That said, you should never take tylenol in higher doses or more frequently that what the label on the bottle says, because it is dangerous for your liver to overdo it.
posted by vytae at 4:19 AM on January 1

In my case the tension headaches were related to things in my life and so I changed them. I still get headaches occasionally but not the daily ones I had on and off for a long time.

Aside from that I tried to make sure I ate well and exercised. Exercise sometimes helped my tension headaches. The main problem for me really was that sometimes something worked and sometimes it didn't, including drugs.

A friend of mine gets massages. I haven't tried that but she also has TMJ and has said that it helps a lot with that as well. She has a monthly type deal at Massage Envy.

After my experience I disagree with everyone who says to "just take more" and not to worry because the dose you're taking is fine. It might be, but you are clearly concerned about it since you're posting here. I was concerned as well and now my opinion is that it is best to use the drugs as a band-aid while you deal with the stuff in your life that is actually causing the tension headaches.

No one has mentioned rebound headaches. yet. I am pretty sure I was suffering from rebound headaches as well because I was taking ibuprofen a lot. Just the regular dose, but taking it pretty much daily.
posted by fromageball at 4:32 AM on January 1 [2 favorites]

Rebound headaches are a thing. I used to get them whenever I took Ibuprofen for a headache. I switched to naproxen and no longer have that problem.
posted by gjc at 4:58 AM on January 1 [3 favorites]

Do you have any problems with your jaw? Does it ever pop in and out when you are chewing?

TMJ can cause headaches. You say you are under stress--you may be clenching your teeth without realizing you're doing it. And if your neck is misaligned it can also cause headaches.

If this continues you definitely should see someone, although I found the night mouthpiece they gave me a complete nuisance.
posted by AuntieRuth at 5:17 AM on January 1

Just make sure that you don't take Ibuprofen on an empty stomach. Ibuprofen (and all of the NSAIDs) are actually fairly strong drugs and can be really hard on your gut, which is easy to forget sometimes, I think, because it's so easy to buy massive quantities of Ibuprofen or Aleve in the U.S. So be kind to your stomach and only take Ibuprofen after you've eaten something, or after you've drunk something like milk that will coat your stomach a bit.
posted by colfax at 7:42 AM on January 1 [1 favorite]

Hey I used to get LOTS of headaches and migranes. I used to get really serious headaches a few times month (sometimes I would vomit and need to go to the hospital for a painkiller injection) and I would take the ibuprofen at the start of the day when I felt the beginnings of a headache to stop it getting out of control and interfering with my day. My school nurse also told me to track my migraines carefully so I could see any patterns or triggers because in many cases there are obvious ones that you can quite easily avoid.

But what worked for me in the end was trying out alternative medicine. I got chinese medicine and acupuncture (my grandmother is Chinese so she forced me to go in spite of my heavy skepticism) and now I don't get headaches very much anymore. I don't anticipate them or dread them or worry about getting them during exam period... My head feels uncomfortable maybe once a month or in high pressure places but generally I can honestly say that I don't get headaches anymore. It's so liberating, and there is much more to gain than to lose so if you can find a good practitioner give it a shot! :)
posted by dinosaurprincess at 7:43 AM on January 1

A lot of the advice here is good (take NSAIDs with food, etc.) but the last time I talked about headaches with my doctor, she said my borderline blood pressure might be an issue. Check that at your local pharmacy, because if that's your problem, NSAIDs will not only not solve your problem, they might exacerbate it. They can cause high blood pressure, particularly in combination with other drugs (e.g., birth control pills).
posted by immlass at 12:20 PM on January 1

One other factor to consider if this continues is that taking regular pain relief for headaches can start causing headaches - medication overuse headaches.

I find stretching and yoga help my tension headaches. Consciously unclenching my jaw also helps.
posted by kadia_a at 1:37 PM on January 1

Try stretching your neck, shoulders and jaw. A heating pad might help too.
posted by radioamy at 1:39 PM on January 1

For ANY Non-Steroidal anti-inflammatory drug (NSAID) be sure to limit the duration that you take them. I had brutal constant headaches for 2 years (24/7). Never got a good diagnosis. To make a long (very long) story short, I was on NASID's for the whole time...they eventually shut down my internal waste disposal system. No fun.

I got off the drugs...ALL drugs, which were only mitigating and not "curing" anyway.

Shockingly, at least to me, acupuncture did the trick.
posted by jeporter99 at 7:46 AM on January 2