Pharmacological and Non-Pharmacological approaches to manage Tension-Type Headache: a Systematic Review.
Chloé Barreira, Bruno Daniel Carneiro, Carlos Faria et al.
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In 30 seconds
This systematic review assessed randomized clinical trials of pharmacological and non-pharmacological treatments for episodic or chronic tension-type headache (TTH), examining headache pain and related clinical outcomes. It included 93 trials, most judged to have moderate to low risk of bias. Because of substantial clinical and methodological heterogeneity, the authors used narrative synthesis rather than meta-analysis. The review concluded that pharmacological, manual, and behavioral therapies may each have specific indications and could be combined according to individual needs, with the goal of reducing symptoms over the long term, limiting side effects, and improving quality of life.
Key findings
- The review included 93 randomized clinical trials; most had a moderate to low risk of bias.
- Clinical and methodological heterogeneity led the authors to use narrative synthesis rather than meta-analysis.
- The review identified specific indications for pharmacological, manual, and behavioral therapies, but did not report a pooled treatment effect.
Why it matters
TTH is common, and chronic symptoms can affect physical, cognitive, emotional, and social functioning. The review highlights that treatment evidence spans several approaches rather than establishing one optimal long-term strategy. Its synthesis may help frame individualized treatment discussions, while the heterogeneity of the evidence limits direct comparisons between options.
What to keep in mind
Substantial clinical and methodological heterogeneity prevented meta-analysis, limiting quantitative comparison of treatment effects.