3 Behavioral Therapies for Your Headaches

When Medication Alone Isn't Enough

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Headache is not just a physical disorder. It can impact a person's mental health, relationships, career prospects, basic life functions like sleep and exercise, and overall well-being.

This is why a combination of medication and behavioral therapies are often used to treat headache disorders—and research shows this holistic approach works better than either therapy alone. 

While there are number of complementary therapies advertised as being effective for managing headaches, many do not have the scientific proof to back them up.

Of course, this does not necessarily mean a particular therapy won't soothe your personal headaches. Rather, if you are going to choose a complementary headache strategy, it's probably best to choose one that has been found to be beneficial based on research studies.

With that, three behavioral therapies found to be effective in preventing and controlling your headaches are:

  • relaxation therapy
  • biofeedback
  • cognitive-behavioral therapy

Relaxation Therapy 

For people prone to headaches, even everyday mild stresses can be headache-triggering—like a work deadline, caring for a child, or paying bills. These mild stresses can arouse a person's nervous system and lead to an increase in heart rate and blood pressure, shallow breathing, sweating, muscle tightening, and an inability to sleep. 

Since these physical responses can trigger headaches, the purpose of relaxation therapy is to calm your nervous system down to prevent or offset these headaches.

It's important to note that relaxation training is likely much different than you think. In fact, learning how to relax is a skill and is more complex than getting a back rub from your partner. 

Typical relaxation techniques include both deep breathing and progressive muscle relaxation. With deep breathing, a person learns how to maximally fill their lungs with air and then release that air properly and slowly—this increases oxygen flow to your brain and muscles.

Progressive muscle relaxation, or PMR, is the most commonly utilized form of relaxation therapy for treating headaches. In PMR, a person learns how to tighten and relax muscles throughout their body. This way,when a headache trigger presents itself and the body tenses up, a person can learn how to alleviate that tension and prevent a headache or reduce its impact.

Relaxation training generally requires weekly sessions with a psychologist over a period of one to three months. In between sessions, a person practices their relaxation skills at home, until they are comfortable and aware enough to incorporate them into their own daily lives. 


In biofeedback, a device measures your body's physical responses to stress and then feeds this information back to you. This way you can develop an awareness of your body's responses and learn how to control them.

The two forms of biofeedback used to prevent and control headaches and migraines are:

  • EMG (electromyographic) biofeedback
  • Thermal (hand-warming) biofeedback

    In EMG biofeedback, electrodes are placed on certain muscles, commonly the forehead muscle, jaw muscle, and neck muscles—these three muscles tend to tighten when you are experiencing stress or negative feelings. The electrodes measure muscle tension, and the EMG machine sends that information back to you, usually in the form of sound.

    In thermal biofeedback, a biofeedback device is used to measures the temperature of your hand or finger—the idea being that when stressed or anxious, your hands become cold and damp. A visual display on the EMG machine is used to send information about skin temperature back to you. 

    Once you have learned the skills of biofeedback, you will learn how to recognize your body's responses without a machine. It requires consistent practice but can help you gain a sense of power over your headache disorder. 

    Cognitive-Behavioral Therapy 

    With this type of therapy, people first learn how to identify their unique headache and migraine triggers. Common ones include:

    • stress
    • negative emotions (e.g., anger, guilt, or anxiety)
    • sleep problems (e.g., lack of sleep or too much sleep)
    • hunger
    • certain foods (e.g., cheese or chocolate)
    • alcohol
    • weather changes
    • environmental or sensory triggers (e.g., smells, sunlight exposure, noise, eyestrain)

    After a person pinpoints their own triggers, he or she is taught how to best cope with them to minimize headache occurrence and/or headache-related disability.

    In fact, coping with your own triggers, instead of avoiding them, is a big focus of cognitive-behavioral therapy now. This is because avoiding all of your potential headache triggers is truly impossible, creates more stress, and may lead to a restricted lifestyle.

    All in all, it is important that the cognitive-behavioral therapy you undergo be tailored to your individual needs and goals. Be sure to seek care from an experienced, licensed professional, like a psychologist or psychiatrist. 

    A Word From Verywell

    When considering a complementary headache therapy, be sure to first seek out the guidance of your doctor. Research shows that a combination of medication (if appropriate) and behavioral therapies best optimizes a person's headache health. Also, it's sensible to be choosy about which complementary therapy you engage in, as they require a time commitment and effort on your part. 

    Continue to remain proactive in seeking out headache therapies. Follow your gut too. If a therapy is not working, that's OK. Speak with your doctor to consider an alternative plan.

    Remember, caring for your headache is a delicate balance between lifestyle, medication, and behavioral strategies. This care will require consistent evaluation and modification. 


    American Academy of Neurology. Evidence-Based Guidelines For Migraine Headache: Behavioral and Physical Treatments

    American Headache Society. (2014). Headache Toolbox: Behavioral and Other Nonpharmacologic Treatments for Headache

    Lipchik G. (May 2008). American Headache Society: Biofeedback and Relaxation Training for Headaches

    Martin PR, et al. Enhancing cognitive-behavioural therapy for recurrent headache: design of a randomized controlled trial. BMC Neurol. 2014;14:233. 

    Rains JC, Penzien DB, McCory DC, & Gray RN. Behavioral headache treatment: history, review of the empirical literature, and methodological critique. Headache. 2005;45 Suppl 2:S92-109. 

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