19th June 2023

Management

Treatment of tension-type headaches includes:

• Avoidance of triggers or exacerbating factors, e.g. caffeine excess
• Simple analgesia e.g. paracetamol, aspirin, NSAIDs. However, caution not to overuse as it could lead to medication overuse headache.
• Avoidance of opioids
• Management of associated comorbidities such as mood disorders, chronic pain, and sleep disorders.

Prophylaxis of tension-type headache

Prophylaxis is indicated if chronic features and includes:

• Non-pharmacological, e.g. acupuncture
• Pharmacological options include a trial of low dose amitriptyline (off label use)