From the Research
Tension headaches are typically treated with a combination of over-the-counter pain relievers, such as ibuprofen or paracetamol, and lifestyle modifications, with ibuprofen showing better efficacy than paracetamol for pain-free status at 2 hours, as found in the most recent study 1. The treatment of tension headaches involves a multi-faceted approach, including:
- Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB) 400-600mg or paracetamol (Tylenol) 500-1000mg, taken every 4-6 hours as needed, not exceeding the maximum daily dose listed on the package 1
- Lifestyle modifications, such as:
- Applying a heating pad or ice pack to the neck or back of the head for 10-15 minutes several times a day to relax tense muscles
- Stress management techniques, such as deep breathing exercises, meditation, or gentle yoga, to prevent and reduce headache severity
- Ensuring adequate hydration, regular sleep patterns, and taking breaks from screen time or repetitive tasks to prevent tension headaches from developing
- For chronic tension headaches occurring more than 15 days per month, a doctor might prescribe preventive medications, such as amitriptyline 10-25mg daily, which has been shown to be effective in reducing headache frequency and severity 2 These treatments work because tension headaches typically result from muscle contractions in the head and neck regions due to stress, poor posture, or eye strain, and the interventions either reduce inflammation, relax muscles, or address underlying triggers. It is essential to note that the use of pain relievers more than twice weekly can place patients at risk for progression to chronic daily headache, as highlighted in the study 3. Additionally, sedating antihistamines or antiemetics can potentiate the pain-relieving effects of standard analgesics, but analgesics combined with butalbital or opiates have an increased risk of causing chronic daily headache 3. The most recent and highest quality study 1 provides the best evidence for the treatment of tension headaches, and its findings should be prioritized in clinical practice.