Tension Headache Treatment & Management

Updated: Nov 15, 2022
  • Author: Michelle Blanda, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Medical Care

Various modalities are used in the treatment of tension headaches. These include hot or cold packs, ultrasound, electrical stimulation, improvement of posture, trigger point injections, occipital nerve blocks, stretching, and relaxation techniques.

Regular exercise, stretching, balanced meals, and adequate sleep may be part of a headache treatment program. [12]


Alternative Medicine

Non-pharmacological treatments for headache include behavioral treatments such as cognitive-behavioral therapy, relaxation, and biofeedback, as well as acupuncture and massage. These treatments are options for patients who prefer non-pharmacological treatments or cannot take medications such as pregnant patients. [13] Relaxation techniques such as meditation are effective for chronic headaches as measured by headache parameters. Patients with chronic headaches have been showed to have low levels of cortisol that normalized with the practice of meditation over time.

Acupuncture may be helpful for patients experiencing frequent or chronic TTH. A review of eleven studies involving 2,317 patients found evidence to support acupuncture as a valuable, nonpharmacologic tool for episodic or chronic TTH. Two of the studies reviewed compared acupuncture to treatment of acute headaches or routine care only and found statistically significant and clinically relevant short-term (up to 3 months) benefits of acupuncture over control for response, number of headache days, and pain intensity. [14] According to several studies, massage may also be an effective therapy for individuals suffering from TTH. Massage can relieve tight muscles in the back of the head, neck, and shoulders, which may in turn relieve headache pain. [15, 16]  A combination of therapy with stress re-education and biofeedback may be best for patients.