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Pain Management

Which Alternative Headache Remedies Are Safe?

Depending on the severity of their condition, headache sufferers may take over the counter medications or prescription remedies. Many “alternative” treatments are available as well. According to the National Center for Complementary and Alternative Medicine (NCCAM), researchers are continuing to study the effectiveness of these treatments. While some of these widely-touted remedies may not work as advertised, others are effective.

Here, from the NCCAM, is a rundown of the current research on alternative remedies for headaches:

RELAXATION TRAINING. This technique is considered safe for healthy people, according to the NCCAM. In very rare cases, the agency says, some relaxation techniques may worsen symptoms in people with epilepsy or mental illness, or patients who have suffered abuse or trauma. Talk to your doctor if you have any of these conditions, or if you have heart disease, talk with your doctor before doing progressive muscle relaxation.

BIOFEEDBACK. Combining biofeedback with an antidepressant and high blood pressure medication was more effective for tension-type headaches than just medication, a study showed. Biofeedback is a technique that uses electrical monitoring to change automatic bodily reactions. A tension headache, the NCCAM says, is the most common type of headache. Sufferers report that the moderately severe condition feels as if a band is tightening around their head.

ACUPUNCTURE. The NCCAM says that researchers who reviewed two large trials of people with tension-type headaches, adding acupuncture to a pain-reliever regimen was more effective than pain relievers alone. The NCCAM says acupuncture is considered safe when it’s done by a qualified practitioner who uses sterile needles. Complications, which occur very rarely, include infection and punctured organs.

TAI CHI. Researchers found in a small clinical trial that a 15-week tai chi program effectively reduced the impact of tension-type headaches. But check with your doctor whether this is right for you. The NCCAM says that while tai chi is relatively safe, some health-care practitioners may advise their patients to avoid or modify postures because of joint or bone pain.

For more information, visit www.nccam.nih.gov.

COGNITIVE-BEHAVIORAL THERAPY. This technique, which works to control negative mental reactions, may provide additional relief for migraines if it is combined with medicine for preventing migraines.

MASSAGE. The role of massage in headache treatment has been rigorously examined in only a few small studies. The NCCAM says that the findings indicate that massage may help reduce the frequency, intensity and length of headache. Another technique, craniosacral therapy, which involves a light touch and manipulation of the skull and spine to relax tissue, was more effective than doing nothing to combat a tension-type headache.

Additionally, researchers are looking into whether massage therapy can help with migraines, which are more severe than tension-type headaches. So far, massage therapy seems to have some effect: The NCCAM cites a study that found massage of the back, shoulders, head and neck can reduce the frequency of migraines, though not their severity.

SPINAL MANIPULATION. Reviews of the medical literature on spinal manipulation indicate that it may help with tension-type headaches and even prevent migraines if it is used with the medication amitriptyline. Side effects from spinal manipulation can include temporary headaches, tiredness, or discomfort. The NCCAM says that while reports of serious complications such as stroke have been rare, safety is important. Talk to your doctor about whether spinal manipulation is right for you.

DIETARY SUPPLEMENTS. Researchers are continuing to study dietary supplements to see if they can prevent, relieve or reduce headaches.

Riboflavin and coenzyme Q10 – may be helpful for headaches, but there is no definitive proof yet. These supplements are generally well tolerated. Riboflavin isn’t recommended for pregnant women.

Magnesium – Studies examining its ability to prevent migraines have been inconclusive. The NCCAM also notes that magnesium supplements may cause diarrhea.

Feverfew (Tanacetum parthenium) and butterbur (Petasites hybridus). These are historically used remedies for headache. The NCCAM says studies have indicated they may help reduce the frequency of migraines.

They have mild side effects – for feverfew, open sores in the mouth and upset stomach; for butterbur, mild gastrointestinal upset. Some butterbur products, though, have potentially harmful chemicals called pyrrolizidine alkaloids (PAs). If you want to buy butterbur, the NCCAM stresses get one that is certified as PA-free. Pregnant women should avoid both feverfew and butterbur.

Overall, the NCCAM says, there are a few things to keep in mind if you’re considering a complementary health approach to your headaches:

Don’t replace conventional, proven treatments with products or practices whose results haven’t been verified.

Talk to your health care provider if you want to use a dietary supplement. This is especially true if you are pregnant or nursing. Also, some dietary supplements may have interactions with conventional treatments.
If you’re looking for someone who can treat you with biofeedback or acupuncture, ask your health care provider or your local hospital if they can recommend anyone.

And always, the NCCAM says, make sure your doctor is up to date on every supplement and remedy you are taking.

For more information, visit www.nccam.nih.gov.