Effective tension headache treatment depends on whether your headaches are episodic or chronic. For episodic TTH, optimized use of acute analgesics (NSAIDs, acetaminophen) combined with trigger management and lifestyle adjustments is typically sufficient. For chronic tension-type headache (15+ days/month), preventive medications — particularly amitriptyline — are first-line per Canadian clinical guidelines. Additional options include trigger point injections, nerve blocks, physiotherapy, biofeedback, and stress management. Your specialist at Infiniti Medical will determine the right combination for your specific headache pattern.

Yes. A physician referral is required for all new patients at Infiniti Medical Headache & Migraine Clinic. Please speak with your family doctor or a walk-in clinic physician about your tension headache symptoms and ask for a referral. Your physician can fax the completed referral form to 403-460-4569. Full referral information is available at infinitimedical.ca/headache-clinic/referral-information/

Episodic tension-type headache involves fewer than 15 headache days per month and is the most common form. Chronic tension-type headache is defined as 15 or more headache days per month for more than 3 months, and typically requires preventive treatment in addition to acute management. Chronic TTH is also associated with a higher risk of medication overuse headache if pain relievers are used too frequently. Specialist evaluation is strongly recommended for chronic TTH.

Yes. For patients with frequent episodic or chronic tension-type headache, preventive medications can significantly reduce headache frequency. Amitriptyline has the strongest evidence base for TTH prevention and is recommended in Canadian Headache Society guidelines. Other agents such as mirtazapine or venlafaxine may be considered depending on the patient’s profile. Preventive medication is typically assessed over 3–6 months and guided by your specialist at Infiniti Medical.

Several non-pharmacological treatments have strong evidence for tension-type headache. These include physiotherapy and manual therapy for pericranial muscle dysfunction, biofeedback training, cognitive behavioural therapy (CBT) for stress-related TTH, relaxation training, sleep hygiene optimization, and structured exercise programs. At Infiniti Medical, these approaches are integrated into your care plan alongside medication management — with referrals to physiotherapy, psychology, or other allied health providers as clinically indicated.

Tension-type headache and migraine can coexist in the same patient — a condition known as mixed or combined headache disorder. TTH typically presents as bilateral, pressing/tightening pain that is not worsened by activity; migraine is typically one-sided, throbbing, and worsened by movement with nausea and light/sound sensitivity. An accurate diagnosis from a headache specialist using IHS diagnostic criteria is the first step — and often explains why previous treatments have not worked.