Headache Tension

Tension headaches usually start at the back of your head and move forward covering your whole head with a steady dull pain.

Signs and Symptoms

• The headache starts at the back of your head and spreads.
• Dull pressure or a squeezing pain lasts from half an hour to several hours or days.
• Muscles in your neck shoulders and jaw are tight and sore.
• Aching usually continues through the day.
• Your headache does not feel worse if you move about.

What Causes It?

When you feel tense the muscles in your shoulders neck and jaw tighten up and press on blood vessels surrounded by nerves making those nerves send pain messages to your brain. Causes include the following.

• Sitting too long or in an uncomfortable position
• Premenstrual syndrome (PMS)
• Low blood sugar
• Food allergy
• Not enough sleep; not enough fluids
• Clenching your jaw or grinding your teeth
• Pain that originates from other areas such as your sinuses
• Stress
• Depression or anxiety

What to Expect at Your Provider's Office

Your health care provider will ask questions about your headaches such as when they occur and how long they last. Your provider may run tests to rule out medical problems that could be causing your headaches.

Treatment Options

Treatment Plan

A treatment plan for tension headaches includes learning ways to avoid and manage stress. Biofeedback yoga and relaxation techniques can be helpful in relieving and avoiding headaches. Regular exercise can reduce how often you get a tension headache. Most people respond well to nonprescription pain relievers. Your health care provider will prescribe painkillers if necessary.

Drug Therapies

Prescription

• Naproxen—for acute pain; various side effects
• Prescription pain killers—for severe headache; for example codeine or oxycodone; various side effects
• Antidepressants—help prevent headaches for some people; various side effects
• Beta-blockers—help prevent headaches for some people; various side effects

Over the Counter

• Ibuprofen—use as directed

Complementary and Alternative Therapies

Main emphasis of therapies is muscle relaxation and stress management.

Nutrition

• Replacing micronutrients depleted in times of stress is essential; the most critical are the vitamins C E beta-carotene B-complex and the minerals magnesium potassium calcium zinc manganese and selenium. Magnesium (aspartate or glycinate up to 750 mg per day) is especially critical because of its antispasmodic action.
• Avoid caffeine.
• Essential fatty acids can improve blood flow. Reduce animal fats and increase fish. A mix of omega-6 (evening primrose) and omega-3 (flax seed) may be best (2 tbsp. oil per day or 1 000 to 1 500 IU twice a day).
• Vitamin E: 400 to 800 IU/day may decrease muscle cramping.
• Elimination diet: Some tension headaches respond dramatically to this approach. The most common allergic foods are wheat dairy products corn soy and chocolate. Eliminate these foods completely for 2 weeks then reintroduce the foods one at a time every 3 days and note reactions. Citrus alcohol red meat flour products spices and carbonated drinks may also aggravate headaches.
• Calcium/magnesium: 1 000/500 mg per day may help regulate muscle contraction and relaxation.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

• Peppermint (Mentha piperata) oil is effective against tension. Add two drops of peppermint essential oil to 1 cup of water. Soak a cloth in the solution and apply as a compress.
• White willow bark (Salix alba) contains salicin the pain reliever in aspirin. Do not use if you cannot take aspirin.
• Meadowsweet (Filipendula ulmaria) relieves pain reduces nausea and heartburn and helps relieve tension and digestive discomfort.
• Valerian (Valeriana officinalis) helps you relax and reduces spasms and helps relieve tension with anxiety or digestive discomfort.
• Jamaican dogwood (Piscidia piscipula) helps you relax and relieves pain and spasms.
• Ginkgo (Gingko biloba) increases blood circulation to your brain and can help relieve tension.
• Combine white willow (Salix alba) meadowsweet (Fillipendula ulmaria) and two of the above herbs. Herbs—1 tbsp. in 1 cup water three times a day. Tincture—60 drops three times a day.
• Kava kava (Piper methysticum)—45 to 60 mg of kavalactone content three times a day has a calming effect if anxiety is prominent.

Homeopathy

Some of the most common remedies used for tension headache are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Aconite is for tension headaches that appear suddenly with anxiety following shock or with fever.
• Bryonia is recommended for congestive headaches that feel worse when you move and better with pressure or with your eyes closed.
• Gelsemium is recommended for heavy-feeling headaches.
• Belladonna is recommended for throbbing headaches.

Physical Medicine

You can do other things to avoid tension headaches or relieve pain.

• Biofeedback to control muscle tension.
• Acupuncture can help relieve pain.
• Using small circular motions press acupressure points at the web between your thumb and index finger.
• Practice gentle neck stretches to ease tightness.
• Put an ice pack on your forehead. To increase the pain-relieving effect soak your feet in hot water at the same time.
• Breathe deeply or try other relaxation exercises such as yoga.
• Get regular exercise especially for your back and abdomen.

Following Up

Tension headaches may keep occurring if you do not treat the underlying causes. Exercise and stress reduction techniques will help.

Supporting Research

Berkow R. The Merck Manual. 15th ed. Rahway NJ: Merck Sharp & Dohme Research Laboratories; 1987.

Scalzo R. Naturopathic Handbook of Herbal Formulas. Durango Colo: 2nd ed. Kivaki Press; 1994.

Walker L Brown E. The Alternative Pharmacy: Break the Drug Cycle With Safe Natural Treatment for 200 Everyday Ailments. Paramus NJ: Prentice Hall; 1998.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.