Although tension headaches cannot be cured, it is possible to prevent future episodes. There are a number of prevention options available.
Medications to prevent tension headaches
Many prescription and over-the-counter medications may be used to prevent tension headaches and stop their progression. Some medications that help reduce the frequency and severity of future tension headaches include:
Antidepressants. Normally prescribed to relieve mental depression, these drugs prevent tension headaches by stabilizing the levels serotonin and other brain chemicals. Commonly prescribed antidepressants include:
Tricyclic antidepressants. These include amitriptyline and nortriptyline. They are commonly used to prevent chronic and episodic tension headaches.
Selective serotonin reuptake inhibitors (SSRIs). Paroxetine, venlafaxine and fluoxetine are among these. This type of antidepressant is favorable because it often causes fewer side effects than tricyclic antidepressants, but they are usually less effective in preventing tension headaches.
While helpful, antidepressants are not without their risks. Antidepressants can increase the risk of suicidal thoughts and behavior in some people. The Food and Drug Administration (FDA) has issued an advisory that people being treated with these drugs should be closely monitored for unusual changes in behavior.
Nonsteroidal anti-inflammatory drugs (NSAIDs). While they are often used as acute therapy to stop the pain of an existing headache, daily use of NSAIDs may also manage chronic tension headache in many individuals.
Anticonvulsants. These include divalproex and gabapentin. Usually used to control seizures, these medications may also be prescribed to prevent tension headaches.
Muscle relaxants. Tizanidine is an example of a muscle relaxant. In some cases, muscle relaxants are recommended for the prevention of tension headaches.
If you have tension headaches with the features of a migraine, you may benefit from taking beta blockers or calcium channel blockers. These medications are typically used to lower blood pressure and reduce the workload of the heart. Calcium channel blockers also increase the flow of oxygen-rich blood to the heart. These drugs are commonly used to treat migraines, but they can be used alone or in combination with antidepressants to reduce the frequency of tension headaches.
In order for the medications to be effective, you need to take drugs used to reduce the frequency and severity of tension headaches at regular intervals. These medications are not for everyone. They may be right for you if you:
- Experience three or more headaches per week
- Do not find relief from acute or nondrug therapy
- Have headaches lasting longer than three or four hours
- Have severe pain that becomes disabling
- Have severe pain that causes overuse of acute medication
- Cannot take acute medication because of unrelated medical conditions
Because preventive medication can take several weeks to build up in the nervous system and take effect, you might not notice improvement for a couple of months or more. Some women may require a combination of medications to achieve the greatest effectiveness.
Other methods to prevent tension headaches
In addition to taking medications, you might be able to reduce the frequency of tension headaches by avoiding factors that trigger them. Identify these triggers by keeping a headache diary for at least two months. To compile this diary, record certain information after each headache occurs, including:
- When the headache occurred
- How severe the headache was
- Where the headache was located
- How long the headache lasted
- What medications you took
- What events occurred prior to the headache
- What you ate 24 hours before the headache occurred
- How your sleep patterns may have changed and how much sleep you have been getting
- How much stress you are experiencing
Lifestyle changes to prevent and relieve tension headaches may help you more than any other preventative measure. Lifestyle-related treatment methods include:
Exercise regularly. You can reduce the frequency and severity of tension headaches with regular aerobic exercise, such as walking, swimming and bicycling. These activities help to relax the muscles and increase the levels of the body's natural stress relievers. Exercise can also relieve the pain of an existing headache. Discuss physical activity with you doctor before starting an exercise routine.
Manage your stress. Stress is a common trigger of tension headaches. You can use a number of relaxation techniques, including deep breathing, yoga and meditation to relieve stress. Organizing daily activities ahead of time can also help. Biofeedback might also be recommended. During this procedure, electronic monitoring devices are used to teach you how to consciously regulate your bodily functions through relaxation or imagery. Behavior therapy may also be used to reduce stress in women with depression or anxiety.
Relax your muscles. Some of those with tension headaches may benefit from relaxing their muscles. Methods used to relieve muscle tension include thermotherapy and cryotherapy. Thermotherapy, or heat therapy, includes the use of heating pads, hot-water bottles, warm compresses, hot towels, and hot baths or showers. Cryotherapy, or cold therapy, includes the use of ice packs and cold showers or baths. Massage therapy for your head, neck and shoulders can also reduce stress and relieve tension.
Improve your posture. Good posture can prevent muscle tension. There are a number of techniques you can use to perfect your posture:
Hold your shoulders back and head high when standing. Also, pull in your stomach and buttocks and tuck in your chin.
When sitting, keep your thighs parallel to the ground and do not slump your head forward.
Avoid sitting, standing or working in one position for an extended period of time.
Avoid wearing high heels or shoes that do not fit properly.
Regularly perform stretching and strengthening exercises for your neck and shoulders.
Place weight on both feet when standing. When standing in place for an extended period of time, elevate one foot on a stool. Change to the other foot periodically.
When sitting for an extended period of time, use a footstool to elevate your feet. Get up and move around every 30 minutes.
Sit in straight-back chairs and keep the head supported.
Avoid carrying shoulder bags or purses weighing more than two pounds (one kilogram).
Other ways to prevent tension headaches include:
- Don't smoke
- Don't drink too much caffeine
- Don't drink alcohol
- Eat a regular, balanced diet
- Maintain a regular sleep pattern and get plenty of sleep and rest
- Keep warm if your headache is triggered by the cold
- Try using a different pillow
- Try sleeping if a different position
When compared to people who do not experience headaches, those with tension headaches are more likely to experience anxiety and depression. These complications, which often result from living with chronic pain, can in turn trigger more headaches. If you are anxious or depressed, you might benefit from counseling or a headache support group.
Tension headaches do tend to come back after they have been treated, but you don't have to dread their return. There are many ways you can prevent the recurrence and reduce the severity of tension headaches. Many useful lifestyle changes, such as exercising and eating regularly, are good for your general health as well..