Tension Headache

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What is a tension headache?

A tension headache is the most common kind of a headache. Many people describe the pain of these as similar to having a band fastened tightly around their head. The pain is most often mild to moderate. What causes a tension headache is not fully understood, but the condition is treatable. Most of the time tension headaches are managed by pursuing a healthy lifestyle, finding treatments that are effective that involve the appropriate use of medications as needed.

Tension headache pain is a dull pain, with a tight feeling around your brows or the back of your head and neck and are the most widely recognized headaches for grown-ups.

When you get them under 15 days for each month, they’re called long-winded headaches. In the event that they happen more frequently, they’re called unending.

These tension headaches can last from 30 minutes to a couple of days. The long-winded headaches ordinarily begin gradually, frequently amidst the day.

These tension headaches can go on for many days. The pain may become worse, or lessen during the day. Despite the fact that your head hurts, tension headaches, for the most part, don’t keep you from your day to day activities, and they don’t influence your vision.


The prevalence of tension headaches is high around the world, in the East as well as in the West, in less-developed and developed countries. Some research suggests that over 63% of men and 85% of women will have a tension headache sometime during each year and that virtually every person has one or more tension headaches at some point during their life.

People who have the highest risk for chronic tension headaches are women who are middle-aged, Caucasians and those who are well-educated. Studies show that approximately 3% to 5% of the general population has a chronic tension-type headache.

Up to 80% of adults in the U.S. get them occasionally. Around 3% have constant everyday tension headaches.

Risk factors

Risk factors for a tension headache include:

  • Gender: Women are more likely to get a tension headache than men
  • Age: Tension headaches are most common among adults in their 40’s. People of any age can get a tension headache, but as people age, tension headaches tend to occur less often.


The exact reason a tension headache occurs is not known. It was believed at one time that the pain of a tension headache was caused by muscles contracting in the neck, face, and scalp, possibly due to stress, tension or other extreme emotions. It has now been suggested that the pain is not caused by muscle contractions.

It is most commonly thought that people who have a tension headache have a more sensitive response to pain and are possibly more sensitive to stress. Tenderness in the muscles, which is often a symptom of a tension headache, may be the result of a pain system that is sensitized.

The trigger that is most commonly reported as a tension headache is stress.


There are four different classifications of tension headaches.

  • Frequent episodic tension-type headaches: These occur at least one day per month, but not more often than 15 days in one month for at least three months. The duration of this tension headache is at least 30 minutes up to seven days.
  • Infrequent episodic tension-type headaches: These tension headaches occur less than monthly, but at least ten times per year. Since they occur less often, they don’t as severely impact a person’s life, and they may not require medical treatment.
  • Chronic tension-type headaches: These tension headaches last for hours and may be continuous. They occur at least 15 days out of the month for at least three months.
  • Probable tension-type headaches: These may be any of the above three kinds of tension headaches. They have many of the symptoms of tension headaches, but not all, they are not found to be caused by neurological disorders, and they are not migraines. They may be related to overuse of medications.


When a person has chronic tension headaches, their job and their overall quality of life can be affected. The pain can make it impossible for them to go to work, or if they do go to their job, their ability to function may be impaired. The frequency of tension headache pain can also make it difficult to attend events or activities.

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What are Tension Headache Symptoms?

Most tension headaches symptoms happen briefly and are typically fleeting (settle inside minutes to a couple of hours). In uncommon cases, the tension headache symptoms may keep going for a long time. A tension headache symptom that happens over 15 days every month is alluded to as permanent tension headache.

  • Continuous head pain
  • The pain of constant tension headaches symptoms tends to vary in severity.
  • The pain related to tension headaches symptoms ordinarily impacts the entire head, however, may start in the back of the head or over the brows.

A few people encounter a top or band-like sensation which circles their skull, while others depict their pain as a muscle pressure in their neck or shoulder districts.

  • The pain is often described as steady and weight like.
  • The pain tends to progress slowly but even at greatest power is not debilitating.
  • Many people who have tension headaches symptoms can proceed with their day to day exercises in spite of the pain.

