Headaches are epidemiologically the most common and, after dementia and stroke, the third most costly disease of the nervous system. In general practice, they are among the most frequent reasons for doctor visits; in cases of treatment resistance, they often result in emergency room admissions and, in chronic cases, cause serious disabilities and complications. Worldwide epidemiological studies show that in adulthood, more than 11% of the population suffers from migraine, 42% from tension-type headaches, and 3% from daily headaches. Due to its widespread global prevalence, tension-type headaches cause an even greater social disability than migraine. The World Health Organization (WHO) ranks headaches 10th among the most disabling diseases for both sexes and 5th for women.
Topical treatment with peppermint oil (Oleum menthae piperitae) has proven significantly effective compared to placebo in controlled studies. Peppermint oil intervenes in the pathophysiology of tension-type headaches via numerous mechanisms of action. Its efficacy is comparable to that of acetylsalicylic acid or paracetamol. A 10% peppermint oil solution in ethanol is approved for the external treatment of tension-type headaches in adults and children from the age of 6. It is included in the guidelines of professional societies and is considered a standard medication for the acute treatment of tension-type headaches.
The current review shows that in carefully controlled studies, 10% peppermint oil in an ethanolic solution, when applied topically to painful areas of the forehead and temples, leads to a highly significant reduction in tension-type headaches compared to placebo. The therapeutic effects are clinically significant. The tolerability is very good. The analgesic mechanisms of action of peppermint oil are very complex, encompassing both central and peripheral effects. Studies in recent years have demonstrated the pronounced analgesic effects of peppermint oil at the clinical, neurophysiological, and molecular levels. Based on these study data, 10% peppermint oil in an ethanolic solution is approved for the external treatment of tension-type headaches in adults and children aged 6 years and older. It is currently the only medicinal product approved for the specific indication of tension-type headaches based on proven efficacy.
A key advantage of using topically applied peppermint oil for headaches is the absence of systemic effects. In particular, there is currently no evidence that medication overuse headaches can cause headaches. Accordingly, the International Classification of Headache Disorders does not list peppermint oil as a possible cause of medication overuse headaches.
Peppermint oil has now been included in the treatment recommendations and guidelines of professional societies. The guideline of the German Society for Neurology points to the effectiveness of large-area local application of peppermint oil. The German Migraine and Headache Society recommends peppermint oil as a preferred treatment during pregnancy and for use in children. The practice guideline "Primary Headaches" of the German Society for Pain Medicine lists peppermint oil as a first-line treatment for acute tension-type headaches.
Clinical experience shows that none of the currently available medications are effective for all types of pain and for all patients at all times. Therefore, various options are necessary. Due to its proven efficacy and good tolerability without systemic side effects or sensitization of the pain defense system (and the associated risk of headaches from medication overuse), the analgesic efficacy of peppermint oil makes it a preferable treatment option in many cases.
Source:
CME The Pain, pp 1-16
First online: 22 April 2016
Peppermint oil in the acute treatment of tension-type headache
H. Göbel, , A. Heinze, K. Heinze-Kuhn; , A. Göbel; C. Göbel
I use 100% therapeutic-grade peppermint oil and it almost always helps quickly and without the numbing feeling I always had with painkillers.
For many years I used peppermint oil for migraines, then I couldn't tolerate the smell anymore. For the past few years I've been using the red Tiger Balm and find it very soothing.
I use peppermint oil very often at the onset of a migraine and also during one.
It eases the pain somewhat.
But if I also have neck problems, for example, tension in my cervical spine, I rub peppermint oil on it, wrap a warm scarf around it, and the next day it's fine.