Health Library

Tension Headache

Tension Headache

Related Terms

Headache, Tension

Tension headache is a spreading, steady head pain that can be mild or severe. It may happen often or only once and a while. They do not get in the way of daily activities.

They are treated with medicine. Some people may turn to natural therapies to prevent headaches or further ease pain.

Natural Therapies

May Be Effective

These therapies may be effective:

  • Acupuncture uses thin needles in specific body points. It may reduce headache frequency.A1-A5
  • Aromatherapy is the use of aromatic plant extracts and essential oils. Tiger balm, a combination of camphor, menthol, cajaput, and clove oil, may reduce headache frequency and the use of pain relievers.B1
  • Cognitive behavioral therapy is a way of reframing negative thought patterns to change unwanted behaviors.L1, L2
  • EMG Biofeedback teaches a person to control the body’s responses to reduce headache frequency and the use of pain relievers.D1-D3
  • Hypnosis relaxation is a mental state like sleep that allows a person's thoughts to be influenced by another person. It may reduce headache frequency prevent headaches if used often.E1
  • Manual therapies is a physical treatment often used by physical therapists to treat pain by moving the muscles and joints.M1-M3
  • Massage, especially Thai traditional massage, may reduce headache frequency.F1
  • Mindfulness meditation is a way of paying attention to the present without judgement. It may reduce pain intensity.G1, G2
  • Myofascial release is a manual therapy often used in massage. It may reduce headache frequency, duration, and the use of pain relievers when it is done to the facial muscles.H1-H3
  • Relaxation training is any method that helps a person to relax. It may improve sleep and well being.I1, I2
  • Spinal Manipulation is when practitioners use their hands or a device to put force on a joint of the spine. It may reduce headache frequency and pain.C1-C5
  • Therapeutic touch uses the body's energy shield to heal without physical contact. It may reduce headache pain.J1

5-HTP (5-Hydroxytryptophan) is an amino acid used to build serotonin in the body. It may reduce the frequency of headaches and the use of pain relievers.K1

May Not Be Effective

These therapies may not provide benefit:

  • Autogenic training teaches the body to respond to verbal commands.O1
  • Dry needling is the use of a needle without medication or injection to ease pain.N1

Not Enough Data to Assess

  • Physiotherapy P1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.

References►

Acupuncture

A1. Linde K, Allais G, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;4:CD007587. A2.

A2. Millstine D, Cen CY, et al. Complementary and integrative medicine in the management of headache. BMJ 2017;357:j1805.

A3. Krishnan A, Silver N. Headache (chronic tension-type). BMJ Clin Evid. 2009 Jul 22;2009. pii: 1205. PMC2907789.

A4. Baxter GD, Bleakley C, et al. Clinical effectiveness of laser acupuncture: a systematic review. J Acupunct Meridian Stud. 2008 Dec;1(2):65-82.

A5. Davis MA, Kononowech RW, et al. Acupuncture for tension-type headache: a meta-analysis of randomized, controlled trials. J Pain. 2008 Aug;9(8):667-677.

Tiger Balm

B1. Schattner P, Randerson D. Tiger Balm as a treatment of tension headache. A clinical trial in general practice. Aust Fam Physician. 1996;25(2):216.

Spinal Manipulation

C1. Vernon H, Jansz G, et al. A randomized, placebo-controlled clinical trial of chiropractic and medical prophylactic treatment of adults with tension-type headache: results from a stopped trial. J Manipulative Physiol Ther. 2009;32(5):344-351.

C2. Posadzki P, Ernst E. Spinal manipulations for tension-type headaches: a systematic review of randomized controlled trials. Complement Ther Med. 2012;(4):232-239.

C3. Clar C, Tsertsvadze A, et al. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropr Man Therap. 2014;22(1):12.

C4. Vernon H, Borody C, et al. A randomized pragmatic clinical trial of chiropractic care for headaches with and without a self-acupressure pillow. J Manipulative Physiol Therap. 2015;38(9):637-643.

C5. Lenssinck ML, Damen L, et al. The effectiveness of physiotherapy and manipulation in patients with tension-type headache: a systematic review. Pain. 2004 Dec;112(3):381-388.

EMG Biofeedback

D1. Nestoriuc Y, Rief W, et al. Meta-analysis of biofeedback for tension-type headache: efficacy, specificity, and treatment moderators. J Consult Clin Psychol. 2008;76(4):379-396.

