How to relieve tension headaches

When experiencing a tension headache, it may feel like your head is being tightly wrapped, gradually tightening around your temples. Sometimes, you may also feel discomfort in the scalp and neck area. While tension headaches are the most common type of headache, the exact causes are not fully understood. Experts suggest that these headaches may arise from reactions to stress, depression, anxiety, or trauma. However, with the right treatment, you can reduce the intensity of a tension headache.

Take over-the-counter pain relievers. These medications include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen sodium (Aleve), and aspirin. Avoid exceeding the recommended dosage on the medication label, and aim to take the lowest dose that effectively relieves the headache.

• Be aware that combining over-the-counter headache medication with caffeine can damage the liver if taken in high doses or for prolonged periods, especially if you drink alcohol or have liver issues.
• Consult with your doctor if you have been taking over-the-counter headache medication for more than a week but your tension headaches persist.
• Avoid using over-the-counter headache medications more than a few days a week, and never exceed a week or ten days without medical guidance. Overuse of painkillers can cause rebound headaches, which are a common side effect of long-term use. You may also develop a dependence on the medication and experience headaches when you stop taking it.

Consult your doctor about prescription medication. If over-the-counter pain relievers and lifestyle changes don’t alleviate your tension headaches, your doctor may prescribe stronger medications. These include naproxen, indomethacin, and piroxicam.

• Prescription medications may cause side effects such as bleeding, stomach pain, and an increased risk of heart disease. Your doctor will discuss any potential side effects or complications before prescribing these drugs.
• If you suffer from chronic tension headaches and migraines, your doctor may prescribe triptan medications to help relieve the pain. Opioids and narcotics are rarely prescribed due to their side effects and the risk of addiction and dependency.

Try acupuncture therapy. Acupuncture is a treatment method that uses thin needles inserted into specific points on the body. These needles are stimulated by hand or electrical current, which enhances blood circulation to surrounding areas, helping to reduce stress and pressure. Research has shown that acupuncture can be effective in reducing chronic tension headaches.

• Acupuncture is generally painless and should be performed by a licensed acupuncture professional. When done correctly, acupuncture has been shown to help alleviate tension headaches.
• Dry needling is another form of treatment similar to acupuncture, but it doesn’t follow traditional Chinese medical principles. This method involves inserting needles into specific trigger points on the body to help relax muscles and reduce stress, a common cause of tension headaches. This treatment can be performed by trained healthcare professionals, such as physical therapists, massage therapists, and physicians.

See a chiropractor. Studies have shown that chiropractic spinal manipulation performed by a licensed professional can help treat tension headaches, particularly chronic ones.

• If you are in the U.S., you can find a list of licensed chiropractors in various states on the Federation of Chiropractic Licensing Boards website. Ensure that the treatment is carried out by a trained and licensed chiropractor.

Ask your doctor about massage therapy. Medical massage therapy is different from general relaxation massage. Focused massage on the neck and shoulders has been shown to be effective in treating tension headaches and reducing their frequency. You can ask your doctor for a referral to a qualified massage therapist.

• Massage therapy may not be covered by health insurance. However, if your doctor refers you, it’s possible that your insurance will cover it. Check with your hospital to see if they offer coverage.
• If you are in the U.S., you can find certified and licensed massage therapists through the American Massage Therapy Association here.

Get an eye exam. Eye strain is a common cause of tension headaches. If you experience headaches frequently (more than twice a week), consider scheduling an eye exam. Vision problems can contribute to headaches.

• If you wear glasses or contact lenses, it’s important to contact your optometrist for a check-up. Your prescription may have changed, and your eyes may become strained if your current glasses or lenses no longer suit your vision needs.

Rest in a dark and quiet room. Stress is one of the main causes of headaches. When experiencing a headache, you may become sensitive to light and noise. To manage this, sit or lie down in a room with dim lighting. Close your eyes and try to relax your back, neck, and shoulders.

• Turn off any sources of noise like the TV, computer, or mobile phone.
• You can also close your eyes and gently press the palms of your hands onto your eyes for about 2 minutes. This action will help relax the optic nerves and ease the tension in your body.
• You can try neck exercises while in a dark and quiet room. Place the palm of your hand on your forehead and gently press your forehead into the palm using your neck muscles. Be sure to keep your head upright as you press.

Practice deep breathing exercises. Deep breathing exercises can help you relax and relieve tension throughout your body, including your head. Breathe slowly and steadily, focusing on relaxation.

• Close your eyes and take several deep breaths.
• Exhale slowly, releasing tension from areas of your body that feel tight. Imagine peaceful scenes such as a beach with sandy shores, a sunlit garden, or a country road.
• Lower your chin to your chest and slowly rotate your head in a half-circle from side to side.
• Inhale once more, then exhale slowly. Continue visualizing the peaceful scenery in your mind.
• Keep practicing this technique until you reach a state of relaxation.

Apply a hot or cold compress to your forehead. Both heat and cold temperatures can help alleviate pain and relieve muscle tension in your head and neck.

