What is the abortive treatment for tension headaches?

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Multiple Choice

What is the abortive treatment for tension headaches?

For tension-type headaches, the goal of an abortive treatment is to stop an attack quickly, and the best first-line option is an NSAID such as ibuprofen or naproxen. NSAIDs reduce pain by blocking cyclooxygenase and decreasing prostaglandin-mediated inflammation and peripheral sensitization around head and neck tissues, which underlie the dull, pressure-like pain of tension-type headaches. They’re effective for mild to moderate attacks and are preferred over stronger analgesics when the headache is self-limited. Triptans, while effective for migraine, don’t reliably relieve pure tension-type headaches because they target migraine-specific pathways (trigeminovascular activation and cortical spreading phenomena) that aren’t the main drivers in tension-type headaches. Opioids are discouraged due to limited added benefit for TTH and a higher risk of dependence and medication-overuse headaches. Verapamil, on the other hand, is used mainly as a preventive measure for certain headache disorders, not as an acute (abortive) treatment for tension-type headaches. If headaches are frequent, it’s important to address triggers, consider nonpharmacologic strategies, and evaluate whether preventive therapy is appropriate.

For tension-type headaches, the goal of an abortive treatment is to stop an attack quickly, and the best first-line option is an NSAID such as ibuprofen or naproxen. NSAIDs reduce pain by blocking cyclooxygenase and decreasing prostaglandin-mediated inflammation and peripheral sensitization around head and neck tissues, which underlie the dull, pressure-like pain of tension-type headaches. They’re effective for mild to moderate attacks and are preferred over stronger analgesics when the headache is self-limited.

Triptans, while effective for migraine, don’t reliably relieve pure tension-type headaches because they target migraine-specific pathways (trigeminovascular activation and cortical spreading phenomena) that aren’t the main drivers in tension-type headaches. Opioids are discouraged due to limited added benefit for TTH and a higher risk of dependence and medication-overuse headaches. Verapamil, on the other hand, is used mainly as a preventive measure for certain headache disorders, not as an acute (abortive) treatment for tension-type headaches.

If headaches are frequent, it’s important to address triggers, consider nonpharmacologic strategies, and evaluate whether preventive therapy is appropriate.

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