We all have had those days when stress, fatigue, or a long to-do list seems to trigger a nagging headache. But not all headaches are the same. One of the most common types of headaches is tension headache. It is often described as a dull, squeezing pain around the head that feels like a tight band. While they are not usually dangerous, they can be frustrating and disruptive.
In this blog we’ll learn about tension headaches, what causes them, what are their symptoms, how to tell them apart from migraines, and what you can do to treat and prevent them.
What is Tension Headache?
Tension headache is a type of primary headache (meaning it’s not caused by another underlying health condition) which presents as pain or discomfort in the head, scalp, or neck. It is often associated with muscle tightness in these areas, and often feels like a tight band squeezing around the forehead.
For most people they tend to occur episodically— usually once or twice a month. However in some cases they can become chronic and can happen much frequently.
Causes of Tension Headache:
Tension headaches happen when muscles in the neck and the scalp tightens or contracts, often as a reaction to stress, anxiety, depression, or even head injuries. While they may develop at any age, they are most commonly seen in adults and older teenagers. Women tend to experience tension headaches slightly more often than men, and they can sometimes run in families.
The exact cause of tension headache is not fully understood, but different factors are known to contribute to it, these include:
- Physical or emotional stress
- Sleep problems
- Poor posture
- Eye strain
- Fatigue
- Teeth grinding or jaw clenching
- Dehydration
- Skipped meals
- Caffeine (too much or withdrawal)
- Excessive smoking
- Alcohol
- Cold, flu, or sinus infections
Symptoms:
Tension headaches can vary from person to person, but the most common symptoms include:
- A dull aching head pain (not throbbing)
- Pain on both sides of the head, face, or neck
- Pressure or tightness around the forehead or the back of head
- Tenderness in the scalp, neck, or shoulder muscles
- Mild sensitivity to light and noise (though not as intense as with the migraines)
- Irritability or fatigue
These headaches can last anywhere between 30 minutes to several hours, and in some cases, they can persist for days. They tend to come and go but can become chronic if they occur more than 15 days a month.
Tension Headache vs Migraine:
Sometimes when the pain from a tension headache becomes intense, it can be mistaken for a migraine. However there are some important differences between the two, these include:
| Feature | Tension Headache | Migraine |
| Pain type | Steady, pressing, or tightening pain | Throbbing or pulsing pain often on one side of the head |
| Pain intensity | Usually mild to moderate | Often moderate to severe |
| Impact of physical activity | Not typically worsened by movement | Often gets worse with physical activity |
| Additional symptoms | Usually doesn’t include nausea or vomiting | Commonly includes nausea, vomiting, or visual disturbances (auras) |
| Sensitivity to light and sound | Rarely causes sensitivity, but in some cases, mild light or sound sensitivity can occur | Frequently causes strong sensitivity to light and noise |
How to Treat Tension Headaches?
Most tension headaches are not serious and can be treated with simple self-care and over-the-counter remedies. The main goal in managing tension headaches is two-folds: to relieve the symptoms as soon as they begin and to prevent future headaches by identifying and avoiding the triggers. A big part of this involves how to take care of your headaches at home.
Here are some helpful steps you can take:
- Keep a headache diary— track when your headache occurs, what you were doing before, and how severe they are. This can help both you and your healthcare provider to pinpoint your triggers and make lifestyle changes to reduce how often they occur.
- Learn Early Relief Techniques— recognising the signs of tension headache early and knowing what helps like rest, hydration, and stretching etc., can make a big difference in reducing the pain.
- Use Medications Properly— understand how and when to take your headache medications to avoid complications or overuse.
Therapies that Can Help:
Many people find relief through conservative therapy that aims at managing stress and relaxing tight muscles.
These therapies include:
- Massage therapy
- Biofeedback— a relaxation technique that teaches you to manage pain and stress
- Cognitive Behavioral Therapy (CBT) for stress and anxiety management
- Acupuncture— an alternative therapy that helps reduce your stress by applying fine needles to different areas of your body
- Applying heat or cold packs to the head, neck, or shoulders for 5 to 10 minutes several times a day
- Taking a warm bath or shower to relax your muscles
Medication Options:
If lifestyle changes and relaxation techniques are not enough, medications may help. These include:
- Over-the-counter pain relievers like aspirin, ibuprofen, or acetaminophen. However these medicines should be taken occasionally as over use of over-the-counter medications can lead to “overuse” or “rebound” headaches.
- If tension headaches keep coming back and over-the-counter medications are not helping, your healthcare provider may recommend prescription medicines like:
- Tricyclic antidepressants
- Beta blockers
- Anti-inflammatory drugs like naproxen and indomethacin
- Muscle relaxants, to reduce muscle tension
- In some cases antidepressants like selective serotonin reuptake inhibitors (SSRIs) may also be recommended to help regulate serotonin levels in your brain and improve your ability to manage stress
Note: Narcotic pain medications are generally not recommended for tension headaches, as they can lead to dependency and rebound headaches.
How to Prevent Tension Headaches?
Preventing tension headaches often involves lifestyle changes and stress management.
Here are a few practical tips that can help you prevent tension headaches:
- Practice good posture— use ergonomic chair, adjust your computer screen height, and take posture breaks if you work at a desk
- Manage stress— incorporate relaxation techniques like deep breathing, yoga, and mindfulness in your daily routine
- Take regular breaks— especially if you are working on a screen or doing something repetitively
- Exercise regularly— even moderate daily exercise like walking and stretching can reduce stress and muscle tension
- Stay hydrated— aim to drink at least 8 glasses of water everyday or more if you are physically active
- Get enough sleep— aim to get 7 to 8 hours of sleep everyday
- Limit caffeine and alcohol— both can be a trigger for tension headaches
When to See a Doctor?
Tension headaches are usually harmless, but there are some signs that suggest something more serious. You should consult your healthcare provider if:
- Your headaches are frequent or worsening
- Your headache is disrupting your life
- Over-the-counter treatments aren’t helping
- You have headaches that wake you up from your sleep
- You notice new or unusual symptoms like confusion, vision problems, or numbness
- The headache comes suddenly and severely (often described as “the worst headache of your life”
- You are having a headache after a head injury
A doctor can rule out other causes of headache, determine if your headaches are chronic, and develop a personalised treatment plan for you.
Final thoughts:
Tension headaches may be common but it doesn’t mean you have to live with them. With the right habits and a little self-awareness, you can manage and prevent these headaches from taking over your day. And if they do become persistent, don’t hesitate to contact a healthcare provider.
