Tension headache treatments

Tension headache is the most common type of headache. Most adults have experienced a tension headache, which often feels like a tight band of pressure around the head. Tension headaches can be triggered by a lack of sleep, stress, dehydration, skipping meals and poor posture.

Treatments for tension headaches include lifestyle measures, medicines, treatments to reduce stress and complementary therapies.

Lifestyle

Making sure you drink plenty of fluids, eat regular meals and get adequate sleep can help prevent tension headaches. Other measures that can help include reducing your caffeine intake and getting regular exercise.

If you have frequent tension headaches, your doctor may suggest keeping a diary of your headaches and other activities to see if there is a pattern and to determine if anything is triggering your headaches.

Medicines

Painkillers

There are many pain relievers available for the treatment of headache, including paracetamol, aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs) (including diclofenac, ibuprofen and naproxen).

Paracetamol is associated with few side effects, but if too much is taken it can cause serious liver damage.

Regular use of NSAIDs or aspirin increases your risk of developing a peptic ulcer in the stomach. Aspirin and NSAIDs can also irritate the stomach, causing heartburn, nausea and vomiting. Use of NSAIDs is associated with a small increased risk of having a heart attack or stroke. Allergic reactions are also possible.

Aspirin should not be used in children younger than 16 years, except under medical advice. NSAIDs and aspirin should also be avoided by people who have a history of asthma symptoms being triggered by these medicines, those with kidney problems and pregnant or breast feeding women.

Preventive medicines

Some people have chronic (ongoing) tension headaches or very frequent tension headaches. Use of painkillers in these people can make the headaches worse.

Treatment to prevent tension headaches may be recommended for people with frequent or chronic tension headaches. A type of tricyclic antidepressant medicine called amitriptyline can be used to help prevent tension headaches.

Possible side effects associated with amitriptyline include dry mouth, nausea, dizziness and drowsiness.

Treatments to reduce stress and tension

Therapies that may be helpful in the treatment and prevention of tension headaches by reducing stress and tension and improving relaxation include the following.

  • Massage can relieve tension in the muscles of the back of the head, neck and shoulders and relieve headache pain for some people.
  • Heat can also help treat tension headache – try taking a hot shower or using a heat pack.
  • Correcting poor posture can help by relieving muscle tension.
  • Biofeedback – the use of electronic devices to teach people how to regulate body functions and responses, such as muscle tension – can help reduce pain.
  • Cognitive behavioural therapy (CBT), a type of therapy that involves identifying and challenging negative thinking patterns and developing alternative ways of thinking and acting, can help reduce stress. CBT can be used to treat tension headaches that are constant or frequently recurring.
  • Relaxation exercises (including deep breathing or progressive muscle relaxation) and stress management training can help prevent tension headaches.

Complementary therapies for headache

Acupuncture

There is some evidence that acupuncture can be effective in the treatment of tension headaches. Acupuncture can prevent tension headaches in people who suffer from frequent headaches.

Acupuncture is generally considered safe when performed by qualified practitioners using sterile needles. Side effects are uncommon.

Supplements

Supplements that may help to relieve headaches include riboflavin and coenzyme Q10, both of which are generally well tolerated.

It’s important to remember that, like conventional treatments, complementary therapies are associated with side effects and can interact with other medicines. Some complementary therapies should not be used during pregnancy.

It’s always best to tell your doctor if you are using or planning on using a complementary therapy. In addition, conventional treatments should not be replaced with unproven products or practices.

Last Reviewed: 11 August 2014
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References

1. Tension headache (revised June 2011). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2014 Mar. http://online.tg.org.au/complete/ (accessed Jul 2014).
2. MayoClinic.com. Tension headache (updated 16 Jul 2013). http://www.mayoclinic.org/diseases-conditions/tension-headache/basics/definition/con-20014295 (accessed Jul 2014).
3. NHS Choices. Tension-type headaches (updated 27 Aug 2013). http://www.nhs.uk/Conditions/headaches-tension-type/Pages/Introduction.aspx (accessed Jul 2014).
4. National Centre for Complementary and Alternative Medicine (NCCAM). Headaches and complementary health approaches (updated Dec 2012). http://nccam.nih.gov/health/pain/headachefacts.htm (accessed Jul 2014).
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