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Understanding Treatment Options for Tension Headaches

More than 45 million Americans are living with frequent severe headaches. Tension headaches are second only to migraines as the most common type of headache. Tension headaches cause a characteristic pain around the temples, forehead, and back of your head, earning the nickname “headband headache.”

If you’re one of the millions of people affected by chronic tension headaches, it’s important to know your treatment options and discuss them with an experienced doctor like Samuel I. Fink, MD, FACP.

Symptoms and causes of tension-type headaches

Tension headaches may strike unexpectedly, last anywhere from hours to days, and can be as debilitating as migraines. Some people who experience regular migraines also get tension headaches.

Common symptoms of tension headaches include:

The exact cause of tension-type headaches is unknown. Several factors may contribute to them, including:

Some people report physical or emotional stress as a trigger for their tension headaches. Discovering your triggers and making changes to limit your exposure to triggers is part of managing tension headaches.

Diagnosing tension headaches

Dr. Fink has extensive experience diagnosing headaches and works with you to create a treatment plan to help improve your headache symptoms. As part of a thorough evaluation, he rules out underlying conditions to determine whether you have primary or secondary headaches.

Primary headaches are the most common type of headache and are not caused by an underlying condition. Secondary headaches are often caused by a more serious condition.

In addition, Dr. Fink may order imaging scans and other tests to diagnose your headaches, such as magnetic resonance imaging (MRI) or a computerized tomography (CT) scan.

Treatment options for tension headaches

Your tension headache treatment plan depends on several factors, including the frequency and severity of your headaches as well as what triggers are identified. Tension headaches respond to various treatment options.

Physical therapy

Problems with the musculoskeletal system can cause tension-type headaches that may respond well to physical therapy. For example, damage or wear-and-tear of the cervical spine (neck) can cause headaches. Physical therapy to treat cervicogenic problems can help relieve related headaches.

Anti-inflammatory medication

Non-steroidal anti-inflammatory drugs (NSAIDs) can help improve symptoms of tension headaches. Dr. Fink also may order blood tests to check levels or certain inflammatory markers to prescribe an effective medication.

Muscle relaxant medication

Muscle contractions in the head contribute to tension headaches. Medications that relax your muscles can improve tension-type headache symptoms in some cases.

Tricyclic antidepressants

This class of antidepressants, which includes amitriptyline, affects certain brain chemicals and can be beneficial for tension headaches. Tricyclic antidepressants are well-studied prophylactic (preventive) agents that can help prevent tension-type headaches. You typically take it 1-2 hours before bedtime.

Selective serotonin reuptake inhibitors (SSRIs)

Similar to drugs like amitriptyline, SSRIs are found to be beneficial for tension headaches in some cases.


When combined with preventive medication and other therapies, biofeedback is proven to significantly reduce tension-type headaches. Biofeedback devices record functions such as your blood pressure, breathing rate, muscle activity, and skin temperature. 

When you’re under stress or feeling tense, these functions change. Biofeedback therapy teaches you to observe these functions and control them with relaxation techniques so you can reduce or prevent tension headaches.

Successfully treating tension headaches involves creating a tailored treatment plan to reduce their occurrence and improve your functioning and quality of life. It takes time and patience to find a combination that works to effectively control your headaches. Left untreated, tension-type headaches can lead to significant disability. 

If you’re struggling with tension headaches, we can help you get your life back. Call our Tarzana, California, office to schedule a visit with Dr. Fink, or request an appointment online

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