Headaches: What are some non-drug options?

Many people would like to do something to get relief from headaches other than taking tablets. But researchers still have a lot to do in this area. Non-medical ways to try to relieve headaches have not been adequately tested.

Headaches are often handled with medication. A wide variety of physical alternatives are also often tried. This includes massage, exercise, hot or cold compresses, acupuncture, chiropractic or other manipulation or mobilisation, and TENS (transcutaneous electrical nerve stimulation).

It is hard to tell what might be worthwhile. Researchers from the Cochrane Collaboration tried to find out what helps and what does not work by analysing available trials to get an overview of the options.

The study could not fully answer the researchers' questions. They found 22 trials involving more than 2,500 people who tested one or another non-drug headache treatment. But a close analysis of the trials showed that no definitive conclusion is possible. Although 22 trials sounds like a lot, on one hand they were spread among studies of five different types of headache - migraine, tension headaches, mixed migraine-tension headaches, headaches associated with neck pain and headaches after an injury. What's more, the studies tested a long list of different treatments. That meant there was not a lot of evidence about any particular treatment for a specific type of headache.

The most commonly studied treatment was manipulation of the neck. This is a treatment used by chiropractors and physiotherapists. It involves movement and pressure on the joints in the neck area to try to relieve headache pain. The analysis of these results showed some benefit for recurring headaches, but these results were not conclusive. The possible adverse effects of manipulation have also not been adequately studied.

For the other options, the research inventory was even more disappointing. None of the many other treatments have been studied well enough to be able to draw conclusions about their advantages and disadvantages.

© IQWiG (Institute for Quality and Efficiency in Health Care)