Nonpharmacologic treatments for migraine and tension-type headache: How to choose and when to use

Robert A. Nicholson, Dawn C. Buse, Frank Andrasik, Richard B. Lipton

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Opinion statement: There are a variety of nonpharmacologic treatments for headache. Educating patients about headache and its management, identifying and managing triggers (via diaries), modifying lifestyles, and understanding the importance of adopting and adhering to interventions (either pharmacologic or nonpharmacologic) are relevant to all persons with headache. In addition, specific nonpharmacologic treatments can be used either alone or in conjunction with ongoing pharmacologic intervention. Strong candidates for nonpharmacologic treatment include individuals with significant headache-related disability, comorbid mood or anxiety disorders, difficulty managing stress or other triggers, medication overuse, and patients who prefer a specific treatment. Behavioral treatments (relaxation, biofeedback, and cognitive-behavioral therapy) possess the most evidence for successful headache management. They have a long history of randomized trials showing efficacy and are considered first-line preventive options. Among complementary and alternative treatments, recent positive findings from randomized trials using acupuncture provide evidence of its potential as a first-line intervention. Other complementary and alternative techniques do not have a consistent base of research to recommend them for headache prevention, but they may be used if the patient prefers this approach or when other first-line interventions (nonpharmacologic or pharmacologic) have not provided adequate results. Among "natural" treatments, both butterbur extract and vitamin B2 have shown efficacy in more than one randomized trial and are thus potentially useful first-line preventive interventions.

Original languageEnglish (US)
Pages (from-to)28-40
Number of pages13
JournalCurrent Treatment Options in Neurology
Volume13
Issue number1
DOIs
StatePublished - Feb 2011

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Tension-Type Headache
Migraine Disorders
Headache
Therapeutics
Petasites
Riboflavin
Cognitive Therapy
Acupuncture
Anxiety Disorders
Mood Disorders
Life Style
Research

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Nonpharmacologic treatments for migraine and tension-type headache : How to choose and when to use. / Nicholson, Robert A.; Buse, Dawn C.; Andrasik, Frank; Lipton, Richard B.

In: Current Treatment Options in Neurology, Vol. 13, No. 1, 02.2011, p. 28-40.

Research output: Contribution to journalArticle

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