Natural treatments for tension headaches
Natural treatments for tension headaches encompass a variety of therapies aimed at alleviating the discomfort characterized by aching, dull, or throbbing pain typically located in the forehead, temples, or base of the skull. Common natural approaches include acupuncture and chiropractic care, both of which have shown mixed results in studies. While acupuncture has demonstrated effectiveness in reducing headache frequency and intensity for some individuals, the extent of its benefits compared to placebo treatments remains debated. Chiropractic spinal manipulation has also been explored, with some studies indicating potential advantages, particularly in addressing neck tension that may contribute to headache symptoms.
In addition to these primary treatments, a range of other natural therapies such as aromatherapy, biofeedback, relaxation techniques, and therapeutic touch have been evaluated for their efficacy. Some evidence suggests that these methods can be beneficial, especially when used in combination with each other. Certain herbs and supplements, like butterbur and 5-hydroxytryptophan, have been considered for their potential effects on migraine and tension headaches, although results may vary. Conversely, caution is advised with the use of kava, which has been linked to serious health risks and lacks evidence of effectiveness for headache relief. Overall, individuals seeking natural treatments for tension headaches may explore these options while also considering professional medical advice to determine the best personal approach.
Natural treatments for tension headaches
- PRINCIPAL PROPOSED NATURAL TREATMENTS: Acupuncture, chiropractic
- OTHER PROPOSED NATURAL TREATMENTS: Aromatherapy; body-mind therapies such as biofeedback, hypnosis, relaxation therapies, and therapeutic touch; butterbur; 5-hydroxytryptophan; massage; osteopathic manipulation; prolotherapy
- HERBS AND SUPPLEMENTS TO AVOID: Kava
DEFINITION: Treatment of aching, dull, and throbbing pain most commonly felt in the forehead, temples, and base of the skull
Introduction
Modern life is stressful, and tension headaches are one result of that stress. People with such headaches often describe a sensation like a tight band around the headthis band may, in fact, exist as a contracted muscle. Other characteristics of tension headache include aching, dull, or throbbing pain, usually concentrated in the forehead, temples, or base of the skull. Symptoms may overlap those of migraine, cluster, or sinus headaches, and medical advice may be necessary to distinguish among them.
Medical treatment for tension headaches generally involves the use of nonsteroidal anti-inflammatory drugs and sometimes muscle relaxants. Physicians may also recommend physical therapy techniques in hopes of addressing the causes of tension headaches, such as muscle tension in the neck or jaw.
Principal Proposed Natural Treatments
Both acupuncture and chiropractic have undergone significant evaluation as treatments for tension headaches.
Acupuncture. Placebo-controlled studies of acupuncture for tension headaches have yielded mixed results. One study compared six sessions of traditional acupuncture with sham acupuncture in eighteen people with chronic tension headaches. The real treatment caused a 31 percent reduction in pain, significantly more effective than placebo. A study of twenty-nine students with various types of headaches found that a single acupuncture treatment decreased the number of days during which headaches occurred and the total use of medications. A statistically insignificant reduction in the number of days of attacks was seen in the placebo group.
Another study enrolled forty-three children who experienced migraine or tension headaches and compared laser acupuncture with placebo laser acupuncture. An individualized treatment approach based on the principles of traditional Chinese medicine was used. The results indicated that real laser acupuncture was statistically more effective than placebo acupuncture. In a large randomized trial involving 3,182 headache patients, the group receiving fifteen individualized acupuncture sessions in three months experienced significantly fewer headache days and less pain than the group receiving usual care. However, despite its large size and positive results, this study did not include a placebo group.
On the negative side, a study of thirty-nine participants with a tension headache found no convincing evidence that acupuncture was helpful. In addition, a single-blind study of fifty participants with tension headaches found that a special brief acupuncture style given once a week for six weeks did not reduce headache frequency. Several other trials also failed to find evidence of benefit with various forms of acupuncture.
In a 2008 analysis of five randomized controlled trials that were considered the highest in quality, researchers determined that real acupuncture has limited effectiveness over sham acupuncture for tension headaches. While it is clear that many headache patients benefit from acupuncture, it is unclear whether this represents more than a placebo effect. A later systematic review of fifteen randomized controlled trials concerning acupuncture’s efficacy in treating migraines found generally positive results among more than two thousand participants. Four studies found acupuncture was as effective as traditional medications in treating migraine. Other studies found that acupuncture decreased the severity and frequency of headaches and migraines.
Chiropractic spinal manipulation. Neck tension can cause tension and pain in the head. Such cervicogenic headaches, sometimes called tech neck because individuals develop this pain from using screens, overlap closely with tension headaches. Chiropractic spinal manipulation has shown some promise for these conditions, but the evidence is incomplete and somewhat contradictory.
In a controlled trial of 150 participants, investigators compared spinal manipulation to the drug amitriptyline for the treatment of chronic tension-type headaches. By the end of the six-week treatment period, participants in both groups had improved similarly. However, four weeks after treatment was stopped, people who had received spinal manipulation showed statistically better reduction in headache intensity and frequency and used fewer over-the-counter medications than those who had used the amitriptyline.
In another positive trial, fifty-three participants with cervicogenic headaches received chiropractic spinal manipulation or laser acupuncture plus massage. Chiropractic manipulation was more effective. However, a similar study of seventy-five participants with recurrent tension headaches found no difference between the two groups. Smaller studies of spinal manipulation have also been reported with mixed results.
