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Suggest treatment for tension headache

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Answered by

General & Family Physician
Practicing since : 2009
Answered : 3094 Questions
Hi, thanks for your help. I have had a debilitating tension headache for 2 days. After starting off with more infrequent doses of ibuprofen only, I've been taking 1000mg acetaminophen and 400mg ibuprofen and now 325mg aspirin every four hours and it's not proving enough to get rid of it. Can I safely increase these doses at all, or do you have other non-prescription suggestions for dealing with this? (For what it's worth, my headaches often seem triggered by an upset stomach and/or skipping/delaying meals. I'm eating as much as I can now after not feeling able to eat two nights ago, but it hasn't gotten rid of the headache either.)
Posted Sun, 10 Aug 2014 in Headache and Migraines
Answered by Dr. Luchuo Engelbert Bain 3 hours later
Brief Answer:
Check drugs, reconsider diagnosis, see neurologist

Detailed Answer:
Hi and thanks for the query,

The very first thing is to be sure that the headache you are experience is tension headache. Distinguishing tension headaches from other primary headaches like migraine and cluster headaches is imperative.

The medication you are using (Acetaminophen and Ibuprofen) at the current doses are very appropriate and generally should cause sufficient relief, as seen in most patients. Associating Aspirin increases the risk of you developing serious side effects from anti inflammatory drugs like gastrointestinal bleeding. I would suggest you could instead take a drug containing Acetaminophen and caffeine. Considering prophylactic therapy for chronic headaches, especially in tension headaches like about 50mg of Amitryptiline at night once daily or Selective Reuptake Serotonine Inhibitors like Fluoxetine or Venlafaxine have been used and are useful. Your doctor should carefully evaluate your health status and see which drug to chose and add.

It might be interesting to know if you do smoke or not. If yes, stopping smoking improves such headaches. Relaxation is very imperative and is very helpful in such persons.

Persons of the headache after appropriate treatment should cause the diagnosis of tension headache to be careful reconsidered. Other headache types should be considered too. The opinion of a neurologist could be helpful.

Kind regards,

Dr Bain
Above answer was peer-reviewed by
Follow-up: Suggest treatment for tension headache 59 minutes later
Thanks for your reply. I don't smoke. I'll get some acetaminophen with caffeine tomorrow and will look into the other drugs and headache categories you mentioned further. For tonight, my question is if I can try, say, 600mg of ibuprofen per dose, or at least every other dose (say, sticking to 400mg on alternate uses) to try to get some consistent leverage over the pain. I'm also using ice but that isn't helping much either. Is 600mg of ibuprofen acceptable? Thanks.
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Brief Answer:
It is safe

Detailed Answer:
Hi and thanks for the update,

I think 600mg of Ibuprofen is acceptable. You can go ahead.I suggest you eat something and take the drug about 30 minutes after your meal. taking it on an empty stomach could cause stomach irritation.

As per the dosage, it is very safe.

Thanks and mind regards

Dr Bain
Above answer was peer-reviewed by
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