Which pain reliever is best for headaches? A comprehensive guide

October 10, 2025 •

4 min read

According to the World Health Organization, headache disorders are one of the most common nervous system disorders worldwide. When managing this common ailment, understanding which pain reliever is best for headaches is crucial, as the right choice depends on the type and severity of your pain.

Quick Summary

An exploration of common over-the-counter headache medications, including acetaminophen and various NSAIDs, their differences in action, and appropriate use. Important considerations like side effect risks and when to consult a healthcare provider are also covered.

Key Points

Identify Your Headache Type: Tension-type headaches are generally milder than migraines. Migraines are typically more severe, often accompanied by nausea or light sensitivity.
Consider Acetaminophen for Mild Pain: Acetaminophen blocks pain signals and is a good option for mild to moderate tension headaches, especially if you have stomach sensitivities, but be mindful of liver risks from overdose.
Choose NSAIDs for Inflammation: Ibuprofen, naproxen, and aspirin are NSAIDs that reduce both inflammation and pain, making them potentially more effective for headaches with muscular tension or migraine-related inflammation.
Be Cautious with Combination and Frequent Use: Combination products with caffeine can boost effectiveness but carry a higher risk of medication overuse headaches. Avoid taking OTC pain relievers more than two to three days per week.
Know When to Seek Professional Help: If OTC medications are ineffective or if you experience severe, frequent, or escalating headaches, consult a healthcare provider for a proper diagnosis and consideration of prescription options.
Explore Non-Drug Therapies: Non-pharmacological options like staying hydrated, managing stress, getting adequate sleep, and applying cold compresses can also be effective complementary treatments.

Understanding Your Headache: Type and Severity

Before reaching for a pain reliever, it's helpful to understand the type of headache you are experiencing, as different medications target different pain mechanisms. The most common types are tension-type and migraine.

Tension-Type Headache: Often described as a tight band around the head, this is the most common type. Pain is usually mild to moderate and not accompanied by other symptoms like nausea or light sensitivity.
Migraine: These are more severe and debilitating, often involving a throbbing pain on one side of the head. Symptoms may include nausea, vomiting, and extreme sensitivity to light and sound.

Over-the-Counter (OTC) Pain Relievers

For many headaches, especially mild to moderate tension-type headaches, over-the-counter medications are the first line of defense. The two primary categories are acetaminophen and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).

Acetaminophen (Tylenol)

Acetaminophen works by blocking pain signals in the brain but does not reduce inflammation. It is often recommended for fever and mild to moderate pain. For headaches, some find it effective, particularly for tension headaches.

Pros: Generally well-tolerated and less likely to cause stomach irritation compared to NSAIDs. It is also considered safe for pregnant women (consult a doctor first).
Cons: Overdosing or heavy long-term use can cause liver damage, especially if combined with alcohol. Many multi-symptom cold and flu products also contain acetaminophen, increasing the risk of accidental overdose.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen, naproxen, and aspirin, work by blocking cyclooxygenase (COX) enzymes that create prostaglandins, which cause inflammation, fever, and pain. Their anti-inflammatory action can be particularly beneficial for some types of headache.

Ibuprofen (Advil, Motrin IB)

Ibuprofen is a popular NSAID that reduces inflammation and pain effectively. It can be a good choice for tension headaches, especially those with neck or muscle tension.

Naproxen Sodium (Aleve)

Naproxen sodium is another NSAID that provides longer-lasting relief than ibuprofen, which means fewer doses are needed throughout the day. It is often recommended for more persistent pain.

Aspirin (Bayer)

Aspirin is one of the oldest and most widely used NSAIDs. It is effective for both tension headaches and migraines, especially when taken in higher doses for acute attacks.

Pros: Effective against inflammation-related pain and available in combination with other medications like caffeine for enhanced relief.
Cons: Can cause stomach irritation, heartburn, and ulcers. Increases the risk of bleeding and should be used with caution by those on blood thinners. Should not be given to children under 19 due to the risk of Reye's syndrome.

Combination Products

Some OTC products combine acetaminophen, aspirin, and caffeine (e.g., Excedrin Migraine). For some individuals, this combination can be more effective and faster-acting for migraine relief than single-ingredient options. However, the caffeine content can contribute to medication overuse headaches if taken too frequently.

