Tension headache is characterized by a tight, band-like pain around the back of the neck/head to the forehead and temples. It typically does not favor one side which means you will typically feel it across the entire back of your neck/head or entire area of your forehead/temples. It is not well understood what the root cause of a tension headache is, but many triggers include stress, depression and poor posture.
Treatment
- Chiropractic Care
- Massage therapy/Soft tissue care
- Magnesium and Vitamin D supplementation
- Food allergy elimination
- Fish oil supplementation
Chiropractic Care for Tension Headache
There is significant evidence that chiropractic care can help with tension headaches. In a 6-week course of chiropractic care, consisting of soft tissue work and spinal manipulation, there was a reduction in tension headache pain by 40%1 (Click here for research study). This was as much improvement as those patients taking prescribed amitriptyline for the tension headache. In addition, the relief from the chiropractic treatment on tension headache was longer lasting than from that of the prescribed amitriptyline medication.
Massage Therapy for Tension Headache
Stress is a common trigger of tension headache. Stress can cause muscle spasm/tightness which might explain why stress causes tension headaches. With that said, if muscle spasm/tightness is the cause of the tension headache pain, then massage therapy and soft tissue care can be very beneficial for tension headache pain.
Magnesium and Vitamin D Supplementation for Tension Headache
Tension headache has been associated with low levels of magnesium. Once again, stress is the common cause. In one study, circulating levels of magnesium were low in 40-50% of patients with tension headaches.2 (Click here for research study). Except when contraindicated due to renal failure or drug interaction, magnesium supplementation is safe, effective, and reasonable for essentially all patients with tension headache.3 With that said, patient history and lab tests should be performed by your chiropractor before supplementing with magnesium. Lab tests will help rule out renal failure and can also demonstrate magnesium deficiency and need of magnesium supplementation for tension headache. In addition, magnesium negatively effects the absorption of several drugs; therefore, your chiropractor should make sure you are not on these medications while supplementing with magnesium.
Tension headache can also be relieved with vitamin D supplementation. Vitamin D is an anti-inflammatory, and in one study, 8 patients had chronic tension headaches relieved with vitamin D supplementation4(Click here for research study).
Food Allergy Elimination for Tension Headache
Food allergies are considered a top cause of any type of headache, including tension headache. In a very significant study by Grant5 (Click here for research study), the following foods were identified as the most common headache triggers: wheat (78%), orange (65%), eggs (45%), tea (40%), coffee (40%), chocolate (37%), milk (37%), beef (35%), corn, cane sugar, and yeast (33% each). Your chiropractor can help you figure out the specific food(s) that are triggering your headaches, and by eliminating those foods from your diet, you will most likely get rid of your tension headaches. It is also recommended that you keep a food diary by keeping track of the foods you are eating each day. You also need to include in your diary on which day and an hour your tension headache occurs. This can help you and your chiropractor figure out the foods causing your tension headache.
Fish Oil Supplementation for Tension Headache
Fish oil acts as an anti-inflammatory and might be helpful in reducing tension headache pain. Although fish oil is highly effective for treating migraine headaches, it might be worth trying in combination with soft tissue and chiropractic care for the treatment of tension headaches.
References
1. Boline PD, Kassak K, Bronfort G, et al. Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: A randomized clinical trial J Manipulative Physiol Ther 1995;18(3): 148-154.
2. Altura BM, Altura BT. Tension headaches and muscle tension: is there a role for magnesium? Med hypotheses 2001; 57:705-713.
3. Vasquez, A. Integrative Orthopedics: Concepts, Algorithms, Perspectives and Therapeutics. The Art of Creating Wellness While Effectively Managing Acute and Chronic Musculoskeletal Disorders. Second Edition. Fort Worth, Texas; Integrative and Biological Medicine Research and Consulting: 2007.
4. Prakash S, Shad ND. Chronic tension-type headache with vitamin D deficiency: casual or causal association? Headache 2009; 49:1214-1222.
5. Grant EC. Food allergies and migraine. Lancet 1979 May 5;1(8123);966-9