What is the treatment for headaches caused by screen time at work?

Treatment for Screen-Related Headaches After Work

For headaches caused by prolonged screen time at work, start with ibuprofen 400 mg or acetaminophen 1000 mg as first-line treatment, combined with immediate workplace ergonomic modifications including lowering your screen 15-20 degrees below eye level and positioning it 60-100 cm from your eyes. 1

Immediate Pharmacologic Treatment

First-Line Options

• Ibuprofen 400 mg is the preferred initial treatment for acute tension-type headaches (TTH), which are the most common type of screen-related headaches, showing statistically significant pain-free response at 2 hours 1
• Acetaminophen 1000 mg is equally effective as an alternative if NSAIDs are contraindicated, though lower doses (500-650 mg) do not show significant benefit 1
• Limit acute medication use to no more than twice weekly to prevent medication-overuse headache, which develops with NSAIDs used ≥15 days/month 1, 2, 3

When to Escalate Treatment

• If your headaches have migraine features (throbbing, one-sided, nausea, light sensitivity), consider combination therapy with aspirin-acetaminophen-caffeine or a triptan like sumatriptan 1, 2
• Do not use opioids or butalbital-containing medications as they lead to dependency and rebound headaches 1

Critical Workplace Modifications (Non-Pharmacologic)

Screen Positioning

• Position your monitor 60-100 cm (approximately arm's length) from your eyes, as this is the preferred viewing distance that minimizes eyestrain 4
• Lower the screen so your gaze angle is 15-20 degrees below horizontal (not at eye level), which significantly reduces eyestrain compared to screens positioned at eye level 1, 4
• Individual preferences vary within a narrow range, so fine-tune within these parameters based on your comfort 4

Environmental and Behavioral Interventions

• Take regular breaks using the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds to reduce accommodative strain 5, 6
• Adjust lighting to reduce glare on the screen and use anti-glare filters if needed 5
• Increase conscious blinking during screen work, as blink rate decreases significantly during computer use, contributing to dry eye and headache symptoms 5, 6
• Use lubricating eye drops if you experience dry eye symptoms, which are a major contributor to computer vision syndrome 5, 6

Preventive Treatment for Chronic Screen-Related Headaches

When Prevention is Needed

• If headaches occur more than 2 days per week despite acute treatment and ergonomic modifications, preventive therapy is indicated 1
• If you're using acute medications more than twice weekly, you need prevention rather than more frequent acute treatment 1, 2

Preventive Medication Options

• Amitriptyline 50-100 mg daily is the recommended preventive treatment for chronic tension-type headaches, significantly reducing monthly headache days 1
• Be aware of anticholinergic side effects (dry mouth, constipation, drowsiness), especially if you're older or have cardiac conditions 1

Physical Therapy and Exercise

• Supervised physical therapy combining trigger point massage, thermal methods, and mobilization techniques is beneficial for both migraine and tension-type headaches 1
• Aerobic exercise 2-3 times weekly for 30-60 minutes or upper-body progressive strength training 3 times weekly reduces headache frequency and intensity 1

Common Pitfalls to Avoid

• Don't increase the frequency of pain medication use when headaches worsen—this creates medication-overuse headache and makes the problem worse 1, 2
• Don't ignore ergonomic factors and rely solely on medication—screen-related headaches have a strong environmental component that medication alone won't fix 5, 6
• Don't position your screen at eye level—this is a common mistake that significantly increases eyestrain compared to a downward gaze angle 4
• Don't wait until headaches are severe to treat them—early treatment with NSAIDs or acetaminophen is more effective 1, 2

When to Seek Further Evaluation

• If headaches persist despite optimal acute treatment, ergonomic modifications, and preventive therapy after 2-3 months 1
• If you develop new neurologic symptoms, sudden severe headache, or headache with fever 7
• If headache pattern changes significantly or becomes progressively worse 7