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Tension Headache

A tension headache is pain or discomfort in the head, scalp, or neck, usually associated with muscle tightness in these areas.

Causes, Incidence and Risk Factors of Tension Headache

Tension headaches are one of the most common forms of headaches. They may occur at any age, but are most common in adults and adolescents.

If a headache occurs two or more times a week for several months or longer, the condition is considered chronic. Chronic daily headaches can result from the under- or over-treatment of a primary headache.

Rebound headaches are headaches that keep coming back. They may occur if you overuse painkillers.

Tension headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, a head injury, or anxiety.

Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or other computer work, fine work with the hands, and using a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger a tension headache.

Other triggers of tension headaches include:

Tension headaches can occur when you also have a migraine. Tension headaches are not associated with brain diseases.

Symptoms of Tension Headache

The headache pain may be described as:

The pain may occur as an isolated event, constantly, or daily. Pain may last for 30 minutes to 7 days. It may be triggered by or get worse with stress, fatigue, noise, or glare.

There may be difficulty sleeping. Tension headaches usually do not cause nausea or vomiting.

People with tension headaches tend to try to relieve pain by massaging their scalp, temples, or the bottom of the neck.

Signs and Tests for Tension Headache

A headache that is mild to moderate, not accompanied by other symptoms, and responds to home treatment within a few hours may not need further examination or testing, especially if it has occurred in the past. A tension headache reveals no abnormal findings on a neurological exam. However, tender points (trigger points) in the muscles are often seen in the neck and shoulder areas.

The health care provider should be consulted -- to rule out other disorders that can cause headache -- if the headache is severe, persistent (does not go away), or if other symptoms are present with the headache.

Headaches that disturb sleep, occur whenever you are active, or that are recurrent or chronic may require examination and treatment by a health care provider.

Treatment for Tension Headache

The goal is to treat your headache symptoms right away, and to prevent headaches by avoiding or changing your triggers. A key step in doing this involves learning to manage your tension headaches at home by:

Medicines that may relieve a tension headache include:

Remember that pain medications only relieve headache symptoms for a short period of time. After a while, they do not work as well or they do not relieve headaches for as long. Overuse of pain medications during most weeks can lead to rebound headaches -- headaches that keep coming back.

You may take some medicines daily to help prevent or decrease the number of headaches. These medicines are normally used to treat depression, but they can also help prevent tension headaches. They include:

Ask your health care provider about relaxation or stress-management training, biofeedback, cognitive behavioral therapy, or acupuncture, which may help relieve chronic headaches.

Botox (botulinum toxin) is becoming popular as a treatment for chronic daily headaches, including tension headaches. However, it is currently not approved for such use.

Expectations / Prognosis of Tension Headache

Tension headaches often respond well to treatment, and do not cause serious medical problems. However, chronic tension headaches can have a negative impact on the quality of life and work.

Calling your Health Care Provider of Tension Headache

Call 911 if:

Also, call your doctor if:

Prevention of Tension Headache

Learn and practice stress management. Some people find relaxation exercises or meditation helpful. Biofeedback may improve relaxation exercises and may be helpful for chronic tension headache.

Tips to prevent tension headaches:

Massaging sore muscles may also help.


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