Headaches

Headaches are often a reason people consult a complementary practitioner. This can be quite an elusive symptom as many headaches come and go. However there is a reasonable evidence that natural treatments can be helpful in some cases.

A lot depends on the skill of the practitioner and how you feel about working with them. Complementary therapies are not widely available through the NHS, so a typical session could cost you from £40 to £80. Nevertheless, some people say they have found having time with a practitioner very helpful.

You should always look for a practitioner who is properly trained and registered with the relevant professional body.

Summary
Acupuncture is a traditional form of treatment that began in China thousands of years ago. Thin needles are inserted into the skin at special points on the body, which practitioners believe will help restore health. The treatment sometimes also involves heat, pressure, electrical currents or soft-laser light. In the UK, acupuncture is most commonly used for pain relief.

Evidence
There has been quite a lot of research on acupuncture for tension headaches. The results indicate that acupuncture can help make tension headaches less frequent and less severe.

Safety
Acupuncture is generally safe if practised by a trained acupuncturist. The most common side-effects are slight discomfort (common) and bruising (occasionally).

Cost
A session may cost £40-£60. Frequency of treatment will depend on you and your practitioner.

Find out more
The following professional organisations can help you find a qualified practitioner:
Acupuncture Association of Chartered Physiotherapists
British Academy of Western Medical Acupuncture
British Acupuncture Council
British Medical Acupuncture Society

Summary
AT classes require time and discipline, but may have greater benefits than simple muscle relaxation. In AT classes you learn to create feelings of warmth and heaviness throughout your body, and this is said to bring about very deep physical relaxation, mental peace and a quietening of negative thoughts. AT uses simple phrases that you repeat to yourself as you release tension from each part of your body.

Evidence
The evidence from research is mixed, but autogenic training might be helpful to some people with tension headaches.

Safety
AT is best learned from an experienced teacher in a small class. There are no safety issues, though anyone with a long-term mental health problem should get advice from their psychiatrist before starting AT.

Cost
You will have to pay for the classes but once you have learned this technique you can practise it at home at no cost.

Further information
The British Autogenic Society (BAS) is the professional and educational organisation for autogenic therapists in the UK.

Summary
There are many different types of massage, some more vigorous and going deeper into the muscles than others. Massage has traditionally been used for relaxation. It may be just on one part of the body (for example, the back and shoulders), or it can be done on the whole body. Aromatherapy massage uses pleasant-smelling essential oils.

Evidence
Massage may help with pain when combined with other physical treatments such as manipulation.

Safety
Massage is safe if carried out by qualified massage therapists, and it rarely causes problems. Vigorous massage should be avoided if you have blood disorders, some forms of cancer, skin problems or are on blood-thinning medications (such as warfarin). Allergies or skin irritation can occur with some essential oils used in massage.

Cost
Monthly cost will depend on how regularly you receive treatments.

Further information
It is important to find a qualified practitioner such as one registered with The General Council for Soft Tissue Therapies.

Summary
Physiotherapists use exercises and stretches to improve strength, flexibility and stiffness. Often these exercises need to be done at home at least once daily for many weeks or months. Some physiotherapists can provide massage, hydrotherapy in a special pool, many use soft lasers, electrotherapy or ultrasound to speed up healing. A lot of physiotherapists use acupuncture techniques as well. Ask your physiotherapist what sort of methods they have available.

Tension headaches often start in the muscles of the neck and shoulders. So particular neck exercises may help relax these trigger points and so help with your tension headaches.

Evidence
Certain exercises may help prevent tension headaches. They may also reduce the severity of headaches..

Safety
Physical treatments are generally safe if practised by a trained therapist.

Cost
The exercises are simple, but they need to be done every day. They cost nothing once you have learned to do them. However you need advice for particular neck exercises for tension headaches and your GP can refer you to an NHS physiotherapist. Private physiotherapy is available in all areas. A half hour appointment will vary in cost between £30 and £60. Monthly cost will depend on duration of the treatment.

Further information
It is important to find a qualified practitioner such as one registered with The Chartered Society of Physiotherapy.

Summary
Some people find their headaches are directly triggered by conflicts or emotional distress. If you get headaches every day, you tend to expect them, and psychological approaches may be useful to help counter this and if you have severe long-term headaches.

