From the Guidelines
Tension-type headaches (TTH) are best managed with ibuprofen (400 mg) or acetaminophen (1000 mg) for acute treatment and amitriptyline (50-100 mg) for preventive treatment, as these options demonstrate statistically significant improvements in pain-free response and reduction in monthly headache days, respectively 1.
Symptoms of TTH
- Dull, pressure-like pain often described as a tight band around the head
- Typically caused by muscle tension, stress, or anxiety
- Can be triggered by poor posture, eye strain, or other factors
Treatment Options for TTH
- Ibuprofen (400 mg) or acetaminophen (1000 mg) for acute treatment, as these medications demonstrate statistically significant improvement in pain-free response at 2 hours 1
- Amitriptyline (50-100 mg) for preventive treatment, as it significantly reduces monthly headache days 1
- Non-medication approaches, such as:
- Applying a cold or warm compress to the forehead or neck for 15 minutes
- Practicing relaxation techniques, such as deep breathing or meditation
- Ensuring adequate hydration and maintaining regular sleep patterns
Prevention Strategies for TTH
- Identifying and avoiding personal triggers
- Practicing stress management techniques daily
- Maintaining good posture and taking regular breaks from screen time
- Considering preventive medications, such as amitriptyline or topiramate, for chronic cases
- Aerobic exercise or physical therapy can also be beneficial in managing TTH and migraines, as they have been shown to reduce headache frequency and intensity 1
From the Research
Symptoms of Tension-Type Headache (TTH)
- Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput 2
- Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache 2
- Migraine-type features (unilateral, throbbing pain, nausea, photophobia) are not present 2
Treatment Options for TTH
- Treatment of tension-type headache typically involves the use of over-the-counter analgesics 2
- Sedating antihistamines or antiemetics can potentiate the pain-relieving effects of standard analgesics 2
- Analgesics combined with butalbital or opiates are often useful for tension-type pain but have an increased risk of causing chronic daily headache 2
- Amitriptyline is the most widely researched prophylactic agent for frequent headaches 2
- Osteopathic manipulative treatment and lifestyle modifications may also be effective in resolving tension headaches 3
- Fixed-dose combinations of acetaminophen, acetylsalicylic acid, and caffeine, as well as monotherapies with ibuprofen or acetylsalicylic acid, are recommended as first-line therapy for tension-type headache 4