Most patients treat episodic tension-type headaches with over the counter pain relievers. It is generally believed that the fast acting anti-inflamatory medications such as ibuprofen and Aleve® work better than tylenol but benefits among patients can vary. Aspirin can also work quite well but carry a higher risk of ulcer if used excessively. In all cases, use on a daily basis may become the basis for episodic tension-type headache to become a daily headache.

When over-the-counter medications fail, then physicians commonly use combination medications that include caffeine and short acting barbituates. These are potentially habit forming. Midrin, a different type of combination medication, is also quite useful. None of these medications have been well studied as they came to market before the present I.H.S. system.

When episodic tension-type headaches become more severe, then the use of patient diaries during a headache is quite important, as one study showed an unexpected 33% error rate among headache specialists. Narcotics are commonly used if these headaches are infrequent and prior medications fail.

There is no acute treatment for chronic tension-type headache. In fact, stopping the acute therapies mentioned above may be critical in the successful treatment of chronic tension-type headache patients who became chronic due to medication overuse.