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Are alternative and complementary therapies effective for tension-type headaches in children?
  1. Archith Kamath1,
  2. Jayakara Shetty2,3
  1. 1 Medical School, Oxford University, Oxford, UK
  2. 2 Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
  3. 3 Division of Health Sciences, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Jayakara Shetty, Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh EH9 1LF, UK; Jay.Shetty{at}

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Clinical scenario

You are sitting in a busy paediatric outpatient clinic. Your patient is a 12-year-old girl who describes tight band-like headaches occurring daily affecting her school attendance and general mood for the past 8 months. Paracetamol and ibuprofen do not relieve her symptoms. Her GP prescribed Pizotifen, which made her tired and did not relieve the headache. After taking a detailed history and performing a thorough clinical examination, you make a diagnosis of tension-type headaches (TTH). The patient’s mother is keen to explore alternative and complementary therapies (ACTs).

Structured question

In children with TTH (population), do ACTs (intervention) improve symptoms (outcome)?


MEDLINE (1946–present via PubMed), Embase (1974–present via Ovid) and the Cochrane Library were all searched. Search terms were (Alternative Medicine OR Complementary Medicine) AND (Headache NOT Migraine) AND (Infant OR Child OR Adolescent). MEDLINE turned over 362 records, Embase turned over 131 records and Cochrane turned over 3 records. A further search including keyword ‘Migraine’ was performed in order to screen for records previously eliminated but still containing data for TTH.

Inclusion criteria: age 0–18 years, English language, randomised controlled trials (RCTs)/systematic reviews/pragmatic clinical trials. RCTs were excluded if already analysed by an included systematic review, or if both TTH and migraines were included in the study group but TTH-specific data were not available. …

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  • Contributors AK thought of the clinical scenario, searched the evidence, appraised the evidence, wrote the manuscript. JS reviewed manuscript structure.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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