Herbals
Place In Therapy
Peppermint
Peppermint has been used traditionally as a remedy for tension
type headache for centuries. Unfortunately, only 2 small trials by the same investigator demonstrate any efficacy for this claim. Compared to acetaminophen 1000mg, peppermint oil was found to be non-inferior in reducing patient reported symptom severity. Given this trial’s small sample size, and non-validated symptom measure, further higher quality trials are needed to definitively draw this conclusion. Tertiary literature lists peppermint oil as a potential treatment, but few substantiate these claims. With respect to peppermint oil safety, little adverse effects are reported beyond those of an allergy-mediated response. Peppermint is used in many cosmetic products safely as well. For this reason, peppermint oil is placed first line for individuals seeking an herbal remedy due to its demonstrated benefit and lack of side effects.
Tiger Balm
Tiger Balm White has been traditionally used in Chinese Medicine for centuries. Originally formulated with tiger bone, formulations over the last
century consist of a blend of camphor, menthol, cajeput oil, and eugenol. This blend has been used traditionally to treat pain, including pain associated with tension-type headaches. One small trial demonstrated non-inferiority of Tiger Balm applied to the forehead every
30 minutes three times to acetaminophen 1000mg. This trial was conducted in a small population and has methodological flaws that leave the trial open to biases. As a result, interpretation of these findings should be done with caution. Tertiary literature, consisting of mostly opinion reviews, conflicts on the use of Tiger Balm in tension-type headaches. Tiger Balm should be considered second line with respect to natural
health products given its adverse drug event profile. Tiger Balm is formulated with multiple volatile oils and ingredients, and is well reported to cause irritation and contact dermatitis.
References
Peppermint:
1. Gobe H, Fresenius J, Heinze A, Dworschak M, Sokya D. Effectiveness of oleum menthae piperitae and paracetamol in the therapy of headache of the tension type [Abstract]. Nervenarzt 1996; 67(8): 672-81.
2. Keifer D, Ulbricht C, Abrams T, Basch E, Giese N, Giles N, Kirkwood C, Miranda M, Woods J. Peppermint (mental xpiperita) an evidence based systematic review by the Natural Standard Research Collaboration. Journal of Herbal Pharmacotherapy 2007; 7(2):91-143
Tiger Balm:
1. Schattner P, Randerson D. Tiger Balm as a treatment of tension headache. A clinical trial in general practice [Abstract]. Australian Family Physician. 1996; 25(2): 216-220.
Peppermint has been used traditionally as a remedy for tension
type headache for centuries. Unfortunately, only 2 small trials by the same investigator demonstrate any efficacy for this claim. Compared to acetaminophen 1000mg, peppermint oil was found to be non-inferior in reducing patient reported symptom severity. Given this trial’s small sample size, and non-validated symptom measure, further higher quality trials are needed to definitively draw this conclusion. Tertiary literature lists peppermint oil as a potential treatment, but few substantiate these claims. With respect to peppermint oil safety, little adverse effects are reported beyond those of an allergy-mediated response. Peppermint is used in many cosmetic products safely as well. For this reason, peppermint oil is placed first line for individuals seeking an herbal remedy due to its demonstrated benefit and lack of side effects.
Tiger Balm
Tiger Balm White has been traditionally used in Chinese Medicine for centuries. Originally formulated with tiger bone, formulations over the last
century consist of a blend of camphor, menthol, cajeput oil, and eugenol. This blend has been used traditionally to treat pain, including pain associated with tension-type headaches. One small trial demonstrated non-inferiority of Tiger Balm applied to the forehead every
30 minutes three times to acetaminophen 1000mg. This trial was conducted in a small population and has methodological flaws that leave the trial open to biases. As a result, interpretation of these findings should be done with caution. Tertiary literature, consisting of mostly opinion reviews, conflicts on the use of Tiger Balm in tension-type headaches. Tiger Balm should be considered second line with respect to natural
health products given its adverse drug event profile. Tiger Balm is formulated with multiple volatile oils and ingredients, and is well reported to cause irritation and contact dermatitis.
References
Peppermint:
1. Gobe H, Fresenius J, Heinze A, Dworschak M, Sokya D. Effectiveness of oleum menthae piperitae and paracetamol in the therapy of headache of the tension type [Abstract]. Nervenarzt 1996; 67(8): 672-81.
2. Keifer D, Ulbricht C, Abrams T, Basch E, Giese N, Giles N, Kirkwood C, Miranda M, Woods J. Peppermint (mental xpiperita) an evidence based systematic review by the Natural Standard Research Collaboration. Journal of Herbal Pharmacotherapy 2007; 7(2):91-143
Tiger Balm:
1. Schattner P, Randerson D. Tiger Balm as a treatment of tension headache. A clinical trial in general practice [Abstract]. Australian Family Physician. 1996; 25(2): 216-220.