Researchers from the Department of Clinical Neurosciences at St Vincent's Hospital in Melbourne, Australia, examined the efficacy of CAM (complementary and alternative) therapies, including mind-body techniques, acupuncture and physical treatments for tension type headaches.
The investigators noted that while pharmacotherapy with nonsteroidal anti-inflammatories (NSAIDs) and tricyclic antidepressants comprise the traditional treatment of tension-type headaches (TTH), the use of other therapeutic approaches, in combination with medications, can increase the success of treatment.
The assumption was that especially patients with comorbid mood disorders and frequent headaches might benefit from some of these nonpharmacologic approaches.
Researchers from Bright Path Yoga in Plano, Texas looked at the efficacy of an 8-week strategy of using yoga and meditation to help manage fibromyalgia symptoms, which typically consist of widespread pain, sleep disturbance, stiffness, fatigue, headache, and mood disorders.
The small pilot study looked at the impact of this program on 11 participants.
Results revealed significant improvement in the overall health status of the participants and in symptoms of stiffness, anxiety, and depression. Significant improvements were also seen in the reported number of days "felt good" and number of days "missed work" because of fibromyalgia.
Iranian researchers from Isfahan University, Arak University and Shafa Hospital investigated the efficacy of guided imagery and meditating on a happy memory for relieving the intensity, frequency and duration of chronic tension-type headaches.
Sixty people, all receiving individualized headache therapy, were randomly assigned to one of three groups of 20. One arm listened to a guided imagery audiotape 3 times/week for 3 weeks; one arm imagined their happiest personal memory 3 times/week for 3 weeks; and one group received treatment as usual.
Subjects completed a demographic questionnaire and kept a headache diary.
In three of the outcome measures; headache intensity, headache frequency and headache duration – both guided imagery groups (tape and perceived happy memory) had significantly more improvement than the controls. There were no significant differences between the two kinds of guided imagery groups at any time point.
The investigators conclude that guided imagery may be an effective, available and affordable nonpharmacological therapy, either using a tape or by evoking a perceived happy memory, for the management of chronic tension type headaches.
Citation: Abdoli S, Rahzani K, Safaie M, Sattari A. A randomized controlled trial: the effect of guided imagery with tape and perceived happy memory on chronic tension type headache. Scandinavian Journal of Caring Sciences. 2011 Oct 10. [Epub ahead of print]
Researchers from the Department of Psychiatry at Brigham and Women's Hospital/Harvard Medical School reviewed the evidence on the efficacy of biofeedback for the two most prevalent headache conditions--migraine and tension-type headache.
Two recently published meta-analyses yielded data from 150 outcome studies - randomized controlled trials as well as uncontrolled quasi-experimental designs. Of these, 94 studies were selected for inclusion, going by predefined criteria. Meta-analytic integrations were carried out separately for the two conditions of interest.
Researchers from the University of Hartford reviewed the findings to see if a high level of hypnotic suggestibility (considered a stable individual trait) is necessary for a hypnotic pain intervention to relieve headache pain.
Higher suggestibility has been found to be associated with greater relief from hypnotic pain interventions, and although individuals in the high suggestibility range show the strongest response to hypnotic analgesia, people of medium suggestibility (who represent approximately one third of the population) also have been found to obtain significant relief from hypnosis.
The researchers conclude that high hypnotic suggestibility is not necessary for successful hypnotic pain intervention for headache – medium suggestibility works too . But the available evidence does not support the efficacy of hypnotic pain interventions for people who fall in the low hypnotic suggestibility range. According to some studies, these subjects may benefit from imaginative analgesia suggestions (guided imagery), or suggestions for pain reduction that are delivered while the person is not under hypnosis.
A review and meta-analysis of studies investigating the effects of biofeedback on tension headaches was undertaken by researchers at Philipps-University of Marburg in Marburg, Germany.
A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria. Meta-analytic integration resulted in a significant medium-to-large effect size (d = 0.73; 95% confidence interval = 0.61, 0.84) that proved stable over an average follow-up phase of 15 months.
Biofeedback was found to be more effective than headache monitoring, placebo, and relaxation therapy conditions. The strongest improvements resulted for frequency of headache episodes. Further significant effects were observed for muscle tension, self-efficacy, symptoms of anxiety, depression, and analgesic medication.
Researchers from the Department of Pediatrics at the University of Minnesota, in a retrospective study of clinical records, found that self-hypnosis significantly improved symptoms of recurrent headache in children and adolescents.
Researchers from the Department of Pediatrics at the University of Minnesota did a retrospective review of 178 consecutive outpatient clinical records (referred to the Behavioral Pediatrics Program from 1988-2001) to see if self-hypnosis helped children and youths with symptoms of recurrent headaches.
Investigators from Philipps-University of Marburg in Germany did a meta-analysis of the efficacy of biofeedback (BFB) in treating migraine. A computerized literature search of the databases Medline, PsycInfo, Psyndex and the Cochrane library, enhanced by a hand search, identified 86 outcome studies, of which 55 studies met the inclusion criteria.
Hungarian researchers find that the popular European technique of Autogenic Training is helpful in all three kinds of headache: migraine, tension, and a combination of the two.
Hungarian researchers investigated the effects of auto-suggestion,
using cognitive and symbol therapy elements with auto-suggestion, on
three kinds of headache (migraine, tension and combined). The
assumption was that since headache is prolonged and exacerbated by
depression and anxiety, and these conditions are ameliorated by
autosuggestion, that this technique could be valuable for relieving
headache for multiple reasons.
Twenty five female patients with migraine, tension-type headache or mixed headache participated in an eight-month follow-up study. Headache frequency, analgesic, antimigraine and anxiolytic drug consumption were measured by means of a headache diary.