Document Type
Article
Publication Date
4-1-2026
Abstract
Headache disorders are among the most disabling neurological conditions, affecting over 1.5 billion people globally. Despite advances in pharmacological therapies, major inequities persist due to underdiagnosis, undertreatment and limited access to effective care, particularly in low- and middle-income countries. Social determinants of health, including cultural meanings, language and health beliefs, are increasingly recognized as key drivers of disparities in burden, diagnosis and treatment outcomes. Traditional medicine, used by more than 80% of the global population, remains first-line care in many regions and continues to influence therapeutic choices in high-income settings. Major systems such as Ayurveda, Traditional Chinese Medicine, Unani and Tibetan medicine, as well as diverse indigenous traditions, emphasize holistic approaches that integrate mental and physical symptoms into diagnosis and management. Additionally, religious and spiritual practices are commonly used to relieve suffering and pain. These culturally grounded explanatory models not only strongly shape health-seeking behavior, treatment adherence and patient narratives, but also may delay biomedical care when misconceptions or unsafe practices predominate. This paper introduces Transcultural Headache Medicine as an emerging framework that integrates cultural contexts, linguistic diversity and traditional practices into headache research, clinical care and policy. We review global traditions and therapeutic modalities including herbal, physical, mental and spiritual approaches, and propose a research agenda combining ethnography, culturally adapted diagnostic tools, experimental studies and clinical trials to evaluate benefits, risks, and contextual effects. We conclude with a call to action from the International Headache Society, aiming to map and evaluate culturally embedded practices, strengthen rigorous evidence and build a global learning network that supports culturally safe integration of effective, affordable and safe headache care.
Recommended Citation
Peres, Mario F. P.; Lucchetti, Giancarlo; Vallada, Homero; Riso, Ivy L.; Westenhofen, Georgia K.; Valença, Marcelo Moraes; de Andrade, Juliana Ramos; Brennan, K. C.; Levin, Morris; Takizawa, Tsubasa; Dong, Zhao; Wang, Yonggang; Rattanawong, Wanakorn; Sofyan, Henry Riyanto; Leone, Massimo; Dodd-Glover, Freda; Yuan, Hsiangkuo; Albilali, Abdulrazaq; Alsaadi, Taoufik; Caixeta, Leonardo; Andreou, Anna P.; Goadsby, Peter J.; MaassenVanDenBrink, Antoinette; Ashina, Sait; Burstein, Rami; Pozo-Rosich, Patricia; Ahmed, Fayyaz; and Wang, Shuu-Jiun, "Transcultural headache medicine: A framework for integrating cultural contexts into headache science and care - a call to action from the International Headache Society." (2026). Department of Jefferson Headache Center Papers and Presentations. Paper 30.
https://jdc.jefferson.edu/headache/30
Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Language
English

Comments
This article is the author’s final published version in Cephalalgia : an international journal of headache, Volume 14, 2026, Pages 3331024261432929.
The published version is available at https://doi.org/10.1177/03331024261432929. Copyright © International Headache Society 2026.