What complementary and alternative therapies are safe and effective for tension headache?
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Acupuncture is effective for reducing the frequency and intensity of tension-type headache (TTH). (SOR: A, based on a systematic review.) Biofeedback is effective compared with no treatment in improving frequency, intensity, and duration of headaches. (SOR: A, based on a meta-analysis.) Manipulation therapy is as effective as exercise in reducing pain and frequency of headaches and superior to no treatment. It is not as effective as amitriptyline during the treatment phase, but it has fewer adverse effects and appears to have more lasting benefit after treatment ends. (SOR: B, based on a metaanalysis of heterogeneous RCTs.) Chinese herbal therapy may be effective in decreasing headache frequency. (SOR: C, extrapolated from a prospective cohort study that included multiple headache types.) Homeopathy is not effective. (SOR: B, based on 1 RCT.)
Evidence Based Practice 14(6): 08-09.