• Place a warm, damp towel or compress on your neck or forehead. You can also take a warm shower, allowing the water to flow over your head and neck for a while.
• Wrap ice in a cloth and apply it to your neck or forehead.

Massage peppermint oil on your temples, forehead, and the back of your jaw. Peppermint oil has soothing properties that can help reduce pain and discomfort.

• When you apply a few drops of oil to your skin, you'll experience a cool sensation in the areas where the oil is applied. Take deep breaths and find a quiet place to sit or lie down.
• If your skin is sensitive, you can dilute the peppermint oil with one or two drops of olive oil or water before applying it.

Drink water or herbal tea to hydrate your body. When you feel tension in your head, it's important to drink plenty of water or brew some herbal tea to help relax your mind. Dehydration can often lead to headaches.

• Avoid beverages containing caffeine or alcohol, as they can contribute to further dehydration.

Massage your face, head, and hands. Focus on massaging the upper body. Use your fingertips to gently rub the back and sides of your head, then move on to massaging the areas around your eyes.

• Gently rub your scalp back and forth using your fingertips. Avoid moving the scalp more than 1 cm.
• You can also slide your fingertips along the inner palms of your other hand, massaging both palms together.

Try acupressure therapy to ease your headache. This is a simple pressure-point technique you can do at home.

• Place your thumbs on either side of the base of your skull.
• Find the indentations on each side of your head where it meets your neck. These points are just outside the thick muscle running down the middle of the head, or about 5 cm from the center.
• Press gently upward with your thumbs until you feel a light sensation on your head.
• Continue gently pressing and massaging in small circular motions for about 1-2 minutes.

Exercise regularly. Physical activity can help relieve tension and stress in your body, while also releasing endorphins in the brain that help fight pain.

• Commit to 30 minutes of walking, cycling, or jogging at least three times a week. It's important to stick to a consistent workout schedule.

Stand in the “Mountain” pose to enhance your posture. A correct posture can prevent muscle strain and alleviate head pressure. Yoga poses like the “Mountain” pose help you improve your posture and promote relaxation.

• Stand with your feet shoulder-width apart.
• Place your hands by your sides and pull your shoulders back.
• Engage your core and direct your tailbone toward the floor.
• Lower your chin to your chest and hold this pose for 5-10 breaths.

Sit in the “Staff” pose. This yoga position is ideal for improving posture and practicing deep breathing.

• Sit with your legs extended in front of you.
• Point your toes toward your body.
• Pull your shoulders back and place your hands flat on the floor beside you.
• Engage your core and direct your tailbone down. Tuck your chin toward your chest. Hold for 5-10 breaths.
• If the extended leg position is uncomfortable, you can fold your legs instead.

Avoid foods containing monosodium glutamate and caffeine. Monosodium glutamate (MSG) is a common seasoning found in Chinese cuisine. Some individuals react to MSG with headaches, although there is no scientific proof linking MSG to headaches. Other foods that may trigger headaches include:

• Chocolate
• Cheese
• Foods containing the amino acid tyramine, such as red wine, aged cheese, smoked fish, chicken liver, figs, and certain beans
• Nuts
• Peanut butter
• Fruits like avocado, bananas, and citrus
• Onions
• Dairy products
• Meats with nitrates, such as bacon, sausage, and salted meats
• Fermented or pickled foods

Get at least 8 hours of sleep each night. Regular sleep routines help keep your brain and body relaxed, minimizing stress and anxiety, which are key contributors to tension headaches.

Keep a headache journal. This will help you identify the triggers of your headaches and adjust your environment and habits to avoid them.

• When you first notice a headache coming on, record the date and time it started. Note the food and drinks you had a few hours before, how many hours you slept the previous night, and what you were doing before the headache appeared. Also, note how long the headache lasts and the methods that help relieve it.

Practice relaxation techniques and stress management daily. You can join a morning yoga class, meditate for 15-20 minutes, or practice deep breathing before bed.

• Practice at least 3 times a week to release stress and pressure.

Maintain a healthy lifestyle. Avoid caffeine, alcohol, and tobacco. Ensure you get 8 hours of sleep each night and take care of yourself by reducing stress at home and work.

• Follow a balanced diet, avoid MSG, or foods that may trigger headaches.
• Drink plenty of water every day to stay hydrated.

Consult with your doctor about preventive medications if you suffer from chronic headaches. Your doctor will perform tests to ensure you don't have migraines or any other serious conditions. If your headaches don't improve with medications and pain relief therapies, your doctor may prescribe preventive drugs. These may include:

• Tricyclic antidepressants, the most commonly used to prevent tension headaches. Side effects may include weight gain, drowsiness, and dry mouth.
• Anticonvulsants and muscle relaxants like topiramate. However, further research is needed to determine the effectiveness of anticonvulsants and muscle relaxants in preventing tension headaches.
• Keep in mind that preventive medications may take weeks or longer to accumulate in your body before becoming effective. Therefore, you must be patient and continue taking the prescribed dosage, even if you don't notice any improvement at first.
• Your doctor will monitor the effectiveness of the preventive treatment.