Premna, particularly species such as Premna serratifolia, has a long history of use in traditional medicine systems like Ayurveda and various Southeast Asian ethnomedicines. Traditionally, different parts of the Premna plant, including leaves and roots, have been used for their purported analgesic and anti-inflammatory properties. In Ayurvedic practice, Premna is recognized as "Agnimantha" and is one of the "Dashamoola" herbs, a classical combination used for managing pain, inflammation, and nervous system disorders, including conditions that may present as headaches. While there is some preclinical research indicating that extracts from Premna species may possess anti-inflammatory and mild analgesic properties, the evidence is limited, and there are few to no high-quality clinical trials specifically investigating its efficacy for tension headaches. Most supporting data come from traditional usage patterns and anecdotal reports rather than rigorous scientific validation. Therefore, its use for tension headache is justified primarily by tradition rather than by strong scientific evidence. In summary, Premna's role in managing tension headaches is rooted in its traditional use as part of broader herbal formulations for pain and inflammation; however, direct scientific support for its effectiveness against this specific condition is lacking or very limited.