Some people with tension headaches don't seek medical attention and try to treat the pain on their own. Unfortunately, repeated use of over-the-counter (OTC) pain relievers can actually cause another type of headache, overuse headaches.
A variety of medications, both OTC and prescription, are available to reduce the pain of a headache, including:
Pain relievers. Simple OTC pain relievers are usually the first line of treatment for reducing headache pain. These include the drugs aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve).
Prescription medications include naproxen (Naprosyn), indomethacin (Indocin) and ketorolac (Ketorolac Tromethamine).
- Combination medications. Aspirin or acetaminophen or both are often combined with caffeine or a sedative drug in a single medication. Combination drugs may be more effective than are single-ingredient pain relievers. Many combination drugs are available OTC.
- Triptans and narcotics. For people who experience both migraines and episodic tension headaches, a triptan can effectively relieve the pain of both headaches. Opiates, or narcotics, are rarely used because of their side effects and potential for dependency.
Your doctor may prescribe medications to reduce the frequency and severity of attacks, especially if you have frequent or chronic headaches that aren't relieved by pain medication and other therapies.
Preventive medications may include:
- Tricyclic antidepressants. Tricyclic antidepressants, including amitriptyline and protriptyline, are the most commonly used medications to prevent tension headaches. Side effects of these medications may include constipation, drowsiness and dry mouth.
- Other antidepressants. There also is some evidence to support the use of the antidepressants venlafaxine (Effexor XR) and mirtazapine (Remeron).
- Anticonvulsants and muscle relaxants. Other medications that may prevent tension headaches include anticonvulsants, such as topiramate (Topamax). More study is needed.
Preventive medications may require several weeks or more to build up in your system before they take effect. So don't get frustrated if you haven't seen improvements shortly after you begin taking the drug.
Your doctor will monitor your treatment to see how the preventive medication is working. In the meantime, overuse of pain relievers for your headaches may interfere with the effects of the preventive drugs.
The following nontraditional therapies may help if you have tension headache pain:
- Acupuncture. Acupuncture may provide temporary relief from chronic headache pain. Acupuncture practitioners treat you using extremely thin, disposable needles that generally cause little pain or discomfort. The American Academy of Medical Acupuncture website provides referrals to medical doctors who use acupuncture in their practices.
- Massage. Massage can help reduce stress and relieve tension. It's especially effective for relieving tight, tender muscles in the back of your head, neck and shoulders. For some people, it may also provide relief from headache pain.
- Deep breathing, biofeedback and behavior therapies. A variety of relaxation therapies are useful in coping with tension headaches, including deep breathing and biofeedback.
Aug. 19, 2017
- Daroff RB, et al. Headache and other craniofacial pain. In: Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed May 28, 2016.
- Semenov IA. Tension-type headaches. Disease-A-Month. 2015;61:233.
- Tension-type headache (TTH). International Headache Society. http://ihsclassification.org/en/02_klassifikation/02_teil1/02.00.00_tension.html. Accessed May 28, 2016.
- Infrequent episodic tension-type headache. International Headache Society. http://ihsclassification.org/en/02_klassifikation/02_teil1/02.01.00_tension.html. Accessed May 28, 2016.
- Chronic tension-type headache. International Headache Society. http://ihsclassification.org/en/02_klassifikation/02_teil1/02.03.00_tension.html. Accessed May 28, 2016.
- Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm. Accessed May 29, 2016.
- Taylor FR. Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis. http://www.uptodate.com/home. Accessed May 28, 2016.
- National Clinical Guideline Centre. Headaches: Diagnosis and management of headaches in young people and adults. London (UK): National Institute for Health and Clinical Excellence (NICE); 2012.
- Freitag F. Managing and treating tension-type headache. Medical Clinics of North America. 2013;97:281.
- Headache hygiene tips. American Headache Society Committee for Headache Education. http://www.achenet.org/resources/trigger_avoidance_information/. Accessed June 3, 2016.
- Headaches: In depth. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/pain/headachefacts.htm. Accessed May 31, 2015.