How are tension-type headaches treated?

Tension-type headaches are treated with several different strategies, including:

Regardless of the treatment, tension-type headaches are best treated when the symptoms first appear and are mild, before they become more frequent and painful.

Stress management/relaxation training

Both episodic and chronic tension-type headaches can be improved by managing stress and practicing relaxation training.

Relaxation techniques include deep breathing exercises, progressive muscle relaxation, mental imagery relaxation, or relaxation to music. Ask your health care provider for more information about these techniques.

Counseling

It is helpful to recognize and treat the underlying stress and tension that are causing the headaches. Often, many people have long forgotten what stressful events caused their headaches. Counseling can help the person identify his or her headache triggers and learn useful coping methods.

Biofeedback

Biofeedback is another method of learning how to manage stress. During biofeedback, a series of sensors are connected to your body. The sensors detect changes in physical functions, such as muscle tension, blood pressure, heart rate, or skin temperature, and provide immediate feedback through a tone or display on a computer screen.

Biofeedback helps you to: recognize that your body is tense; identify what you are doing to make it tense; learn how to reduce the tension; and, practice releasing the tension through effective physical skills. Biofeedback usually requires several sessions with a skilled biofeedback therapist.

Medications

To relieve symptoms of episodic or chronic tension-type headaches, over-the-counter (OTC) medications are recommended. Ask your doctor or pharmacist about using acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), aspirin, or naproxen sodium (Aleve®) to relieve your headaches.

Take these medications only when necessary. If you do take them, use the smallest dose needed to relieve your pain. Overusing pain medications can actually cause rebound headaches. In addition, aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can have serious side effects, including stomach or intestinal pain or bleeding and ulcers.

If OTC pain relievers don't help, your doctor may prescribe a medication to reduce the severity and frequency of your headaches. The most effective drug for treating tension-type headaches is often the antidepressant amitriptyline (Elavil®), which provides some relief for about 65% of people.

For relief of chronic tension-type headaches, preventive medications may be prescribed to reduce both the frequency and severity of the headaches. These medications may include antidepressants with a sedating effect (causes drowsiness), such as Elavil, and NSAIDs, such as Aleve. These medications are not habit-forming.

Benzodiazepines, butalbital combinations, and narcotics (such as codeine and oxycodone) should be avoided because these medications could become habit-forming or addictive. Overuse of these medications, or using OTC pain-relieving medications every day, can cause analgesic rebound headaches.

Keep in mind that medications do not cure headaches and that over time, painkillers and other medications may lose their effectiveness. In addition, all medications have side effects. If you take medication regularly, including products that you buy over the counter, discuss the risks and benefits with your doctor.

Also, remember that pain medications are not a substitute for recognizing and dealing with the stressors that may be causing your headaches. This is especially important to prevent rebound or medication overuse headaches.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy