Tension headache treatments
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Effective Treatments for Tension Headaches
Tension-type headaches (TTH) are the most common form of headache, characterized by a dull, aching pain and tightness around the forehead or back of the head and neck. Various treatments have been explored to alleviate the symptoms of TTH, ranging from pharmacological to non-pharmacological approaches. This article synthesizes the findings from multiple research studies on the effectiveness of different treatments for tension headaches.
Acupuncture for Tension Headaches
Effectiveness of Acupuncture
Acupuncture has been studied extensively as a treatment for tension-type headaches. Research indicates that acupuncture can be more effective than no treatment or routine care in reducing headache frequency and pain intensity in the short term (up to three months) . However, its long-term benefits remain unclear. When compared to sham acupuncture, acupuncture shows small but statistically significant benefits in reducing headache frequency and pain intensity 14. Despite these findings, the lack of standardization in acupuncture point selection and treatment protocols suggests that more research is needed to confirm these results .
Cognitive and Behavioral Therapies
Cognitive Therapy, Relaxation, and Biofeedback
Cognitive therapy, relaxation techniques, and electromyographic (EMG) biofeedback have been shown to be effective in treating tension headaches. These therapies are superior to no treatment and placebo therapies in reducing headache frequency and intensity . However, the effectiveness of these treatments may be influenced more by patient characteristics, such as the duration of headache complaints and the age of the patient, rather than the specific treatment characteristics . Despite some studies showing inconsistent results, these behavioral treatments are generally considered beneficial for managing TTH .
Dry Needling
Short-Term Benefits of Dry Needling
Dry needling is another technique used to treat tension-type headaches. While it does not significantly outperform other interventions in reducing headache pain intensity in the short term, it has been found to significantly improve related disability and other outcomes such as headache frequency, quality of life, and cervical range of motion . The evidence supporting dry needling is of very low quality, indicating a need for further high-quality studies to draw more robust conclusions .
Physical Therapy and Manual Therapy
Physical Therapy Interventions
Physical therapy, including manual joint mobilization and supervised physical activity, has shown positive effects on headache frequency, pain intensity, and quality of life in patients with TTH 56. Techniques that focus on the cranio-cervical-mandibular region are particularly effective in reducing pain intensity and headache frequency in the short and medium term . However, there is no standardized physical therapy protocol for TTH, and more long-term studies are needed to establish the most effective approaches .
Manual Therapy Techniques
Manual therapy, including spinal manipulation and massage, has been found to be effective in reducing headache frequency and improving cervical spine range of motion 78. Combining massage with manipulative techniques yields better results than massage alone, particularly in increasing the range of motion of the upper cervical spine and reducing the impact of headaches . Soft tissue interventions and dry needling are also effective in improving pain intensity and frequency . However, high-velocity, low-amplitude thrust manipulations do not show significant benefits over no treatment .
Conclusion
In summary, various non-pharmacological treatments, including acupuncture, cognitive and behavioral therapies, dry needling, physical therapy, and manual therapy, have shown effectiveness in managing tension-type headaches. While acupuncture and dry needling offer short-term benefits, cognitive and behavioral therapies provide a broader range of benefits influenced by patient characteristics. Physical and manual therapies, particularly those targeting the cranio-cervical-mandibular region, are effective in reducing pain intensity and headache frequency. Further high-quality research is needed to standardize treatment protocols and confirm long-term benefits.
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