Behavioral factors in headache management


Headache is a major public health problem, which can result in significant disability to the individual and costs to society. The most common types of primary headache are tension-type headache (TTH) and migraine. These headaches can lead to considerable pain, marked reductions in quality of life, and medical and psychological comorbidities including depression and anxiety. A number of behavioral treatments have been shown to be efficacious, chief among these being biofeedback, relaxation training, and cognitive behavior therapy. These behavioral treatments are not only effective for reducing pain, but they also favorably impact negative cognitive and affective states and headache-related disability. Meta analyses have shown that outcomes are greatest when medication treatment for migraine is combined with behavioral approaches. Special challenges in headache care can be best managed with the addition of behavioral techniques (e.g., medication overuse headache).

Publication Title

The Handbook of Behavioral Medicine