D2. Verhagen AP, Damen L, et al. Behavioral treatments of chronic tension-type headache in adults: are they beneficial? CNS Neurosci Ther. 2009;15(2):183-205.

D3. Nestoriuc Y, Martin A, et al. Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback. 2008 Sep;33(3):125-140.

Hypnotic Relaxation

E1. Ezra Y, Gotkine M, et al. Hypnotic relaxation vs amitriptyline for tension-type headache: let the patient choose. Headache. 2012;52(5):785-791.

Massage

F1. Chatchawan U, Eungpinichpong W, et al. Effects of Thai traditional massage on pressure pain threshold and headache intensity in patients with chronic tension-type and migraine headaches. J Altern Complement Med. 2014;20(6):486-492.

Mindfulness Meditation

G1. Gu Q, Hou JC, et al. Mindfulness meditation for primary headache pain: a meta-analysis. Chin Med J (Engl). 2018;131(7):829-838.

G2. Probyn K, Bowers H, et al. Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components. BMJ Open. 2017 Aug 11;7(8):e016670.

Myofascial Release

H1. Ghanbari A, Rahimijaberi A, et al. The effect of trigger point management by positional release therapy on tension type headache. NeuroRehabilitation. 2012;30(4):333-339.

H2. Moraska AF, Stenerson L, et al. Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled clinical trial. Clin J Pain. 2015;31(2):159-168.

H3. Moraska AF, Schmiege SJ, et al. Responsiveness of myofascial trigger points to single and multiple trigger point release massages: a randomized placebo controlled trial. Am J Phys Med Rehabil. 2017;96(9):639-645.

Relaxation Training

I1. Söderberg EI, Carlsson JY, et al. Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training. Clin J Pain. 2011;27(5):448-456.

I2. Verhagen AP, Damen L, et al. Conservative treatments of children with episodic tension-type headache. A systematic review. J Neurol. 2005 Oct;252(10):1147-1154.

Therapeutic Touch

J1. Keller E, Bzdek VM. Effects of therapeutic touch on tension headache pain. Nurs Res. 1986;35(2):101-106.

5-Hydroxytryptophan

K1. Ribeiro CA. L-5-Hydroxytryptophan in the prophylaxis of chronic tension-type headache: a double-blind, randomized, placebo-controlled study. For the Portuguese Head Society. Headache. 2000;40(6):451-456.

Cognitive Behavioral Therapy

L1. Probyn K, Bowers H, et al. Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components. BMJ Open. 2017 Aug 11;7(8):e016670.

L2. Krishnan A, Silver N. Headache (chronic tension-type). BMJ Clin Evid. 2009 Jul 22;2009. pii: 1205. PMC2907789.

Manual Therapy

M1. Mesa-Jiménez JA, Lozano-López C, et al. Multimodal manual therapy vs. pharmacological care for management of tension type headache: A meta-analysis of randomized trials. Cephalalgia. 2015 Dec;35(14):1323-1332.

M2. Lozano López C, Mesa Jiménez J, et al. Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013. Neurologia. 2016 Jul-Aug;31(6):357-369.

M3. Fernández-de-Las-Peñas C, Alonso-Blanco C, et al. Are manual therapies effective in reducing pain from tension-type headache?: a systematic review. Clin J Pain. 2006 Mar-Apr;22(3):278-285.

Dry Needling

N1. France S, Bown J, et al. Evidence for the use of dry needling and physiotherapy in the management of cervicogenic or tension-type headache: a systematic review. Cephalalgia. 2014 Oct;34(12):994-1003.

Autogenic Training

O1. Kanji N, White AR, et al. Autogenic training for tension type headaches: a systematic review of controlled trials. Complement Ther Med. 2006 Jun;14(2):144-150.

Physiotherapy

P1. Lenssinck ML, Damen L, et al. The effectiveness of physiotherapy and manipulation in patients with tension-type headache: a systematic review. Pain. 2004 Dec;112(3):381-388.

Last reviewed December 2019 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 6/29/2020

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.

Copyright ©  EBSCO Information Services
All rights reserved.
Privacy Policy | Editorial Policy

Home |Terms and Conditions |Concerned About Privacy? |Accessibility |Careers |For Employers and Medical Plan Providers

You may also be looking for: CVS/pharmacy | MinuteClinic | Specialty Pharmacy | SilverScript | Accordant