When people think of ‘talking therapies’ they usually mean either counselling or psychotherapy. Counselling and psychotherapy aim to help people change thoughts, feelings and attitudes. Counsellors help you talk about difficult feelings and understand conflict. It can be helpful just to have time alone with a counsellor to talk in confidence about how you feel. Spending time reflecting on problems often brings insight and puts things into perspective. Psychotherapy helps people learn better ways of thinking or behaving that can reduce their symptoms, disability and distress. Some psychotherapists are trained to help you explore possible causes of distress or symptoms in your past. Cognitive behavioural therapy (CBT) is the type of psychotherapy that is currently most widely available in the NHS.

Instead of exploring causes of distress or symptoms in the past (like many other types of therapy), CBT looks for ways to improve your state of mind right now. The therapist does this by helping you spot unhelpful thought processes and change them. The Royal College of Psychiatrists says “CBT can help you to change how you think (‘cognitive’) and what you do (‘behavioural’)”. For instance, CBT can help you make sense of what seem like overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you.

Evidence
There is no good evidence that cognitive behavioural therapy (CBT) helps people with headaches. But it may help you manage stress that triggers them.

Safety
CBT techniques are generally safe if carried out by or under the guidance of a qualified counsellor or psychologist.

Cost
In most areas your GP can refer you for CBT or a psychological therapist in the NHS. There are often long waiting lists. A session of CBT or psychological therapy may cost between £20-£50. Frequency will depend on you and your therapist. A typical course of CBT lasts between 6-12 weekly sessions

Further information
It is important to find a qualified counsellor or psychologist. Contact The British Psychological Society.

Summary
Osteopathy and chiropractic are hands-on approaches to diagnosis and treatment that focus on the way the muscles and joints work. They are both based on the idea that pain often comes from physical strains and tensions in the body, rather than from inflammation or damage caused by disease. Treatment by an osteopath or a chiropractor often involves spinal manipulation. If tender points in your neck seem to affect your headaches, these approaches might help relieve the pain.

Evidence
Two studies have suggested that spinal manipulation is helpful compared with other kinds of treatments.

Safety
Side-effects are rare and mainly linked to manipulation of the neck. Some people experience mild after-effects (aches) from the treatment but they usually last less than 48 hours.

Cost
A session may cost £40-£60. Frequency of treatment will depend on you and your practitioner.

Further information
Both osteopathy and chiropractic are state-regulated professions and allhave to be registered with either The General Chiropractic Council or the General Osteopathic Council.

Summary
Tai chi is also known as ‘moving meditation’. It is a series of slow, graceful, controlled movements, which develop strength, balance, posture and inner peace. It is a discipline that has to be learned in a class from a teacher and can then be practised at home.

Evidence
One trial showed that tai chi may help reduce the pain of tension headaches.

Safety
Tai chi is safe for most people. Though tai chi is slow and gentle, anyone with severe osteoporosis, joint problems, acute back pain or recent injuries should avoid strenuous exercise and build up gently.

Cost
Once you have learned the movements, you can do the exercises at home, at no cost.

Further information
Classes are run in most areas by both private tutors and by adult education services. You can also contact the The Tai Chi Union..

Summary
Yoga, as taught in the UK, generally includes physical postures or stretches, breathing techniques, meditation and relaxation. There are several different types of yoga. Some of them are mainly based on the physical exercises (some types are much more strenuous than others). Others focus more on meditation.

Evidence
Only a few small studies have been carried out on yoga in people with tension headaches. It is not certain whether yoga can help prevent or manage headaches. But it may help you relax, reduce your stress level and help you cope with headaches.

Safety
Yoga is generally safe when practiced appropriately and at the right level. Classes are run for different ability levels so look for one that is right for you. Yoga stretches should be increased slowly. If in doubt, check with your doctor, osteopath or physiotherapist. Avoid with severe osteoporosis or acute joint or back pain, or recent injuries.

Cost
You will have to pay for the classes but once you have learned this technique you can practise it at home at no cost.

Further information
Classes are run in most areas by both private tutors and by adult education services. To find a qualified teacher near you see also the The Yoga Alliance
and the The British Wheel of Yoga.