What home treatments are recommended for patients experiencing tension headaches?

Home Treatments for Tension-Type Headache

For acute tension headache episodes at home, start with ibuprofen 400-800mg or acetaminophen 1000mg, and limit use to fewer than 15 days per month to prevent medication overuse headache. 1

Acute Home Management

First-Line Medication

• Use NSAIDs (ibuprofen 400-800mg) as your primary acute treatment, with acetaminophen 1000mg as an alternative when NSAIDs are contraindicated 1
• Take medication early when headache begins for best effectiveness 2
• Critical warning: Never exceed 15 days per month of simple analgesic use to prevent medication overuse headache, which significantly worsens outcomes and prevents preventive treatments from working 1

Medication Safety Considerations

• Ibuprofen carries risks of gastrointestinal bleeding, ulcers, and cardiovascular events, particularly with prolonged use 2
• Avoid NSAIDs if you have history of stomach ulcers, are taking blood thinners, or have kidney/liver problems 2
• Do not use NSAIDs after 30 weeks of pregnancy 2

Non-Pharmacological Home Treatments

Relaxation Techniques (Highly Effective)

• Practice progressive muscle relaxation (PMR) regularly at home, which has demonstrated 50-56% reduction in headache activity when performed consistently 3, 4
• Include relaxation training, meditative therapy with abdominal breathing exercises, and visualization/guided imagery 5
• Home practice is essential: patients who practiced PMR regularly at home showed 50% clinically significant improvement versus only 15% without home practice 3

Exercise Program

• Engage in aerobic exercise 2-3 times per week for 30-60 minutes as both acute relief and prevention 1
• Consider upper-body progressive strength training 3 times weekly for 30 minutes 1
• Exercise has been shown as effective as medication (topiramate) for migraine prevention and applies to tension headache management 5

Physical Self-Care Techniques

• Apply thermal methods (heat or cold packs) to neck and shoulder areas 1
• Perform gentle neck stretches and self-massage of trigger points in neck and shoulder muscles 1
• Maintain good posture throughout the day to reduce muscle tension 6

Essential Lifestyle Modifications at Home

Daily Habits

• Maintain consistent sleep schedule with good sleep hygiene 1
• Ensure regular meals and adequate hydration throughout the day 1
• Limit caffeine intake, as excessive caffeine can trigger rebound headaches 1
• Engage in stress management through relaxation techniques or mindfulness practices 5

Headache Diary

• Keep a detailed headache diary tracking frequency, severity, triggers, and medication use 7
• This is essential because patients cannot reliably report headache frequency without documentation 7
• Use the diary to identify and avoid personal triggers 1

When Home Treatment Is Insufficient

Indications to Seek Medical Care

• If you experience 2 or more disabling attacks per month lasting 3+ days 7
• If you use acute medications more than twice weekly, creating risk for medication overuse headache 7
• If headaches are not responding adequately to home treatments 7

Prevention May Be Needed

• Frequent tension headaches (more than twice weekly) typically require preventive medication like amitriptyline in addition to home treatments 7, 1
• Combining home treatments with preventive medication yields better outcomes than either alone 5

Common Pitfalls to Avoid

• Medication overuse is the most critical pitfall: using acute medications more than 15 days per month transforms episodic headache into chronic daily headache 1
• Inconsistent practice of relaxation techniques reduces effectiveness—regular daily practice is essential 3
• Ignoring lifestyle factors (irregular sleep, skipping meals, dehydration) undermines all other treatments 1
• Delaying preventive treatment when headaches are frequent leads to chronification 7