From the Guidelines
For the treatment of acute tension headaches, ibuprofen (400 mg) or acetaminophen (1000 mg) is recommended ("weak for") due to their statistically significant improvement in pain-free response at 2 hours 1. When considering treatment options for acute tension headaches, it's essential to prioritize approaches that provide rapid and sustained alleviation of pain and restoration of function.
- Over-the-counter pain relievers like ibuprofen (400 mg) or acetaminophen (1000 mg) are effective options for immediate relief, as they demonstrate statistically significant improvement in pain-free response at 2 hours 1.
- Combination medications containing caffeine may also be considered, although their effectiveness may vary depending on individual patient responses.
- Non-medication approaches, such as applying a cold or warm compress to the forehead or neck, practicing relaxation techniques like deep breathing or progressive muscle relaxation, and ensuring adequate hydration, can also be beneficial in managing acute tension headaches.
- For persistent headaches, prescription-strength NSAIDs or muscle relaxants like amitriptyline (50-100 mg) may be prescribed by a healthcare provider, as they have been found to significantly reduce monthly headache days 1. It's crucial to address the underlying causes of tension headaches, such as stress, poor posture, or eye strain, to achieve long-term management and reduce the frequency and severity of episodes.
- Aerobic exercise or physical therapy (PT) can be used in the management of tension-type headaches, as they have been found to be beneficial in reducing headache frequency and intensity 1.
- Clinicians should work with their patients to craft individualized treatment plans that account for headache type, comorbid conditions, and values and preferences, ensuring the most effective and safe management of acute tension headaches.
From the FDA Drug Label
For Arthritis Pain label • temporarily relieves minor aches and pains due to: • minor pain of arthritis • muscular aches • backache • premenstrual and menstrual cramps • the common cold • headache • toothache For Muscle Aches & Pain label • temporarily relieves minor aches and pains due to: • muscular aches • backache • minor pain of arthritis • toothache • premenstrual and menstrual cramps • headache • the common cold
Acute Tension Headache Treatment:
- Acetaminophen (PO) can be used to temporarily relieve headache, as stated in the drug label 2.
- Ibuprofen (PO) can be used for mild to moderate pain, including headache, with a recommended dose of 400 mg every 4 to 6 hours as necessary for relief of pain 3.
From the Research
Acute Tension Headache Treatment
- Acute tension headache treatment focuses on relieving pain and reducing symptoms, with simple analgesics being the mainstay of treatment 4, 5.
- Over-the-counter or prescribed simple analgesics, such as NSAIDs and acetaminophen, are effective for short-term pain relief in patients with tension-type headaches 4.
- NSAIDs, such as ibuprofen, have been shown to be more effective than acetaminophen, but with more side effects 4.
- Acute treatments for tension-type headaches can also include relaxation techniques, such as relaxation training and biofeedback, although the evidence for these is inconsistent 4.
Pharmacological Therapy
- Pharmacological therapy is the primary treatment for acute tension headaches, with simple analgesics being the first-line treatment 5.
- Preventive treatment, such as amitriptyline, venlafaxine, and mirtazapine, may be considered for individuals with frequent episodic and chronic tension-type headaches 5.
- Antidepressants, such as tricyclic antidepressants, may be effective in reducing headache frequency and severity, but the evidence is limited 6, 7.
Non-Pharmacological Therapy
- Non-pharmacological therapies, such as relaxation techniques, biofeedback, and physical therapy, may be effective in reducing tension-type headache symptoms, but the evidence is inconsistent 4.
- Behavioral interventions, such as cognitive-behavioral therapy, may also be effective in reducing headache frequency and severity, but more research is needed to confirm this 4.