In a later controlled trial, two hundred people with cervicogenic headaches were randomly assigned to receive one of four therapies: manipulation, a special exercise technique, exercise plus manipulation, or no therapy. Each participant received a minimum of eight to twelve treatments in a six-week period. All three treatment approaches produced better results than no treatment, and all had approximately the same effect. While these results may sound promising, in fact, they prove nothing since any treatment will generally produce better results than no treatment because of the power of suggestion. Ordinarily, researchers get around this problem by using double-blind, placebo-controlled trials. While it is not possible to do a truly double-blind trial of chiropractic, the better foregoing trials used a form of placebo treatment, making them more reliable than this one.
Other Proposed Natural Treatments
A number of other alternative treatments have undergone some evaluation for their usefulness in the treatment of tension headaches.
Several techniques in the category of body-mind medicine have shown promise. These techniques include hypnosis, biofeedback, and relaxation techniques, often used together. In a review of multiple controlled studies, researchers concluded that biofeedback is useful for tension headaches, particularly when combined with other relaxation therapies. Another review of twenty control trials found psychological interventions, such as cognitive behavioral therapy, biofeedback, relaxation, and coping strategies, to be associated with reduced chronic headache or migraine pain in 589 children. These treatments were compared with placebo, standard treatment, waiting list control, or other active treatments.
A topical ointment known as Tiger Balm is a popular remedy for headaches, muscle pain, and other conditions. Tiger Balm contains the aromatic substances camphor, menthol, cajaput, and clove oil, making it a form of aromatherapy. A double-blind study enrolling fifty-seven people with acute tension headache compared Tiger Balmapplied to the foreheadwith placebo ointment and with the drug acetaminophen (Tylenol). The placebo ointment contained mint essence to make it smell like Tiger Balm. Real Tiger Balm proved more effective than a placebo. In addition, it was just as effective as acetaminophen and acted more rapidly. Another form of aromatherapy, peppermint oil applied to the forehead, has also shown promise, but studies remain highly preliminary.
Therapeutic touch is a form of energy healing popular in the American nursing community. In a blinded study, sixty participants with tension headaches were randomly assigned to receive either therapeutic touch or a placebo form of the therapy. True therapy proved to be more effective than a placebo.
A study of twenty-eight people with tension headaches compared one session of osteopathic manipulation to two forms of sham treatment and found evidence that the real treatment provided a greater improvement in headache pain. Prolotherapy, massage, and reflexology have all been recommended for the treatment of tension headaches, but there is little evidence to support their use.
The herb butterbur is thought to have antispasmodic and anti-inflammatory properties, making it potentially useful for tension headaches. The supplement 5-hydroxytryptophan (5-HTP) has shown some promise for migraine headaches. However, an eight-week, double-blind, placebo-controlled trial of sixty-five people with tension headaches found that 5-HTP did not significantly reduce the number of headaches experienced. It did, however, reduce participants’ need to use other pain-relieving medications.
Some supplements have shown promise for improving headaches in women experiencing episodic migraines, including B1 (thiamine), B6 (pyridoxine), B12 (cobalamin), B9 (folic acid), and various combinations. A double-blind, randomized, and controlled study found that twelve weeks of using at least one of these vitamins improved migraine symptoms compared to the placebo group. However, the excessive success of these supplements and the lack of variation in success between supplement types indicates an issue with the construction of the study that may indicate these results are invalid.
Herbs and Supplements to Avoid
The herb kava is sometimes suggested as a muscle relaxant and stress reducer. However, there is no meaningful evidence that kava is effective for tension headaches, or any form of muscle tension, and it has been taken off the market in many countries for safety reasons. Its use has been linked with severe liver damage. Finally, numerous herbs and supplements may interact adversely with prescription drugs used to treat tension headaches.
Bibliography
Astin, J., and E. Ernst. “The Effectiveness of Spinal Manipulation for the Treatment of Headache Disorders.” Cephalalgia, vol. 22, 2002, pp. 617-23.
Davis, M. A., et al. “Acupuncture for Tension-Type Headache.” Journal of Pain, vol. 9, 2008, pp. 667-77.
Eccleston, C., et al. “Psychological Therapies for the Management of Chronic and Recurrent Pain in Children and Adolescents.” Cochrane Database of Systematic Reviews, 2009. p. CD003968.
Gottschling, S., et al. “Laser Acupuncture in Children with Headache.” Pain, vol. 137, 2008, pp. 405-12.
Johnson, Jon. "19 Ways to Relieve a Headache Without Medication." Medical News Today, 11 Mar. 2024, www.medicalnewstoday.com/articles/323992. Accessed 1 Oct. 2024.
Naguit, Noreen, et al. “Is Acupuncture Safe and Effective Treatment for Migraine? A Systematic Review of Randomized Controlled Trials.” Cureus, vol. 14, Jan. 2022, p. e20888. doi:10.7759/cureus.20888.
Nematgorgani, Shiva, et al. “B Vitamins and Their Combination Could Reduce Migraine Headaches: A Randomized Double-blind Controlled Trial.” Current Journal of Neurology, vol. 21, no. 2, 2022, pp. 105-18. doi:10.18502/cjn.v21i2.10494.
Nestoriuc, Y., et al. “Meta-analysis of Biofeedback for Tension-Type Headache: Efficacy, Specificity, and Treatment Moderators.” Journal of Consulting and Clinical Psychology, vol. 76, 2008, pp. 379-96.
"Tame Your Tension Headaches Naturally." Cleveland Clinic, 11 Mar. 2020, health.clevelandclinic.org/tame-your-tension-headaches-naturally. Accessed 15 Dec. 2022.