The following nontraditional therapies may help if you have tension headache pain:

Bracing yourself for the next headache attack can result in tight, tense muscles. Your health care provider may suggest physical therapy (PT) if you have problems with muscle tension. Research studies show that PT can offer short-term relief of muscle tension and TTH.

You may request a referral to receive treatment from a physical therapist. A therapist may teach you correct positioning, ergonomics and exercises to do at home. He or she may do techniques to relax your muscles and increase normal head and neck movement. These include:

Exercising at home or at the local gym can also be an important part of your headache treatment program. Exercise can include aerobic reconditioning and stretching exercises. Regular aerobic exercise may help decrease how severe and how often people get headaches such as migraine. Muscle tightness and tenderness that bothers many people with chronic headache can be decreased with stretching exercises. Read some helpful tips on exercise and headaches.

The Feldenkrais Method

The Feldenkrais method is a type of bodywork that uses gentle movements to promote personal awareness of the body, increase flexibility and improve coordination. One of the key philosophies of the Feldenkrais method is that there is no separation between the mind and body and that, as the body strengthens and gains new forms of movement, the mind will also strengthen and improve.

Unlike manipulative physical therapies such as massage or Rolfing, Feldenkrais practitioners generally view the work as a way to expand one’s knowledge of self and promote the connection between the mind and the body. Classes – called “Awareness through Movement” – focus on teaching small, precise movements that can be beneficial to people of all fitness levels and abilities. One-on-one Feldenkrais is called “Functional Integration.” Many people find the experience relaxing and helpful.

Psychological Treatment

Recognize the Effects of Stress

It is widely believed that anxiety and stress can trigger tension-type headaches (TTH). For example, these headaches often become more severe in the afternoon and evening when both stress and tension levels are higher. A combination of factors can bring about tension and stress. Say you're at work and have a project due by 5 pm. You sit in front of the computer screen for hours. Your muscles become tighter and your posture more rigid – a condition known as “muscular bracing.” By 4 p.m., you have a full-blown headache.

Learning how to stop muscular bracing can help you decrease or get rid of TTH pain. Break the cycle by practicing relaxation techniques that focus on your face and back muscles. Take frequent breaks from the computer. Set your watch alarm or computer timer to go off every 30 minutes and then get up, stretch and focus on relaxing tense muscles.

Work With a Mental Health Specialist

If you have chronic TTH, your health care provider may ask you to see a mental health specialist such as a psychiatrist or psychologist. A mental health specialist can work with you and your headache care provider or team. He or she can add behavioral techniques to your other therapies for the best headache control. “Shop around” by interviewing several mental health specialists. Choose a specialist who has experience using relaxation and stress management techniques and counseling to treat people with chronic headaches. Read What Questions Should I Ask When Looking for a Qualified Mental Health Specialist?

Relaxation and Biofeedback

According to medical research studies, about 50-80% of people who use relaxation techniques have headache symptom relief. Read about these common relaxation techniques:

Biofeedback
Cue-controlled relaxation
Progressive muscle relaxation

The effectiveness of each behavioral technique varies from person to person. For example, relaxation alone may help ease headaches for one person. A combination of relaxation and biofeedback may be more effective for another person.

Stress Management

Medical research studies find that that about three of every four primary headache sufferers say that stress is a trigger for their headaches. Study results also suggest that high stress in the workplace increases the risk for developing new onset migraine by 26%. Stress management can help improve headaches by changing the way your body handles stress. Techniques such as autogenic training, cognitive restructuring and distraction can help decrease the number of headaches and the need for medication by migraine, tension-type and mixed headache sufferers. Read about using stress management techniques to help you relax.

Complementary Techniques

When done in combination with medication and other therapies, these techniques may help you control your headache symptoms. Practicing techniques such as meditation, breathing exercises and self-hypnosis every day can help you control feelings and thoughts that can lead to stress and trigger headaches.

Acupuncture – Invented in China thousands of years ago, this practice involves putting long, thin needles into specific points along the body to relieve pain and discomfort. Acupuncturists believe that a healthy body contains channels through which energy flows. When these channels are blocked, energy cannot flow, and bad health can occur. Needles are inserted into the blocked areas to correct imbalances and open up the energy channels again.

Control headache triggers – Learn what triggers your headaches. Once you know your triggers, you can make a plan to avoid or decrease your exposure to these triggers. For example, you may need to avoid sitting for long periods of time while at work or sitting at your computer, emotional stress and/or sleeping in unfamiliar surroundings.
Cranialsacral therapy (CST) – Cranialsacral therapy is an osteopathic tool for balancing fluids. Many physical therapists, as well as certified pracitioners in CST, have this specialized training. It can be helpful in the treatment of sinus and tension -type headache.

Healthy habits – Get enough sleep each night so that you awaken feeling rested. An average healthy night sleep can range from five to ten hours. Eat a well-balanced diet and exercise regularly. Take simple measures at home to relieve stress. Relax by resting in a dark, quiet spot or take a warm bath.

Herbal and dietary supplements – The US Food and Drug Administration (FDA) does not regulate these medicines. Limited research is available about their effectiveness. Some supplements that people with migraine have tried include:
- 5-HTP (L-5-hydroxytryptophan)
- Peppermint oil

Always ask your health care provider before taking your regular and prescription medicines and these supplements at the same time.

Hypnosis – This involves entering an altered state of consciousness whereby suggestions inserted while in that state can lead to changes in perception and behavior. For example, using hypnosis to treat pain may help to alter your physical sensations. Self-hypnosis involves inducing an altered state of consciousness – and thus controlling pain sensation – by yourself.

Manipulation – Chiropractors, osteopathic physicians and manual therapists most commonly do manipulations. Manipulation involves the movement of tissue by the laying on of hands. When done gently, it may be referred to as "mobilization." Doctors of Chiropractic and Osteopathy often do manipulations that are called "adjustments." Patients may feel short-term pain relief from this therapy. Long-term and on-going dependence on these therapies for pain relief is discouraged.

Massage – This technique can help decrease stress and soothe tense muscles in your head, neck and shoulders. Other benefits include increasing blood flow to the tissues and helping the muscles get rid of toxic waste.

Relaxation breathing – Breathing techniques help your body relax and take your mind off of everyday worries. Breathe in through your nose as you count to four, hold it as you count to seven, and breathe out through your mouth while you count to eight. It may seem silly or uncomfortable at first, but relaxation breathing will feel more natural with practice. Slow, steady relaxation breathing can help you relax tense muscles. Truly focusing on your breathing can help you break a cycle of negative thoughts.

Yoga – Yoga is a great way to improve flexibility and muscle tone, develop good deep breathing and relaxation techniques and decrease stress. Developed 5,000 years ago, yoga is an exercise that focuses on physical postures called asanas and breathing exercises called pranayma. As with any exercise program, ask your health care provider before beginning yoga. Begin your yoga practice in a class where an instructor can help you learn to do the postures and breathing correctly.