Treatment of tension type headache: paracetamol and NSAIDs work: a systematic review
Abstract
OBJECTIVE: Tension-type headache (TTH), also known as tension headache or muscle contraction headache is the most commonly experienced type of headache. Our aim was to evaluate the effectiveness of interventions in patients with TTH.
METHOD: We performed a systematic review according to the guidelines of the Cochrane Collaboration. Randomised trials reporting conservative treatments in patients with TTH with headache as outcome were included. In the analysis studies were grouped according to type of intervention: acute pain medication, preventive medication, physiotherapy interventions, behavioural interventions and interventions in children.
RESULTS: A total of 152 trials were included in this review with 17.523 patients, of which 37 studies (24.3%) were considered to be of high quality. Nine studies could not be included in one of the five subgroups. ACUTE MEDICATION: (41 trials). The pooled analyses showed that NSAIDs and acetaminophen are more effective than placebo. No significant differences could be found between different types of NSAIDs, but ibuprofen showed fewer short-term side effects when compared to other NSAIDs. There was a significant difference in favour of NSAIDs when compared to acetaminophen. PREVENTIVE MEDICATION: (44 trials). Overall, the use of antidepressants does not show to be more effective than placebo, and no significant differences between different types of antidepressants were found. Furthermore there is limited evidence concerning the…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 523 participants or records.
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