Comparison of Common OTC Pain Relievers


Feature	Acetaminophen	Ibuprofen	Naproxen Sodium	Aspirin
Mechanism	Blocks pain signals in the brain	Reduces inflammation and blocks pain signals	Reduces inflammation and blocks pain signals	Reduces inflammation and blocks pain signals
Best for	Mild-to-moderate pain, tension headache	Mild-to-moderate pain, tension headache	Longer-lasting relief for persistent pain	Migraine, mild-to-moderate pain
Speed of action	Varies, typically 45+ minutes	Quick relief	Slower onset than ibuprofen, longer duration	Quick relief, can be taken in effervescent form
Main Risks	Liver damage with overdose or heavy use	Stomach irritation, GI bleeding, kidney issues	Stomach irritation, GI bleeding, kidney issues	Stomach irritation, GI bleeding, Reye's syndrome in children
Key Advantage	Safer for those with stomach issues	Effective anti-inflammatory action	Longer lasting pain relief	Effective for migraine, often combined with caffeine
Notes	Safe for pregnant women (consult doctor)	Avoid if you have heart, kidney, or bleeding disorders	Avoid if you have heart, kidney, or bleeding disorders	Not for children; avoid if on blood thinners

Medication Overuse Headache (MOH)

It's crucial to be aware of Medication Overuse Headache (MOH), also known as rebound headache. This occurs when acute headache medications are taken too frequently, leading to more frequent and severe headaches. For NSAIDs and acetaminophen, overuse is defined as more than 15 days per month for at least three months, while for combination analgesics, it is more than 10 days per month. Limiting the use of these medications to a few times per week is a critical preventative step.

When to Consider Prescription Options or Other Therapies

If OTC medications are ineffective, or if you experience frequent or severe headaches, it is important to speak with a healthcare professional. For migraines, prescription medications like triptans or gepants may be necessary. There are also preventative medications and other therapies available, such as antidepressants, anti-seizure medications, and Botox injections, which can help reduce the frequency and severity of headaches. Non-pharmacological approaches like biofeedback, acupuncture, stress management, and supplements like magnesium and B-complex vitamins may also provide relief.

For more detailed information on specific migraine treatments, you can explore resources like the American Migraine Foundation.

Conclusion: Finding Your Best Pain Reliever

The 'best' pain reliever for a headache is not a one-size-fits-all answer. It depends heavily on the type and severity of your headache, your individual health profile, and potential medication interactions. For mild tension headaches, acetaminophen or an NSAID like ibuprofen may suffice. For migraines, a combination product or prescription medication is often needed. Regardless of your choice, it is vital to follow dosing instructions carefully, be mindful of potential side effects, and avoid overuse to prevent rebound headaches. If your headaches are chronic, severe, or not well-managed by OTC options, a consultation with a healthcare provider is the best path forward to find a safe and effective long-term solution.

Frequently Asked Questions

The choice depends on the type of pain. Ibuprofen is an NSAID that reduces inflammation, which can be helpful for headaches with muscular tension. Acetaminophen blocks pain signals and is often effective for mild to moderate headaches, particularly if you are sensitive to NSAIDs or have stomach issues.

For mild migraines, OTC options like NSAIDs (ibuprofen, naproxen) or combination products containing aspirin, acetaminophen, and caffeine (like Excedrin Migraine) may be effective. For more severe migraines, prescription medications like triptans are often more powerful.

Yes, ibuprofen and acetaminophen work differently and can be taken together or alternated, as advised by a healthcare provider. This approach can be beneficial for pain that doesn't respond to a single medication alone.

A medication overuse headache (MOH) is a headache that results from taking too much acute headache medication. For simple pain relievers, this can occur with more than 15 days of use per month over three months. Stopping the overused medication is the key to breaking the cycle.

Yes, several natural remedies can help, including staying well-hydrated, applying a cold compress to the head or neck, ensuring adequate sleep, and managing stress. Some supplements like magnesium and B-complex vitamins may also offer relief for some people.

No. Aspirin can cause stomach irritation and increase the risk of bleeding. It should be avoided by individuals with a history of stomach ulcers, bleeding disorders, or those taking blood thinners. Aspirin is also not recommended for children and teenagers due to the risk of Reye's syndrome.

You should see a doctor if your headaches are severe, frequent (more than a few times per week), or not responding to OTC treatment. Also, seek medical care if your headache is accompanied by fever, neck stiffness, confusion, or changes in vision.