From the Guidelines
For the treatment of Tension-Type Headache (TTH), ibuprofen (400 mg) or acetaminophen (1000 mg) is recommended as a first-line abortive treatment, and amitriptyline (50 mg or 100 mg) is recommended for preventive treatment. When considering treatment options for TTH, it is essential to prioritize non-pharmacological approaches, such as stress reduction, improving sleep habits, and regular exercise, as these can help alleviate symptoms and improve quality of life 1. Some key points to consider when treating TTH include:
- The use of over-the-counter pain relievers like ibuprofen or acetaminophen for immediate relief, with the recommended doses being 400 mg for ibuprofen and 1000 mg for acetaminophen 1.
- The potential benefits of preventive treatments like amitriptyline, which can help reduce the frequency and severity of TTH episodes 1.
- The importance of avoiding overuse of pain medications, as this can lead to rebound headaches and worsen symptoms 1.
- The value of lifestyle modifications, such as regular hydration, maintaining good posture, and taking breaks from prolonged screen time, in preventing TTH episodes 1. It is crucial to consult a healthcare professional for a personalized treatment plan, especially if headaches persist or worsen over time 1.
From the Research
Treatment Options for Tension-Type Headache (TTH)
- Over-the-counter pain medication is a common treatment for TTH, with ibuprofen 400 mg and aspirin 1000 mg recommended as first-choice drugs due to their treatment effect, safety profile, and costs 2
- Non-pharmacological therapies, such as electromyographic biofeedback, physiotherapy, and muscle relaxation therapy, can also be effective in managing TTH 2
- Osteopathic manipulative treatment and lifestyle modifications may be beneficial for some patients, particularly those who are non-responsive to pain medication 3
- For chronic TTH, treatment may involve recognition and management of underlying depression or anxiety states, with non-habituating anxiolytic or antidepressant medications and referrals for psychotherapy as needed 4
- Amitriptyline is a widely researched prophylactic agent for frequent headaches, and other non-medication therapies such as biofeedback, relaxation training, self-hypnosis, and cognitive therapy may also be employed 5
- Paracetamol (acetaminophen) 1000 mg has been shown to provide a small benefit in terms of being pain-free at two hours for people with frequent episodic TTH who have an acute headache of moderate or severe intensity 6
Pharmacological Treatment
- Simple analgesics and non-steroidal anti-inflammatory drugs are the mainstays of management of individual headache episodes 2
- Sedating antihistamines or antiemetics can potentiate the pain-relieving effects of standard analgesics 5
- Analgesics combined with butalbital or opiates may be useful for tension-type pain but have an increased risk of causing chronic daily headache 5
Non-Pharmacological Treatment
- Electromyographic biofeedback, physiotherapy, and muscle relaxation therapy can be effective in managing TTH 2
- Biofeedback, relaxation training, self-hypnosis, and cognitive therapy may also be employed as non-medication therapies 5
- Lifestyle modifications, such as improving posture and addressing sleep disturbances, may also be beneficial 3