Tension Headaches: Complementary and Alternative Medicine

Tension headaches are quite common and, unfortunately, they're also among the most neglected and difficult headaches to treat. With a tension headache, the pain often starts at the back of your head and moves forward, so that it eventually includes your neck, scalp, and head. It's often described as feeling like you have a tight band across your head. It may be caused by staying in one position for a long time, such as in reading, using a computer, or playing video games. It may also be caused by stress, but sometimes there is no obvious cause. In this article we discuss their causes, symptoms, and treatments.

If your headaches happen 15 or more days in a month for several months, they are considered chronic tension headaches. If they occur less frequently, they are called episodic tension headaches. Although tension headaches can be painful, they are rarely a sign of a more serious illness. A combination of lifestyle changes, relaxation techniques, and traditional and complementary therapies can help reduce the number of tension headaches you experience.
 
Signs and Symptoms:
• Headache starts at the back of your head and spreads forward
• Dull pressure or a squeezing pain, often described as a tight band around the head
• Muscles in your neck, shoulders, and jaw can feel tight and sore
• Affects both sides of your head equally
• Possible difficulty sleeping or eating

Causes
Researchers aren't clear what causes a tension headache. For years, scientists thought that it was caused by tightening the muscles in your shoulders, neck, scalp, and jaw when you are tense. But new tests that measure muscle tension show that the muscles of people with tension headaches aren't any tighter. Newer theories suggest tension headaches are caused by changes in brain chemicals called neurotransmitters (including serotonin), similar to what happens with a migraine. Scientists don't know why the levels of neurotransmitters go up and down, but they think it activates pain pathways in the brain. Tight muscles may help trigger the changes in neurotransmitters, or muscle tightness may be a result of changing levels of brain chemicals.

Treatment Approach
A comprehensive treatment plan, including relaxation, exercise, lifestyle changes, and occasional medication can be very effective in reducing the frequency and intensity of tension headaches. Biofeedback, yoga, and relaxation techniques, for example, can help relieve pain and lower the number of headaches you have. Regular exercise helps, too.

Lifestyle
Keeping a headache diary can help identify the source of your tension headaches and how you can change your environment and habits to avoid them. When a headache starts, write down the date and time it began. Note what you ate for the preceding 24 hours, how long you slept the night before, what you were doing just before the headache, any unusual stress in your life, how long the headache lasted, and what you did to make it stop.

Homeopathy
One of the most common reasons people seek homeopathic care is to relieve the pain associated with chronic headaches. Many homeopaths report that homeopathy helps treat and prevent recurrent tension headaches. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

The following homeopathic remedies are commonly prescribed for tension headaches:
• Belladonna: for throbbing headaches that come on suddenly; symptoms tend to worsen with motion and light, but are partially relieved by pressure, standing, sitting, or leaning backwards.
• Bryonia: for headaches with a steady, sharp pain that occurs most often in the forehead, but may radiate to the back of the head; symptoms tend to worsen with movement and light touch, but firm pressure alleviates the pain; the person for whom this remedy is most appropriate is usually irritable and may experience nausea, vomiting, and constipation.
• Gelsemium: for pain that extends around the head and feels like a tight band of constriction; pain usually originates in the back of the head and may be relieved following urination; this remedy is most appropriate for individuals who feel extremely weak and have difficulty keeping their eyes open.
• Ignatia: for pain that may be described as a feeling of something being driven into the skull; these types of headaches tend to be triggered by emotion, including grief or anxiety, and the treatment is appropriate for both children and adults
• Iris versicolor: for throbbing headaches that occur on one side of the head, especially after eating sweets; visual disturbances may also occur; these headaches are worse in the early morning, during spring and fall, and symptoms tend to worsen with vomiting.
• Lachesis: for headaches that tend to occur on the left side of the head; symptoms are typically worse in the mornings, before menstruation, and with exposure to warmth and sunlight; symptoms tend to improve with open air and firm pressure.
• Nux vomica: for headaches associated with hangovers, overindulgence in foods or alcohol, and overwork; these types of headaches are often accompanied by nausea and/or dizziness; this remedy is most appropriate for individuals who tend to be constipated and irritable.
• Pulsatilla: for headaches triggered by eating rich, fatty foods, particularly ice cream; pain tends to move but may be concentrated in the forehead or on one side of the head and may be accompanied by digestive problems or occur around the time of menstruation; children for whom this remedy is appropriate often develop these symptoms while at school.
• Sanguinaria: for right-sided headaches that begin in the neck and move upwards, recur in a predictable pattern (such as every seven days); pain is aggravated by motion, light, or sun exposure, odors, and noise; this remedy is appropriate for children who may have a craving for spicy or acidic foods, despite having a general aversion to eating due to the headache.
• Spigelia: for stinging, burning, or throbbing sinus pain that often occurs on the left side of the head; symptoms tend to worsen with cold weather and motion, but may be temporarily relieved by cold compresses and lying on the right side with the head propped up.

Herbal Remedies
The use of herbs is a time-honored approach to strengthening the body and treating disease. Common herbal remedies include peppermint, feverfew, ginger, capsicum, valerian, Dong Quai, and rosemary.

