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.
May Be Effective
These therapies may be effective:
May Not Be Effective
These therapies may not provide benefit:
Not Enough Data to Assess
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.
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A2. Millstine D, Cen CY, et al. Complementary and integrative medicine in the management of headache. BMJ 2017;357:j1805.
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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.
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.
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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.
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.
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.
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.
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.
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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.
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.
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.
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.
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
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