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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

bulletThe headache starts at the back of your head and spreads.
bulletDull pressure or a squeezing pain lasts from half an hour to several hours or days.
bulletMuscles in your neck, shoulders, and jaw are tight and sore.
bulletAching usually continues through the day.
bulletYour 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.

 

bulletSitting too long or in an uncomfortable position
bulletPremenstrual syndrome (PMS)
bulletLow blood sugar
bulletFood allergy
bulletNot enough sleep; not enough fluids
bulletClenching your jaw or grinding your teeth
bulletPain that originates from other areas, such as your sinuses
bulletStress
bulletDepression 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

 

bulletNaproxen—for acute pain; various side effects
bulletPrescription pain killers—for severe headache; for example, codeine or oxycodone; various side effects
bulletAntidepressants—help prevent headaches for some people; various side effects
bulletBeta-blockers—help prevent headaches for some people; various side effects

 

Over the Counter

 

bulletIbuprofen—use as directed

 

Complementary and Alternative Therapies

Main emphasis of therapies is muscle relaxation and stress management.

Nutrition

 

bulletReplacing 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.
bulletAvoid caffeine.
bulletEssential 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).
bulletVitamin E: 400 to 800 IU/day may decrease muscle cramping.
bulletElimination 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.
bulletCalcium/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.

 

bulletPeppermint (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.
bulletWhite willow bark (Salix alba) contains salicin, the pain reliever in aspirin. Do not use if you cannot take aspirin.
bulletMeadowsweet (Filipendula ulmaria) relieves pain, reduces nausea and heartburn, and helps relieve tension and digestive discomfort.
bulletValerian (Valeriana officinalis) helps you relax and reduces spasms, and helps relieve tension with anxiety or digestive discomfort.
bulletJamaican dogwood (Piscidia piscipula) helps you relax and relieves pain and spasms.
bulletGinkgo (Gingko biloba) increases blood circulation to your brain, and can help relieve tension.
bulletCombine 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.
bulletKava 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.

 

bulletAconite is for tension headaches that appear suddenly, with anxiety, following shock, or with fever.
bulletBryonia is recommended for congestive headaches that feel worse when you move and better with pressure or with your eyes closed.
bulletGelsemium is recommended for heavy-feeling headaches.
bulletBelladonna is recommended for throbbing headaches.

 

Physical Medicine

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

 

bulletBiofeedback to control muscle tension.
bulletAcupuncture can help relieve pain.
bulletUsing small circular motions, press acupressure points at the web between your thumb and index finger.
bulletPractice gentle neck stretches to ease tightness.
bulletPut an ice pack on your forehead. To increase the pain-relieving effect, soak your feet in hot water at the same time.
bulletBreathe deeply or try other relaxation exercises, such as yoga.
bulletGet 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.