Wednesday, March 11, 2009 12:59

Diagnosis of tension headache is usually quite simple. The treatment is also simple – in principle, at least. Take exercise, learn to relax, and regularly put these two things into practice.

Typically, tension headaches don’t respond well to simple painkillers – not because they are a particularly severe or dangerous type of headache, or because they are difficult to treat, but merely because the problems of the stiff neck are not just of pain, but also of muscle spasm.

If you try to treat this situation with just a simple pain-killer, all it can do is relieve the joint pain. It won’t attack the muscle spasm – but the muscle spasm is what keeps the vicious circle going. Spasm causes pain and pain causes spasm.

At this stage it is common for patients to come to their doctor in some alarm, saying, ‘I’ve got a headache that won’t go with pain-killers’, which implies that it must be very serious indeed. In fact, it isn’t. It’s quite simple to remove the pain of a tension headache with a pain-killer and a muscle relaxant. (Or else use an alternative method of removing the muscle spasm, such as massage, physiotherapy, heat, etc). Taking both a pain-killer and a muscle relaxant can be like waving a magic wand: and the great thing about it is that once the vicious cycle is unlocked it stays unlocked.

A favourite over-the-counter combination medicine is Syndol, which principally contains paracetamol to stop the pain, and an antihistamine to relax the muscles. However, it may make you drowsy, so don’t drive or use machinery if you’re affected in this way. (It’s also not a good idea to take any kind of drugs during pregnancy; consult your doctor if you are suffering from tension headache.)

There are many other daigs to choose from: your doctor will have a large number of prescription drugs that can be used to reduce spasm. One of these, surprisingly, is diazepam (commonly known by its trade name, Valium). Normally, diazepam is used to relieve anxiety, but it also has a potent muscle-relaxant effect, and in tension headaches it may be helpful to use it in quite high dosage for a short time, together with a pain-killer. Short-term use like this is quite safe and doesn’t give rise to addiction (unless you’ve previously had problems with addiction lo diazepam or similar dnigs).

Note the reasoning behind the use of diazepam – here it’s being used as a short-term muscle relaxant, acting directly directly on the neck muscles. It is not, repeat not being used to treat the underlying anxiety and mental tension that so often triggers off tension headaches. Diazepam could be used in this way – but it would need a much longer course of tablets, and doctors now prefer to avoid using this group of drugs over a long period, as addiction may occur.

Drug therapy is for short-term treatment only. It may abort the headache, which then goes away for some time, if not for good. However, many people have frequent or even constant tension headaches simply because they are constantly stressed and unrelaxed. Dealing with long-term tension headaches like these are quite different, and therapy revolves principally around anti-stress measures and relaxation therapy.

Anxiety and depression are also common causes of tension headaches.


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