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Before you buy

To be safe, consult a qualified person (such as a pharmacist) before buying or taking any medicine, remedy or supplement:
– if you have a serious medical condition
– if you are breast-feeding, pregnant or planning to become pregnant
– if you suffer from allergies

Registered herbal medicines (bearing the THR logo) will have a package insert. Read this before taking the product.

Avoid taking the product if you think you may be allergic to any of the ingredients.

Do not combine over-the-counter medicines, remedies or supplements with prescribed medicines unless you have first checked with your prescriber or a pharmacist.

Seek advice from your doctor or pharmacist:
– If your symptoms do not get better
– if your symptoms get worse
– if you get new symptoms or have a side effect

The information here, including dosages, only applies to adults (over 16 years). Keep all medicines out of the reach of children.

Vitamins and minerals

In theory, not getting enough of certain vitamins and minerals can cause headaches. But if you eat a balanced healthy diet, it isn’t likely that taking extra vitamin or mineral tablets will help your tension headaches. If you don’t eat a balanced diet, you could try taking a good multi-vitamin pill each day and see whether your headaches are reduced.

Self care options


Do not take anything with other medicines, remedies or supplements unless you have checked with a qualified person (for example a pharmacist).

Mild painkillers, such as aspirin and ibuprofen, are effective in treating tension headaches if you take them as soon as a headache starts. Paracetamol is not quite as effective as ibuprofen or aspirin but has fewer side-effects.

If used in the correct dose, painkillers are generally safe, but taking them (whether prescription or over-the-counter) every day can cause side effects or can be a threat to the stomach.

Side effects can include headaches, indigestion and even stomach ulcers or bleeding. Stop taking them if you start getting indigestion or stomach pain, and tell your GP or pharmacist. Always follow the stated dose.

Painkillers can be bought from pharmacies and other retailers for low cost.

View the evidence

Aspirin in episodic tension-type headache: placebo-controlled dose-ranging comparison with paracetamol.
Steiner TJ, Lange R, Voelker M. Cephalalgia 2003; 23: 59-66.
Double-blind, double-dummy, randomized parallel-groups comparative trial. 638 people with episodic TTH, Aspirin 1000 mg (75.7% response rate; P = 0.0009) and to a lesser extent aspirin 500 mg (70.3%; P = 0.011) and paracetamol 1000 mg (71.2%; P = 0.007), but not paracetamol 500 mg (63.8%; P = 0.104), were statistically more effective than placebo despite a high placebo-response rate (54.5%). Adverse events mild or moderate, and transient. No safety concerns arose.
Link to Abstract

Nonprescription ibuprofen and acetaminophen in the treatment of tension- type headache.
Schachtel B.P., Furey S.A., Thoden W.R. Journal of Clinical Pharmacology. 36(12)(pp 1120-1125), 1996.
Single dose, double-blind RCT of 400 mg of ibuprofen (n = 153), 1,000 mg of acetaminophen (n = 151), and placebo (n = 151) in volunteers with muscle contraction headache. Conclusions: both effective, ibuprofen more effective.
Link to Abstract

Low-dose ibuprofen in self-medication of mild to moderate headache: A comparison with acetylsalicylic acid and placebo.
Nebe J., Heier M., Diener H.C. Cephalalgia. 15(6)(pp 531-535), 1995.
Double-blind, threefold crossover, double-dummy trial, 200 mg ibuprofen compared with 500 mg aspirin and placebo, 95 patients with migraine or TTH. Conclusion: ibuprofen was at least equivalent to acetylsaticylic acid and superior to placebo.
Link to Abstract

Peppermint oil (rubbed into the skin)

Gently rubbing a few drops of peppermint oil into your forehead and temples can produce a cooling sensation, followed by some relief from headache within 30 minutes. Any excess oil left on the skin will gradually be absorbed.

One small study has shown that applying diluted peppermint oil to the forehead and temples helped with headache symptoms.

This oil is safe unless you get it in your eyes or put it on broken or inflamed skin.

Peppermint oil can be bought from health food shops for between £5-£10 per bottle, which should be at least one month’s supply.

View the evidence

Oleum menthae piperitae in the acute therapy of migraine and tension-type headache.
Gobel H., Heinze A., Dworschak M., Heinze-Kuhn K., Stolze H. Zeitschrift fur Phytotherapie. 25(3)(pp 129-139), 2004.
Two RCTs, first in migraine or TTH (105), second in TTH only (44), 6 hours duration. Conclusion: 10% ethanolic peppermint oil solution (LI 170) equivalent to standard medication.

Effectiveness of peppermint oil and paracetamol in the treatment of tension headache.
Gobel H., Fresenius J., Heinze A., Dworschak M., Soyka D. Nervenarzt. 67(8)(pp 672-681), 1996.
RCT, crossover, blinded (traces of peppermint in placebo solution, placebo tablet), peppermint vs paracetamol, 41 patients, 164 headaches, Conclusions; Peppermint oil proves to be a well-tolerated and cost- effective alternative to usual therapies.
Link to Abstract

Transcutaneous electrical nerve stimulation (TENS)

TENS is a way of delivering a small, pulsating current to your muscles and nerve endings. Small electrical currents are sent through pads on the skin near the site of pain. Several small studies have suggested that using TENS machines helps some people with long-term headaches.

Using a TENS machine, combined with massage and stretching exercises, has been shown to help prevent headaches in people with chronic (long-term) tension headaches.

See the information sheet from Versus Arthritis for using TENS machines safely.

TENS machines are available from many pharmacies and some Internet retailers. They usually cost between £20 and £40 but this is a one-off cost.

View the evidence

Non-invasive physical treatments for chronic/recurrent headache.
Branfort G, Nilsson N, Haas M, Evans RL, Goldsmith CH, Assendelft WJJ, Bouter LM. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD001878. DOI: 10.1002/14651858.CD001878.pub2.
SR of 22 studies with a total of 2628 patients with 5 types of headache. For the prophylactic treatment of chronic tension-type headache. Other possible treatment options with weaker evidence of effectiveness are a combination of TENS and electrical neurotransmitter modulation; and a regimen of auto-massage, TENS, and stretching.
Link to Abstract