Integrated Approaches to Tame a Tension Headache


Stress can sometimes get the best of us. With the new school year in full swing, our busy work schedules and lots of family activities piling up, we often manifest our stress in the form of a tension headache. These headaches can be constant and nagging or intense and debilitating. Any way it appears, it puts a damper on daily activities. Our panel of natural health care advocates have come together to offer strategies to tame your tension headache. Their approaches may vary but each can agree on one main point – you must take some time for yourself to focus on self-care. When you’re pain free and full of energy, you can get more done and even have time left over to have fun.

Natural headache relief strategies:



By: Ami Brimhall, Mindfulness Facilitator

ami_brimhallWhen you’re feeling stressed, it’s common to carry it in your body in many ways; tense shoulders, tense jaw, shallow breathing, a stomach that feels like it is in knots and tension headaches. Funny enough, when we’re really stressed we may be experiencing physical pain and not even connect it to our thoughts, emotions and mental state. Here are two practices that I think work best to alleviate headaches and other physical symptoms of stress. Both practices can be done as either one long practice session (20 minutes or more) or several shorter sessions (3-10 minutes) throughout the day. I personally like the longer session where I can lie down, have my whole body supported and be thoroughly relaxed.

A diaphragmatic or belly breathing practice has many proven benefits in the reduction of stress, tension and anxiety. It can help calm the body’s “fight or flight” response and allows you to better focus your mind and relax the body. The new mobile app Breathe2Relax is a great portable tool to help practice a guided breathing exercise, and assess your stress level before and after your breathing session.

A body scan meditation can help you identify what you are feeling, where you are feeling it, and to release the stress in both your body and mind. It’s also a good way to release feelings of “needing to get stuff done.” You will still get things done, you just are more able to focus and drop the stressful feelings around it. It’s good to start with a guided meditation to get a sense of how to move your attention up or down the body. There are many free, guided body scan meditations available online. Find one with a good length for your available time and a voice you find engaging. At least once, do a scan that is longer than you normally would consider. You’d be amazed at the power of this type of practice when done for 40 minutes or longer.


By: Christina Crawford, LMT, Health Centers of UWS, Salem Massage Therapist

christina crawfordI frequently hear clients say, “I had no idea I was that tense.” The stress that accompanies modern lifestyles often manifests as tension in the body’s muscles and is a known trigger for tension headaches. People often feel guilty about relaxing or taking time for themselves. They feel pressure from family, friends, work, etc. to spend every bit of their life providing for other people and making sure other people’s needs are met. It’s not until they begin to suffer muscles aches, fatigue, and headaches that they begin to consider they need to take time for themselves. As a massage therapist I give them that opportunity. The time they spend on my table is all about their needs and what they want. If an hour foot massage on a heated table is going to reduce overall stress and make their head feel better, so-be-it. Don’t be afraid to ask for what you want. Don’t suffer through too much or not enough pressure because you’re used to making everyone else happy. Ask for what you want and expect the outcome that you desire.


By: Aaron Montgomery, DC, Health Centers of UWS Clinician, Gresham

aaron-montgomeryAs the school year is starting and people are struggling to get back into the swing of things, stress and tension headaches are a common occurrence. I would recommend anyone who is dealing with chronic stress headaches get a proper examination and evaluation of the upper back and neck region. I do believe strongly that once this is done, there are many manual treatments including soft tissue work and chiropractic manipulation that would work wonders for stress headaches.

A crucial part of any stress headache treatment, from my perspective as a movement-based chiropractor, is to get the cervicothoracic region out of any problematic position it might be in, created by our modern day posture of sitting for long intervals.

Start by addressing your breathing. Sitting for long hours tends to promote a chest breathing type pattern that will only cause those upper thoracic and cervical muscles to get even tighter as the head remains in an extended position. Practicing diaphragmatic or belly breathing is a great first step to allowing those muscles to do less work in a tiring position. A good way to practice is to simply place one hand on the belly button and another on the upper chest, inhale through the nose and exhale through the mouth and feel for which hand is moving more. Ideally, we want the belly hand to move forward and back in the sitting position and the chest hand to do nothing at all.

To seal the deal for getting the neck to relax I like to have people assume a 90/90 position by lying flat on your back with your hips bent at 90 degrees and knees bent at 90 degrees with your legs supported on a chair/couch. If you tend to have excessive anterior head carriage (head considerably forward of a neutral position where your ears are in a plumb line with your shoulders), consider placing tw0-three inches of folded towels under your head. In this position, practice the diaphragmatic breathing drill above. Your belly hand should move up with nasal inhale and down with mouth exhale. This is a great position and drill to close eyes and work on mindfulness of just your breathing which should really allow for things in your back and neck to relax a great deal. Do this for 5-10 minutes, one to two times/day.


By: Daniel DeLapp, DC, Lac, ND, Health Centers of UWS Clinician, East Portland

ddelappMassage and manipulation can do wonders to relieve an occasional tension headache, but finding ways to manage stress are crucial for optimal health and the relief of recurrent tension headaches. Stress plays a major role in the health of our immune system, brain chemistry, blood pressure, blood sugar levels and hormone levels. There are many techniques for managing stress such as exercise, hobbies, positive thinking, socializing and connecting with nature. However, without a strong foundation gained from getting adequate sleep and healthy eating, managing stress and recurrent tension headaches can be a losing battle. If you need an alarm clock to wake up in the morning chances are likely you are sleep deprived. Try going to bed in increments of 15-30 minutes earlier each week until you can wake up on your own.

The most important step in long-term management of stress is eating real food at the right time. Planning ahead is important for having good food available when you get hungry. Minimally processed foods like eggs, fish, meat, nuts, seeds, tubers, vegetable and fruit are best. Try to schedule time to eat without being rushed. Several times a day take several slow deep breaths, letting your body relax with exhalation. Even a 20-minute walk can help with relaxation, stress management and prevention of tension headaches.


By: Rachel Fischer, MD, MPH, Health Centers of UWS Functional Medicine Physician and Integrative Therapeutics Distinguished Professor

rachel fischerThe functional medicine approach to any diagnosis demands not only that we determine what disease the patient is suffering from, but also discovering the underlying physiological dysfunctions causing the disease. Treatment is aimed at correcting the dysfunction, not simply treating symptoms.

When a patient presents with a “tension headache,” the first step is rule out other causes of headache – such as migraine, cluster or secondary headaches. Each of these diagnoses is likely to have a different underlying cause.

To identify the type of headache, I would obtain a thorough history – including detailed information about diet, exercise, sleep and stress – followed by a physical exam. According to the Mayo Clinic, experts used to think tension headaches stemmed from “muscle contractions in the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress.” But research suggests this may not be the cause – at least not the only cause. For this reason, functional medicine practitioners think about other possible triggers.

After the history and physical, possibly followed by laboratory testing, I would explore for evidence of significant stress (physical and psychological), hormonal imbalances, poor sleep (secondary to sleep apnea or other disorders), food intolerances, vascular disease, thyroid dysfunction, dehydration or adrenal imbalance. Of course treatment will be determined by the cause but could range from dietary adjustments, acupuncture, exercise/movement, supplements or even prescription drugs when necessary. Ultimately, healing from tension headaches is up to the patient, but as a functional medicine doctor, my role is to advise and coach individuals about how to allow healing to occur.