Tension Headaches

What is a tension headache?

A tension headache is a headache that feels like there’s a tight band wrapped around your head that puts pressure on your forehead and temples. Healthcare providers may call them tension-type headaches. Many factors cause tension headaches, and you may be unable to avoid all potential triggers. Fortunately, there are many things you can do to prevent a tension headache. And if home treatment doesn’t work, healthcare providers may have medications and other therapies to ease tension headache pressure.

Types of tension headaches

Healthcare providers classify tension headaches based on how often you have one. Condition types include:

• Infrequent episodic: Headaches happen one day a month or fewer.
• Frequent episodic: You have one to 14 headaches every month for at least three months.
• Chronic: You have more than 15 headaches every month for three months.

Are tension headaches common?

Tension headaches are the most common primary headache type. Researchers estimate more than 70% of people have episodic tension headaches. They typically affect more women and people assigned female at birth than men and people assigned male at birth.

What are the symptoms of a tension headache?

Symptoms may vary, but most people describe tension headache pain as:

• Constant mild to moderate pressure and pain.
• Feeling like something is squeezing the sides of their heads together.
• Aching or tight neck muscles and shoulder muscles.
• Sensitivity to light and sound.

These symptoms may come on slowly. They may last about 30 minutes, but sometimes, they last as long as a week. Some people with chronic tension headaches may feel as if they’re always dealing with headache pain and pressure.

What causes tension headaches?

Researchers are still seeking a single cause for tension headaches. Some believe tension headaches start when muscles between your head and neck knot up, eventually tightening your scalp muscles. That muscular ripple effect may happen because you’re stressed or dealing with emotional conflict. Other tension headache causes include:

• Neck strain from looking down to read or holding a cell phone or landline receiver between your head and shoulder.
• Eye strain from staring at a computer screen or documents for a long time without taking breaks.
• Temporomandibular jaw disorder (TMJ).
• Degenerative arthritis in your neck.
• Sleep disorders issues like sleep apnea and insomnia.
• Anxiety.
• Depression.

What are the complications of tension headaches?

Chronic tension headaches that last for weeks and months may affect your quality of life. For example, a chronic tension headache may make it hard for you to focus on your work or family responsibilities because you’re always dealing with tension headache pressure.

How is a tension headache diagnosed?

Healthcare providers may ask about your medical history and symptoms, including questions like:

• How often do you have symptoms?
• Do your symptoms feel worse at certain times of the day?
• Do your symptoms feel worse after doing certain activities?
• Do over-the-counter pain relievers help you feel better?

They may do computed tomography (CT) scans and brain magnetic resonance imaging (brain MRI) scans to check for underlying issues.

What are the treatments for tension headaches?

Treatments vary depending on the tension headache type. For example, if you have episodic headaches, your provider may recommend you start over-the-counter pain relievers like:

• Acetaminophen (Tylenol®).
• Aspirin.
• Ibuprofen (Advil®, Motrin®).
• Naproxen sodium (Aleve®).

If you have chronic tension headaches, your provider may prescribe:

• Antiseizure medications like gabapentin (Neurontin®) or topiramate (Topamax®, Topiragen ®).
• Antidepressants like amitriptyline that relieve pain.
• Alternative therapies like biofeedback, meditation or cognitive behavioral therapy to help manage stress.
• Physical therapy for sleep apnea or TMJ.

What are treatment side effects or complications?

Side effects and complications vary depending on treatment, but rebound headaches are one common potential side effect of taking over-the-counter and/or prescription pain relievers for tension headaches.

Rebound headaches, or medication overuse headaches, are headaches that happen if you use headache medication too often. Healthcare providers recommend limiting pain relief use to 10 days in any given month.

How can I prevent a tension headache?

Managing stress may be the most effective way to prevent a tension headache. The most effective stress management tools are the ones that you can fit into your daily routine and make you feel good. Some examples include:

• Massage therapy.
• Regular exercise.
• Getting enough rest.

What can I expect if I have a tension headache?

If you’re like most people, you have episodic tension headaches that you can manage with pain relievers and by reducing stress. People with chronic tension headaches may need to take antidepressants or participate in therapy like biofeedback.

How can I get rid of a tension headache?

Over-the-counter pain relievers may help ease occasional tension headaches. Home remedies like placing a hot or cold compress on your head and neck may help.

When should I see my healthcare provider?

Tension headaches aren’t life-threatening, but they can be a sign of a serious medical issue or that an existing issue is getting worse. Talk to a healthcare provider if you have a headache and you have:

• A stiff neck.
• Pain or tenderness in your jaw when you chew or at your temple, like when you comb your hair.
• Fever above 103 degrees Fahrenheit that doesn’t go away.
• Headaches that feel different or happen more frequently than usual, and you’re age 50 or older.
• A headache that happens only when you’re lying flat or when you stand up. This is a positional headache.
• Cancer or an autoimmune disease and notice you’re having more headaches or more severe headaches.
• Numbness or weakness.

When should I go to the emergency room?

You should go to the ER if you have a sudden severe headache that worsens quickly. You should also get immediate medical care if you have a headache and experience:

• Confused thoughts, slurred speech or weakness.
• Changes in your ability to see or speak.
• Weakness, drowsiness, confusion or loss of balance.
• Feeling short of breath.

What questions should I ask my healthcare provider?

You may want to ask your provider:

• What’s causing my tension headache?
• What treatments do you recommend?
• Will I always have to deal with tension headaches?