Prevention of Tension Headaches

Chronic Tension-type Headaches and What to Be Aware of.

When patients begin to have chronic tension-type headaches more than 15 days a month, then it is necessary to avoid the medications mentioned in the acute treatment page. This is because overuse of any pain medication can lead to rebound headache where the pain medicine itself causes the headaches to continue. These headaches are the hardest headaches to treat.  Critically important in these patients is to make sure the diagnosis is correct.  Chronic migraine patients typically have a lot of tension type headaches.  If their headaches are never more than moderate, than many patients believe they have tension type headaches.  If their headaches are moderate and they have any additional symptom that is typical of migraine, then Dr. Loftus typically treats them as probable migraine

The most commonly used medications to treat chronic tension-type headaches are medications that target serotonin (5HT) and norepinephrine (NE).  In animal models of pain in general, the more balanced, the better.  The older tricyclic antidepressants called amitriptyline is the most balanced drug for 5HT and NE but has lots of side effects due to other receptors.  Selective serotonin and norepinephrine re-uptake inhibitors, SNRIs are more selective.  Dr. Loftus usually uses duloxetine as it is best studied across a variety of pain indications.

If a patient fails one of the above medications, then it is critically important in these patients is to make sure the diagnosis is correct.  Chronic migraine patients typically have a lot of tension type headaches.  If their headaches are never more than moderate, than many patients believe they have tension type headaches.  If their headaches are moderate and they have any additional symptom that is typical of migraine, then Dr. Loftus typically treats them as probable migraine

Another medication, tizanidine, has also been shown beneficial for this type of headache.

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Five star patient reviews

Holly B.(Patient Since 2015)

From the time I first contacted the office until the follow-up after my appointment, I was very impressed with the attention from the staff. Dr. Loftus was inquisitive and helpful, spending more time than most doctors these days. His follow-up on the portal was impressively fast and helpful – it’s a great way to have direct communication with your physician.

Kenneth B.(Patient Since 2021)

Dr. Loftus listens to your issues and considers the best possible solutions to be of assistance. He is willing to try various methods and if they don’t work has other options ready. He takes into consideration that he is here to help you be the best you you can be while negotiating your issue. He is very well read on the most up to date options and treatment plans.

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Providing headache and hyperhidrosis care & wellness for over 25 years.

Dr. Brian Loftus, M.D.

Dr. Loftus is Board Certified in Headache Medicine as well as Neurology. In private practice since 1994, Dr. Loftus’ practice has gotten busier and he has decided to concentrate his practice in areas that he can make a particular difference compared to other neurologist. Therefore, Dr. Loftus has chosen to focus his neurology practice on headaches & head painheadaches during pregnancy, and hyperhidrosis. In the spring of 2006, Dr. Loftus relocated his practice from the Texas Medical Center to Bellaire, just 5 miles west. He has been named a Texas Monthly “Super Doctor” and an H Texas magazine “Top Doctor” multiple times.