A tension headache is the most common class of headaches, but the causes are still not fully understood. It includes pain of soft to medium intensity, which is often described by patients as a feeling similar to having a firm belt around the head. Patients often feel that the muscle contractions are accounted for the pain, but there is no medical proof for that. Therapy of tension headaches includes the processes of nurturing a healthy lifestyle, proper non-drug treatment and using the right medications.
Some patients opt for a non-medical treatment. The overuse of over-the-counter (OTC) medications can provoke more headaches.
Both OTC and prescription medications can be used in relieving the pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs) from the class of analgesics are often the first choice for pain therapy. OTC NSAIDs that are often used are Aspirin, ibuprofen and naproxen, and the most common prescription NSAIDs are indomethacin and ketorolac. Acetaminophen and Aspirin can often provoke overuse headaches so their are scarcely used. They can be combined with caffeine or a sedative drug to gain better results. An analgesic-sedative combination is taken by prescription because they can provoke chronic headaches and addiction.
Triptan is used for patients with a combination of migraines and episodic tension headaches. Opiates are seldom in use because of their side effects and the development of an addiction. Pain medications just alleviate the symptoms for a limited amount of time, with the passing of time, their effect is lessened and they can even be the cause of headaches. To prevent that, it is advised not to take OTC medications more than nine days a month. One should be careful about the possible side effects of every medication.
Preventive medications can lessen the incidence and severity of the attacks. They can be introduced into the therapy if the patient encounters chronic pains that are not relieved by standard medications or non-drug therapy. They can also be prescribed if the pain becomes disabling or acute pain relievers cannot be taken because of various medical conditions. Antidepressants can also be used for chronic states, they do not relieve the pain but rather balance the level of brain chemicals like serotonin which are sometimes the cause of headaches. The most commonly used preventive medications are:
- tricyclic antidepressants (amitriptyline, nortriptyline) for all types of headache. They have numerous side effects, for example gaining weight and dizziness.
- selective serotonin re-uptake inhibitors (SSRIs) like paroxetine (Paxil), venlafaxine (Effexor) and fluoxetine (Prozac) possess smaller number of side effects than tricyclic antidepressants but they are less efficient
- anticonvulsants, muscle relaxants
Preventive medications need some time to show their full effect so they should be taken for a couple of weeks.