What are "tension-type" headaches?

"Tension-type" headaches are the most common type of headaches among adults. They used to be commonly referred to as muscle contraction headaches or stress headaches, but these old terms are no longer used.

A tension-type headache may appear periodically (episodic, fewer than 15 days per month) or chronically (more than 15 days per month). An episodic tension headache may be described as a mild-to-moderate, constant, band-like pain or pressure. These headaches may last from 30 minutes to several days. Episodic tension headaches usually begin gradually, and often occur in the middle of the day.

Unlike migraines, tension-type headaches:

  • Are rarely severe.
  • Are not throbbing, but band-like and aching.
  • Affect both sides of the head.
  • Are not made worse by routine physical activity.
  • Are not associated with light and sound sensitivity.
  • Are not associated with nausea or vomiting (though there can be anorexia).

Who is affected by tension-type headaches?

About 30 to 80 percent of the adult population in the United States suffers from occasional tension-type headaches. Chronic daily tension-type headaches affect approximately 3% of the population; women are twice as likely to suffer from them as men.

Most people with episodic tension-type headaches have them no more than once or twice a month, but the headaches can occur more frequently.

Many patients with chronic tension-type headaches have usually had the headaches for more than 60 to 90 days. For many headache sufferers, these headaches have a negative effect on their daily activities.

People who get migraine headaches can also suffer from chronic tension headaches.

What causes tension-type headaches?

There is no single cause for tension-type headaches. This type of headache does not run in families. In some people, tension-type headaches are associated with tightened muscles in the back of the neck and scalp. This muscle tension may be made worse by:

  • Not getting enough rest
  • Poor posture
  • Emotional or mental stress, including depression

Tension-type headaches can be triggered by some type of environmental or internal stress. This stress may or may not be known to the patient and their family. The most common sources of stress include family, social relationships, friends, work, and school. Examples of stressors include:

  • Having problems at home
  • Having a new child
  • Having no close friends
  • Returning to school or training; preparing for tests or exams
  • Going on a vacation
  • Starting a new job
  • Losing a job
  • Being overweight
  • Deadlines at work
  • Competing in sports or other activities
  • Being a perfectionist
  • Not getting enough sleep
  • Being overextended (involved in too many activities/organizations)

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