At times, individuals with tension headaches symptoms report some sensitivity to light or sound.

Are tension headaches symptoms related to side effects or a variety of assorted tension headaches?

Tension headache symptoms are not related to queasiness or vomiting and don’t have side effects like seeing bright lights, blindsides, or numbness of the arms or legs, which happen before a migraine. These side effects can help recognize a tension headache from different types of other headaches (for instance, a migraine).

Tension headache symptoms typically include:

  • Pain is a common tension headache symptom
  • A feeling of pressure or constriction in the back or on the sides of your head or across your forehead
  • Muscles tenderness in your shoulders, neck and on your scalp is a common tension headache symptom

Migraine headaches vs. tension-type headaches

It can be difficult to tell the difference between a tension headache symptom and a migraine. It is also possible to have both migraines and frequent episodic tension headache symptoms. However, there are some differences to be aware of. Some types of migraine headaches are associated with nausea, vomiting or visual disturbances. These are not usually tension headache symptoms. Migraine headaches are usually made worse by physical activity, and activity does not seem to have this effect on a tension headache.

Diagnosing Tension Headache Symptoms

A specialist can regularly and analyze tension headaches by making inquiries about the recurrence and intensity of a tension headache, and also about well-being and way of life factors. They may likewise need to guarantee that a man is not encountering different types of a tension headache symptom, for example,

  • Headache – an incapacitating tension headache issue that is set apart by throbbing pain normally influencing one side of the head. It is frequently joined by queasiness, blurred vision, and different side effects.
  • Pain that is most noticeably bad behind the eye, and a runny nose.
  • Sinus migraines – caused by irritation of the sinuses because of an allergy or other substance.
  • Recurring tension headache

If you have headaches that are chronic or are recurrent, your doctor will most likely complete neurological and physical examinations. In order to find out what type of headaches you are having and the cause for them, your doctor might also ask you for a detailed description of your pain. Some of the questions might be similar to these:

  • Is your pain constant or intermittent? Does it come and go? Is it dull or sharp? Does your pain throb or pulsate?
  • Are you able to work or go to school when you have a headache? Do your headaches wake you from sleep or keep you awake?
  • Where is your pain? Is it only on one side, just on top or is it all over your head? Is it only behind your eyes?

Imaging Tests

Your doctor may order imaging tests if you have complicated or unusual signs and symptoms. These can help rule out causes of headaches that are serious, such as tumors. These tests may include:

  • Computerized tomography (CT) scan: This test uses x-rays taken from many different angles to provide your doctor with a detailed cross-section view of your brain.
  • Magnetic Resonance Imaging (MRI). This test uses a strong magnetic field and radio waves to provide your doctor with clear images of bones and soft tissues.
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Treatment for Tension Headaches

Sometimes people who experience tension headaches come up with treatments for tension headaches themselves instead of seeking medical attention. The problem with this is, if they are using over-the-counter pain medications too frequently (three or more times per week) they may actually get even more tension headaches that are more difficult to treat.

Both prescription medications and over-the-counter pain pills are treatments for tension headaches. They include:

  • Analgesics: Analgesics relieve pain. Non-prescription pain pills which are available over-the-counter are usually tried first. They include aspirin, naproxen (Aleve) and ibuprofen (Motrin IB, Advil, and others). Analgesics that require a prescription for treatments for tension headaches include indomethacin (Indocin) and naproxen (Naprosyn).
  • Combination medications: These medications contain acetaminophen or aspirin, or sometimes both, in combination with caffeine or a medication that causes sedation, in one pill. These combinations of drugs and treatments for tension headaches can often be more beneficial for tension headache treatments than pain relievers that only have one ingredient. Many of these combination drugs are available without a prescription.
  • Triptans and narcotics: People who have both episodic tension headaches and migraines may experience relief from both types of headaches by using a triptan medication. Narcotics are not routinely used as a treatment for tension headaches due to their risk for dependency and also due to their side effects.

