Tension-type headaches are a common headache often causing mild-to-moderate pain, which some describe as feeling like a tight band around their head. Tension headaches can be treated with over-the-counter pain relievers or antidepressants if a prescription is needed. Other treatments include lifestyle changes and learning to ways to respond to stresses.
Headaches are a common health problem. Almost everyone experiences one at some point in life. But they’re not all the same. Medical experts group headaches into more than 100 types.
For most people, headaches lead to minor aches or pains and happen occasionally (every once in a while). Less commonly, more severe headaches (such as migraines) can cause throbbing pain. Some headaches may make routine tasks difficult or near impossible.
Rarely, severe, sudden head pain can be a sign of a serious health problem, such as a brain tumor.
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Tension headaches are the most common type of headache. These headaches often cause mild-to-moderate pain around the head, face or neck. They usually don’t cause other symptoms (like nausea or vomiting). Healthcare providers generally don’t consider tension headaches to be dangerous.
Your healthcare provider may call your tension headache, "tension-type headache. This is what this headache is called by the official medical publication that classifies all headache disorders.
Healthcare providers break down tension headaches into two main types. They base the type on how many headaches you have and how often:
People don’t always see their doctor for a tension headache, which makes exact numbers hard to predict. Researchers estimate that as many as 2 in 3 adults in the U.S. get tension headaches.
Chronic tension headaches are much less common. They affect an estimated 3% of adults. Women get tension headaches more often than men.
Researchers haven’t identified one single cause for tension headaches. This headache type is not hereditary (run in families).
Some healthcare providers believe tightened muscles in the back of your head or neck may trigger (bring on) tension headaches.
You may be more likely to have tension headaches if you have:
People experience tension headache symptoms differently. Some people describe tension headache pain as feeling like someone (or something) is squeezing both sides of their head together or a band around their head.
You may have pain that’s:
Migraines are another common headache type. Migraines and tension headaches tend to cause different symptoms.
A migraine is more likely to cause:
That depends. A tension-type headache may last for 30 minutes or (less commonly) months. In general, episodic tension headache symptoms tend to come on slowly and end sooner. They often happen in the middle of the day. Episodic headaches usually don’t last longer than a week.
People with chronic tension-type headaches can have symptoms that last for months at a time. Pain may stay at the same level of discomfort for days. While uncommon, these headaches can take a toll on your quality of life.
Not according to medical experts. While chronic tension-type headaches can disrupt your life, tension headaches don’t tend cause serious health issues.
Sometimes tension-type headaches may be a sign of an underlying disorder such as thyroid disease or an underlying tumor or a primary headache disorder, such as chronic migraine or new daily persistent headache. Anyone over age 50 with a new onset headache should see their doctor for an evaluation .
No test exists to definitively diagnose tension headaches. Your healthcare provider will start by reviewing your medical history. They will then examine you to evaluate your symptoms.
Your provider may ask you a lot of questions to learn more about your symptoms, such as:
A headache specialist will use a diagnostic manual called the International Classification of Headache Disorders-3 to make sure that you fulfill criteria for tension-type headache.
In some cases, your provider may order an imaging scan, such as an MRI. Imaging tests can help rule out less common but potentially serious causes of your symptoms. Learn more about headache diagnosis and tests.
If you get a tension headache every so often, over-the-counter pain relievers may effectively treat your pain. Your provider may recommend you first try one of these options to relieve your symptoms:
If over-the-counter pain relievers don’t help, your provider may prescribe medication. Certain medications reduce how often your headaches happen or how much they hurt. The antidepressant amitriptyline (Elavil®) has helped some people with chronic tension headaches. Opioids should not be used.
Over-the-counter pain relievers are generally safe. But overusing pain relievers can cause other problems. Make sure to follow the instructions on the bottle carefully. Always check in with your provider if you feel the need to use pain relievers more than twice a week.
Take these medications only when you need them. Use the smallest dose that relieves your pain.
In general, overusing pain medications may cause:
No treatment (medication or otherwise) can cure tension headaches. Medicines help you manage and get relief from your symptoms so that you can enjoy more of life.
Absolutely. While medication may be helpful, it’s not a substitute for coping with stressors that may cause your headaches.
Other tension-type headache treatment options include:
Researchers have yet to uncover how to prevent all headaches. If you experience chronic tension-type headaches or frequent tension-type headaches certain medications may stop some headaches before they start. These are antidepressants such as amitriptyline or venlafaxine or duloxetine. These work on the pain centers in the brain.
Overall, lifestyle changes and reducing your response to stress is the best way to prevent tension headaches. The most effective stress management tool is the one that fits into your life and you feel good using. You may want to try:
Tension headaches can be annoying. In severe cases, they can disrupt your personal life or career in big ways. But most cases cause minor symptoms. Medication and other therapies help many people overcome their symptoms with minimal interruptions to their life.
Most headaches aren’t dangerous. Rarely, headache pain can be a sign of a serious medical problem. You should seek immediate medical care if you have:
A note from Cleveland Clinic
Almost everyone experiences tension headaches. But that doesn’t mean you need to live with the pain. Over-the-counter pain relievers may be enough to relieve minor symptoms. If you have a headache more days than not, reach out to your provider for guidance. Medication and stress management help many people reduce the impact of tension headaches on their life. Massage, meditation, exercise or talking to someone you trust are just some of your options. The best stress-management therapy is the one that works for your lifestyle and feels right to you.
Last reviewed by a Cleveland Clinic medical professional on 02/04/2021.
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