Introduction

Tension headaches are the most common type of primary headache, meaning that they are not caused by an underlying medical disorder. Most people will experience a tension headache in their lifetime. They occur most frequently between the ages of 20 and 50. Tension headaches cause mild to moderate pain that can be relieved with a variety of medications and non-medication treatments.

Anatomy

For years, scientists thought that tension headaches were caused by muscle tension. However, recent researchers dispel this belief and now suspect that the cause is related to changes in brain chemicals, particularly those that play a role in helping nerves communicate pain.

Causes

The exact cause of tension headaches is unknown.

Symptoms

A tension headache causes mild to moderate head pain that may spread throughout your neck and shoulders. It may feel like a tight band is wrapped around your head. The muscles in your shoulders, neck, face, and head may feel sore and tender. You may lose your appetite, feel irritable, and have problems concentrating. You may feel tired all of the time and have difficulty sleeping. Episodic tension headaches last from about 30 minutes to a week and can recur. Chronic tension headaches last for ½ month, months, or years. Chronic tension headaches are less common and occur most frequently in women.

Diagnosis

Your doctor can diagnose tension headache by reviewing your medical history and symptoms. Your examination may include imaging tests, such as CT scans or MRI scans, to rule out more serious conditions. You may be asked to keep a record of your headaches for your doctor to review.

Treatment

Many people find relief with over-the-counter medications, such as aspirin, ibuprofen, and acetaminophen. These medications are most effective when taken at the earliest sign of headache. Your doctor may recommend a combination of medications, including prescription medication. In some cases, preventative prescription medications can reduce episodes. Lifestyle changes, such as getting regular exercise, sleep, and relaxation can help as well.

Prevention

You may help prevent tension headaches by:

• Exercising on a regular basis
• Getting plenty of sleep
• Relaxing, try massage, biofeedback, or yoga
• Use good posture and avoid working in the same position for a long period of time

Am I at Risk

Risk Factors or Triggers for Headaches:

• Skipping meals, not eating, feeling hungry
• Lack of sleep or changes in sleep routine
• Stress, depression, or anxiety
• Poor posture, maintaining one position for a long time, such as when working
• Physical inactivity
• Hormone changes related to pregnancy, menstruation, menopause, or hormone medications
• Medications used to treat high blood pressure or depression
• Overuse of over-the-counter headache medication can cause a “rebound headache”
• Arthritis inflammation
• Teeth grinding, jaw clenching
• Head trauma, whiplash injury

Complications

Tension headaches can become a chronic condition.

Advancements

BOTOX® injections, laser acupuncture, biofeedback and cognitive behavioral therapy have all been shown to lessen headache severity and improve headache control in both adults and children with tension type headaches.