Peppermint: Peppermint oil, applied topically to the forehead, has shown some promise in very early studies. In one study, applying a 10% peppermint oil solution to the temples relieved pain about as well as acetaminophen (Tylenol). More research is needed to know for sure if peppermint oil is effective. Be careful not to get peppermint oil or any essential oil into the eyes.
Feverfew: Feverfew has been used traditionally to treat headaches, and several well-designed studies have found that it may help prevent and treat migraines. However, not all studies agree, and it has not been studied to see if it can prevent or treat tension headaches. Feverfew can increase the risk of bleeding, and should not be taken with blood thinners. If you are allergic to ragweed you may also be allergic to feverfew. Women who are pregnant or breastfeeding should not take feverfew.
Ginger: Many medical research studies point to the effectiveness of ginger for the treatment of headaches. This root has an immediate effect on inflammation relief, and it is most helpful when taken sublingually during a headache episode. A preventative method would be to drink ginger tea a few times a week.
Capsicum: Cayenne peppers have many health benefits, including the almost immediate cessation of strong headaches in some people. When capsicum is made into capsaicin and bottled as nasal spray, it is usually recommended to migraine patients as a very effective and reactive treatment that can stop migraine headaches for about an hour. When capsicum in consumed as part of a regular diet, it can help in preventing future migraine episodes.
Valerian: The root and buds of this wildflower have been used for the treatment of neurological and emotional ailments since ancient times. Even Hippocrates, known as the father of modern medicine, praised the medicinal benefits of Valerian. For migraine patients, Valerian is more effective as part of a preventative approach since it is effective in terms of relaxation and stress reduction.
Dong Quai: The root of this plant is used as a spice in various Chinese dishes, and it tastes just a little stronger than parsley. In ancient times, Dong Quai was prescribed as a sort of cure-all remedy, but it is essentially an analgesic and anti-inflammatory herb. These days, Dong Quai root is usually mixed with other herbs for analgesic purposes. Medical research into this root’s properties and its effectiveness in preventing migraines do not support the idea of incorporating it as part of a preventative treatment strategy.
Rosemary: Many oils and lotions used in therapeutic massage include rosemary as a base ingredient. This aromatic and tasty herb has been used for centuries for the relief of joint pain and arthritic conditions, but its effectiveness in relieving migraine pain has only been studied since the late 20th century. Rosemary is mostly used as a relaxation agent to reduce the most common trigger of migraine episodes: stress. To this effect, this herb can be applied as a topical oil directly to the temples, forehead and neck.

Acupuncture
Scientific studies investigating the use of acupuncture to treat tension headaches have found mixed results. Researchers agree that acupuncture appears safe and that it may be effective for some people. Acupuncturists diagnose tension headaches by paying careful attention to the kidney and its associated meridians (energy pathways in the body), as well as liver and gallbladder meridians. The physical location of the headache also helps the acupuncturist create a treatment plan, which may include lifestyle/dietary changes or herbal remedies. Other studies suggest acupuncture is best used as a preventive treatment for tension headaches, and that electro-acupuncture is more effective than manual acupuncture.

Chiropractic
Several clinical trials indicate that spinal manipulation therapy may help treat tension headaches, especially ones that start in the neck. One study compared spinal manipulation to Elavil and found that people in both groups got better, while those in the spinal manipulation group had less side effects. The benefits of spinal manipulation lasted longer: One month after treatment, the chiropractic group still showed improvement, while the Elavil group did not. Another study found a 50% reduction of headache severity after a single 10-minute spinal manipulation session. However, other studies comparing chiropractic to a sham treatment plus massage found no benefit.

Massage and Physical Therapy
Regular massage may help relieve stress and pain in people with chronic tension headaches, according to one preliminary study. Doing stretches for your head and neck may also help. Practicing proper posture is another important factor in reducing the number of headaches. A physical therapist can be a useful ally in ways to practice proper technique for stretching as well as posture.

Reflexology is a technique that places pressure on specific "reflex points" on the hands and feet that are believed to correspond to areas throughout the body. Some early studies suggest it may relieve pain and allow people with migraines to take less pain medication. However, more research is needed. Practitioners believe reflexology helps you become more aware of your own body signals, which might help you sense the subtle signals that indicate a migraine is about to occur, before pain starts. They also believe reflexology helps improve general well-being and energy level.

Mind-Body Medicine
You can do many things to avoid tension headaches or relieve the pain. These include biofeedback to control muscle tension, learning to meditate, breathe deeply, or other relaxation exercises such as yoga, and developing a daily relaxation routine that focuses on the muscles of the head and neck. Other relaxation techniques that may be helpful include guided imagery and hypnosis.

Conclusion
More than 90% of people with tension headaches can get significant relief from a combination of lifestyle changes, relaxation, and medication.Because people experience negative effects from frequent headaches, it’s important to find natural and effective treatment options. Yoga, nutritional supplements, essential oils, and dietary modifications are all natural, safe, and effective ways to reduce headache symptoms. While traditional methods such as medications are often necessary, there are many natural and effective ways to prevent and treat headaches if you’re looking for a more holistic approach.

For Further Reading:
• Healthline.com has an excellent overview of natural approaches to tension headache at https://www.healthline.com/nutrition/headache-remedies#bottom-line.
• “Tame Your Tension Headaches Naturally” by The Cleveland Clinic is presented at https://health.clevelandclinic.org/tame-your-tension-headaches-naturally/.
• Cigna.com presents their thoughts on this subject at their article “Natural Remedies for Headaches” found at: https://www.cigna.com/knowledge-center/natural-remedies-for-headaches.