From the Cleveland Clinic: Nontraditional Headache Treatments

Nontraditional Headache Treatments

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Headache causes significant productive loss to employers. They are one of the most common complaints seen in the doctor's office.

Although drug treatments are effective, people suffering from headaches often use a wide spectrum of complementary and alternative therapies.

Chronic stress may contribute to the development of the most common types of headaches, including migraines and tension-type headaches. So it's not surprising that alternative treatments aimed at stress reduction, such as biofeedback and relaxation, are well-studied and considered effective treatments for some patients with headaches. There are additional "nontraditional" headache treatments, including acupuncture, massage, herbs, and diets, for which there are varying degrees of effectiveness.

Biofeedback

Biofeedback is a technique that can help a person learn stress reduction skills by providing information (feedback) about muscle tension, skin temperature, brain waves, and other vital signs. Small metal sensors, called electrodes, are attached to the skin and measure the amount of muscle tension or the skin temperature. This information is displayed as numbers, electrical waves, or sounds on a screen. For example, a stress response reduces skin temperature because of constriction of blood vessels, while a relaxation response results in dilated blood vessels and warm skin.

The results of several studies show changes in the blood flow in the brain during migraine attacks and in the pain-free periods in between. Using biofeedback training, a person can influence the blood flow to the brain and better manage a headache.

Most studies on biofeedback indicate that it reduces the frequency and duration of headaches, both in children and adults. In general, the effects of biofeedback appear to be comparable to many medications used for chronic headaches, and can be recommended as early treatment for recurrent migraines.

Stress Management

Life events that increase anxiety and depression have been associated with chronic headache. Certain antidepressant drugs are the primary therapy for some types of chronic headaches, such as tension-type headache. The results of a large study indicate that stress management therapy reduced headache, headache-related disability, and use of pain medications to a similar degree as therapy with antidepressant drugs. However, the best results were obtained when stress management was combined with antidepressant medication.

It may be helpful to incorporate a regular practice of relaxation into a health-promoting lifestyle (getting enough sleep, eating a healthy diet, etc).

Biofeedback and relaxation training can be obtained at the psychology and psychiatry departments of many medical centers.

Acupuncture

Acupuncture is an ancient Chinese technique that involves the insertion of very fine, solid needles into certain points of the body. According to traditional Chinese medicine, acupuncture stimulates the body's ability to resist or overcome illnesses and conditions by correcting energy imbalances. The term "chi" (pronounced "chee") is used to describe the energy that circulates through meridians in the body. The belief is that illness or pain develops when the natural flow of chi is disrupted, leading to an imbalance of energy, and that acupuncture can correct this energy disruption to restore physical, mental, and emotional health.

According to studies, acupuncture may cause the release of pain-reducing opioid chemicals, such as endorphins. In addition, acupuncture may stimulate the brain to release other types of body chemicals and hormones that transmit signals between different types of cells, including those of the immune system.

Acupuncture appears to be beneficial in treating a variety of health problems. The World Health Organization currently recognizes more than 30 diseases or conditions, ranging from allergies to tennis elbow, that can be helped by acupuncture treatment. The Consensus Statement on Acupuncture by the National Institutes of Health, released in 1997, stated that for conditions including headache, low back pain, menstrual cramps, and carpal tunnel syndrome, acupuncture was useful as an additional treatment or an acceptable alternative to be included in a comprehensive pain management program.

What makes acupuncture a unique anti-pain approach is the suggestion that its effects may be long-lasting. In one recent study, acupuncture treatment reduced chronic pain in the neck and shoulder areas and associated headache, with the effects lasting for months.

Does Massage Relieve Headaches?

The value of massage in treating headaches has not been demonstrated convincingly through clinical trials. Nevertheless, massage is a great way to reduce stress and relieve tension. It is especially effective in reducing tightness of tender muscles, such as those in the back of the head, neck, and shoulders, and increasing blood flow in those areas. For some people, massage may provide relief from headaches caused by muscle tension.

Herbs

Among herbs used for headache treatment and prevention, only the effectiveness and safety of feverfew has been examined in clinical trials. Feverfew is the most popular herbal remedy for prevention of migraine headache, and studies have shown that it is helpful and well-tolerated, with only mild side effects. However, the evidence is not convincing that this herb is more effective than a placebo (inactive pill). More rigorous and larger clinical trials are required.

Can Essential Oils Provide Headache Relief?

Another approach that has origins in herbal medicine is aromatherapy. In many traditional medical practices, the use of essential oil, simply by smelling it or by applying it to the skin, is thought to encourage relaxation and alter pain perception. Anecdotal evidence suggests that the use of lavender, ginger or peppermint oils may help relieve tension-type headaches. More research has to be done to determine the effectiveness of this therapy.

Dietary Modifications

Certain foods, such as chocolate, aged cheese, citrus fruits, red wine and others, may cause headaches in susceptible people. For long-lasting management of headaches, it is important to identify and reduce food-related headache triggers (along with others, including stress, sleep deprivation, and fatigue). This can be done by maintaining a careful diary of headaches and eating habits. To date, only a few dietary intervention trials have been conducted to determine if dietary changes can reduce headache pain.

However, a significant decrease in migraine headache has been observed when dietary fat consumption is reduced. Other studies suggest that supplementing the diet with omega-3 fatty acids may be beneficial. Other potentially helpful supplements include coenzyme Q10 and melatonin. Again, more research is needed on these supplements to determine their safety and effectiveness.

Considering the lack of reliable data on benefits of dietary approaches to headache management, it's best to eat a well-balanced diet and avoid skipping meals or fasting, as this may trigger a migraine attack. Also, be sure to talk to your doctor before starting a new diet or taking any new medications, including vitamins, herbs, and supplements.

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Reviewed by the Neuroscience Center, The Cleveland Clinic.

Medically reviewed by Brunilda Nazario, MD, WebMD, October 2005.