Tension-Type Headaches and Aspirin Treatment

Overview of Tension-Type Headaches

Tension-type headaches (TTH) represent a prevalent form of headache experienced at varying intervals. Characterized by mild to moderate pain, individuals often describe this sensation as akin to a tight band encircling the head. This type of headache is notably widespread, affecting one in five people globally. TTH is categorized into three distinct episodes: infrequent (less than one headache per month), frequent (2-14 headaches per month), and chronic (15 or more headaches per month).

Research on Aspirin as a Treatment

Derry et al. conducted a study published in the Cochrane Database of Systematic Reviews, exploring the safety and efficacy of aspirin for treating episodes of TTH. The research involved randomized, double-blinded, placebo-controlled trials where oral aspirin was administered to provide symptomatic relief for TTH. Participants were required to be 18 years or older and were selected through extensive database searches, including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and the Oxford Pain Relief Database, during September 2016.

Study Design and Analysis

The study analyzed various outcomes, including risk ratio (RR), number needed to treat for one additional beneficial outcome (NNT), number needed to harm (NNH), and number needed to prevent one event (NNTp). Participants were divided into two groups based on dosage: one group received 1000 mg of oral aspirin, while the other served as a placebo comparison. In total, 1812 participants took 1000 mg aspirin, while 767 were in the placebo group. Additionally, another group comprised 405 participants who received a 500 mg aspirin tablet alongside 650 mg of placebo.

Results of the Study

Findings indicated that individuals experiencing 2-14 TTH per month reported significant pain relief from the 1000 mg aspirin dosage. However, the study did not find notable pain relief within two hours post-consumption. Among the 1000 mg aspirin group, approximately 10 out of 100 participants required additional painkillers, compared to 30 out of 100 in the placebo group. Furthermore, 55% of participants on aspirin expressed satisfaction with their treatment, in contrast to only 37% in the placebo group. Notably, 15% of both the 1000 mg aspirin group and the placebo group reported experiencing side effects after one dose, indicating no significant difference in adverse outcomes.

Conclusion and Future Directions

In summary, a single dose of aspirin, whether 500 mg or 1000 mg, demonstrated some effectiveness in reducing the frequency of additional medication use. Nonetheless, the quality of evidence between the aspirin and placebo groups was assessed as very low, leading to potentially inaccurate results. There is a need for further research into TTH, as these headaches significantly impact daily life and can act as a disabling condition.

Written By: Seema N. Goolie, BSc