Preventive medications

Sometimes a patient has chronic or frequent tension headaches that are not easily relieved by analgesics and treatments for tension headaches therapies like biofeedback or relaxation. In these cases, a physician may recommend other treatments for tension headaches such as medications to try to reduce the severity and the frequency of the tension headaches. These drug treatments for tension headaches may include:

  • Tricyclic antidepressants: This is the type of treatment for tension headaches that are most often used to prevent tension headaches. Examples of tricyclic antidepressants include amitriptyline (Elavil) and nortriptyline (Pamelor). Potential side effects of tricyclic antidepressants include dry mouth, drowsiness, and weight gain.
  • Other antidepressants: Other antidepressants have also been noted to help prevent the frequency and severity of tension headaches. Treatments for tension headaches of this kind include venlafaxine (Effexor XR) and mirtazapine (Remeron).
  • Muscle relaxants and anticonvulsants: Muscle relaxants and anticonvulsants may also help as a treatment for tension headaches.

These preventive medications don’t work right away. They may require several weeks or a month to reach a level in your body that is effective as a treatment for tension headaches. Your physician will closely monitor your condition and response to the medication. Remember that using pain pills too frequently can lead to more tension headaches or may interfere with the preventive treatments for tension headaches.

Useful Advice

Sometimes all you need for the treatment of tension headaches is something to help you relax such as a short rest, a long, hot bath or shower or cooling ice packs. There are many ways to decrease the frequency, duration, and severity of tension headaches without taking medicine. Consider trying the following for tension headache treatment:

  • Control the stress in your life: Be intentional about setting aside time each day to relax, even if it’s only five or ten minutes. Make those minutes all yours. If you are trapped in a tense situation, take a time-out. Step back. Consider letting it go. Another way to decrease stress and reduce tension headaches is to plan ahead and try to stay organized. Less chaos means less stress.
  • Heat up or cool down: If sore muscles are contributing to your tension headache, use ice or heat, whichever feels better, to soothe and relax them. For heat, try a hot bath or shower or use a heating pad (set on low), a heated towel or a warm compress. For cold, cover an ice pack, a small baggie of ice or a bag of frozen vegetables with a pillowcase to protect your skin. This may help a tension headache.
  • Watch your posture: When you don’t use good posture, your muscles can get tense and tight and trigger a tension headache. When you are standing, keep your head level and your shoulders back. Pull in your abdomen and tuck in your buttocks. When you are sitting, keep your thighs parallel to the floor and keep your head up, not slumping forward.


Regular exercise is one of the best ways to reduce stress and may help with a tension headache. Other techniques such as relaxation therapy and biofeedback training are also effective.

  • Biofeedback training. This is a method that can help reduce the pain of tension headaches by teaching you how to control specific body responses. During a session, you are given feedback through devices that monitor body functions like blood pressure, heart rate, and muscle tension. You can then learn how to reduce the tension in your muscles and decrease your breathing and heart rate yourself to relieve a tension headache.
  • Cognitive behavioral therapy. This involves talking with a therapist and learning ways to manage stress. This can help decrease the severity and frequency of your tension headaches.
  • Other relaxation techniques. This can include anything that helps you relax. For example, meditation, yoga, progressive muscle relaxation and deep breathing. Relaxation techniques are taught in classes, or you can learn them at home using tapes, books or the internet to help decrease your tension headaches.

Combining medications with stress reduction techniques may be more beneficial than any therapy is alone in helping to reduce tension headaches.

A healthy lifestyle may also help as a treatment for tension headaches.

  • Avoid nicotine in any form, including second-hand smoke
  • Drink water. At least 8 glasses per day to help reduce tension headaches.
  • Get 7-8 hours of sleep at night to help reduce tension headaches
  • To reduce tension headaches, eat a healthy diet, on a regular schedule
  • Limit your intake of caffeine, alcohol, and sugar to help reduce tension headaches
  • Exercise regularly


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