Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial

Randomized trial👥 35 participants⚖️ vs. standard careModerate rigor✓ Source-checked📍 Greece

In plain English. Thirty-five people with frequent tension headaches were split into a group that tapped twice a day for two months and a group that just continued their usual care. The tapping group had fewer and less intense headaches, felt less stressed, and reported a better quality of life across the board — but their cortisol (stress hormone) levels didn't actually change, which is a useful honest detail since it means the improvement wasn't explained by that particular biological marker. It's a small trial with a standard-care comparison rather than a placebo.

What they found

people took part

35 patients were randomized to EFT twice daily for two months (n=19) or standard care (n=16); the EFT group had significant reductions in perceived stress, headache frequency, and headache intensity, and improvement on all SF-36 subscales, but no significant change in salivary cortisol in either group.

How the study worked

Who took partpatients with frequent tension-type headache (per International Headache Society criteria) at an outpatient headache clinic in Athens (n=35)

What they didIn a randomized controlled trial, participants were randomly assigned to receive tapping or a comparison condition, then measured and compared.

Compared withstandard care

Measured withPerceived Stress Scale, SF-36 quality of life, salivary cortisol, headache frequency and intensity

⭐ Why this study matters

This is a big deal because it's one of the few tapping trials to measure a hard biological marker — salivary cortisol — directly, instead of relying only on how people say they feel. That cortisol didn't budge is itself valuable, honest information: it tells us the stress relief people reported here isn't simply a cortisol effect, which sharpens rather than undermines the search for what's actually changing in the body.

💡 Where this could help

Imagine someone who gets tension headaches several times a week and is tired of reaching for painkillers as the only option. If a simple daily practice like this one continues to show benefit, it points toward a self-taught technique people could fold into their routine at home for free, no prescription and no clinician visit needed, to cut down on headache frequency and the stress that feeds it.

🔬 What to study next

Cortisol didn't move here even though stress and headaches both improved, which raises rather than closes the mechanistic question — tension-headache stress may run through a different physiological channel than the HPA axis, so the next step is testing muscle tension via EMG, heart-rate variability, or inflammatory markers tied to headache biology, alongside a longer daily-practice trial, to find where in the body this relief is actually showing up if not in cortisol.

The full record

Design	Randomized trial
Participants	35 people
Population	patients with frequent tension-type headache (per International Headache Society criteria) at an outpatient headache clinic in Athens
Comparison group	standard care
Outcome measures	Perceived Stress Scale, SF-36 quality of life, salivary cortisol, headache frequency and intensity
Journal	Explore (NY)
Year	2013
Country	Greece
Language	English
Method	EFT / tapping
Publication type	Study / trial
Verification	✓ Confirmed against the primary source

Read the original study →

Cite this study

APA

Bougea, A.M., Spandideas, N., Alexopoulos, E.C., Thomaides, T., Chrousos, G.P., & Darviri, C. (2013). Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial. Explore (NY). https://doi.org/10.1016/j.explore.2012.12.005

This record is part of the Tapping Evidence Base — an openly-sourced, fully-referenced directory of the research on EFT/tapping. Explore more studies on Pain