by Stephen Janz Clinic Director Kenmore Centre for Health Brisbane
About seven million Australians experience tension-type headache which affects children and adults alike. Treatment is often by over the counter or prescription drugs which come with a risk of side effects. Effective drug free options are available for tension headache treatment and prevention, including massage, acupuncture, herbal medicines, stress reduction and relaxation techniques.
Tension Headache Symptoms
Tension type headaches are characterised by tight and tender muscles in the upper back, neck and head. These headaches can be a dull, aching head pain and may have a sensation of tightness or pressure across the forehead or on both sides and back of the head. Some people experience nausea
and indigestion (but not vomiting) and may have difficulty concentrating. Tension headaches are also commonly associated with depression and anxiety. Tension headaches can occur in a person who also suffers from migraines, but tension headaches are different to migraines.
Cause of Tension Headaches
There are no special tests to diagnose tension headaches and they are usually diagnosed based on the symptoms, history and examination. No one knows exactly was causes tension type headaches. Once thought to be caused purely by muscle tension in the upper back, neck and head, it is now thought for many sufferers that “central sensitisation” is also a factor. “Central sensitisation” refers to an increased sensitivity to pain and stress and can result in headaches. Triggers can include excessive muscle contraction such as frowning or jaw-clenching; poor posture at work, home and when driving; bright lights; prolonged reading; loud noise; medication overuse; stress; anxiety; fatigue; emotional upsets and depression.
See a Doctor if you Experience these Symptoms
All headaches are not tension headaches. Headache Australia recommends that
a doctor be consulted if the headache is:
sudden and severe; is associated with a loss of consciousness; cannot be relieved with medication or requires daily use of medication; occurs after a head injury; is associated with blurred vision, difficulty speaking or numbness of arms or legs; or is accompanied by fever or vomiting.
Treatment of Tension Headaches
Tension headaches are often self-treated with common over the counter pain medication, with more serious cases managed with prescription medications. The overuse of over-the counter medications can ironically lead to chronic daily headaches and other side effects, so fortunately there are non-drug strategies to prevent and treat tension headaches as well. Headache Australia recommends non-drug measures such as:
hot packs; massage; acupuncture; taking time out from stress; ensuring adequate sleep; scheduling regular exercise and leisure and seeking treatment to identify and manage any underlying anxiety or emotional stress, and relaxation techniques.
Drug free Treatment for Tension Headaches
Massage is an ideal treatment for addressing muscular pain, physical muscle tension, postural strain and the effects of stress. Acupuncture can treat tension headache and can also prevent them recurring. Registered acupuncturists take a holistic approach which allows them to address trigger factors such as, anxiety, insomnia and stress, while also treating tight muscles, trigger points and pain. Clinical guidelines recommend a course of up to 10 acupuncture treatments over 5-8 weeks for the prevention of chronic tension headaches. Acupuncture can also be used for migraine prevention. Yoga, biofeedback and meditation also have a role in preventing tension headache and migraine. Herbal medication can also be used to target stress, muscle tension and hormonal imbalances. Magnesium is the popular ‘go to’ nutrient for muscle tension and mental stress.
Tension headaches can have a big impact on quality of life and work performance. Rather than making medication the first choice in treatment, there are abundant lifestyle and non-drug approaches depending on individual preferences to ease the tension and break the cycle of pain.
Headache Australia. Tension Headaches. https://headacheaustralia.org.au/headachetypes/tension-type-headache/
AR. Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD001218. DOI: 10.1002/14651858.CD001218.pub3. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001218.pub3/full
Mier, R. W., & Dhadwal, S. (2018). Primary Headaches. Dental Clinics of North America. doi:10.1016/j.cden.2018.06.006 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001218.pub3/full
National Institute for Health Care Excellence (NICE).Headaches in over 12s: diagnosis and management. Clinical guideline [CG150] Published date: September 2012 Last updated: November 2015https://www.nice.org.uk/guidance/cg150/chapter/recommendations
Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K; Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis (2012) Arch Intern Med. Oct 22;172(19):1444-53. doi: 10.1001/archinternmed.2012.3654.