Tension Headaches

Tension headaches are the most common type of headache. They can be brought on by stressful events, and they are characterized by mild to moderate pain that feels like pressure is being applied to the head or neck. While most people with infrequent tension headache headaches do fine with over-the-counter medications, people with more frequent tension headaches may require more powerful medicine for treatment. In some cases, preventive treatment may also be recommended.

 

What Is a Tension Headache?

A tension headache is named not only for the role of stress may play in triggering the pain, but also for the contraction of neck, face, and scalp muscles brought on by stressful events.
 
Tension headache is a severe but temporary form of muscle-contraction headache. The pain is mild to moderate and feels like pressure is being applied to the head or neck. The headache usually disappears after the period of stress is over. Tension headaches affect some 2-3 percent of people on a chronic basis, with twice as many women affected as men.
 
Tension headaches are the most common type of headache. In fact, ninety percent of all headaches are classified as tension headaches. Other names for tension headaches include:
 
  • Tension-type headache
  • Stress headache
  • Ordinary headache
  • Psychogenic headache.
     

Types of Tension Headaches

There are two types of tension headaches –- episodic and chronic. Episodic tension headache occur fewer than 15 days per month. Chronic tension headaches occur on 15 or more days per month, with varied pain throughout the day.
 

Cause of Tension Headaches

Headache research scientists do not know the specific cause or causes of tension headaches. Tension headaches have not been linked to hormones or foods (as migraine has) nor is there a strong hereditary connection.
 
There are, however, certain factors that can increase a person's risk for developing this type of headache. Specific tension headache risk factors include:
 
  • Depression and anxiety
  • Temporary stress, fatigue, or anger
  • Poor posture
  • People who move their neck and shoulders a lot
  • People who work at stationary, repetitive tasks
  • Certain chronic conditions, such as people with temporomandibular joint dysfunction, or TMD.

 

(Click Tension Headache Cause for more information.)

     

Symptoms of Tension Headaches

The pain of a tension headache is often described as a tight band around the head or a feeling that the head and neck are in a cast.
 
The pain of a tension headache is steady, and is usually felt on both sides of the head either towards the front or on the sides. Neck and shoulder muscles may also be tight.
 
Occasionally, a tension headache will be accompanied by:
 
  • Nausea
  • Blurred vision or other vision changes
  • Hearing changes.
     
(Click Tension Headache Symptoms for more information of tension headache symptoms, including how long they typically last.)
 

Diagnosing a Tension Headache

In order to diagnose tension headaches, your healthcare provider will ask a number of questions about the headache, such as how often you have headaches or where the pain is. He or she will also ask about other symptoms that you may experience. Your healthcare provider will also perform a physical exam, looking for signs of conditions known to cause headaches. If your healthcare provider is unsure of the diagnosis, he or she may also order tests to rule out other more serious causes of headaches.
 
(Click Tension Headache Diagnosis for more information.)
 

Tension Headache Treatment Options

There are many different treatment options for tension headaches based on their frequency, severity, and disability. Most people with infrequent tension headache headaches do fine with over-the-counter medications. Other people may need more powerful medicines. Finally, others may have tension headaches so frequently (chronic tension headaches) that preventive treatment is recommended.
 
In general, your healthcare provider may recommend one or more treatment options, including:
 
  • Treat specific causes
  • Medications
  • Other therapies.
     
(Click Treatment for Tension Headaches to learn more about specific treatment options, including medications that may be recommended.)
 

Migraine Versus Tension Headache

While migraine headaches affect millions of people, they are still less common than tension headaches. Tension headaches cause a more steady pain over the entire head rather than throbbing pain in just one spot.
 
Most of the time, migraine attacks happen occasionally. However, tension headaches can occur as often as every day. While fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by certain foods, changes in the body's hormone levels, and even changes in the weather (see Migraine Triggers or Migraine Food Triggers).
 
There are also differences in how these two types of headaches respond to treatment with medicines. While some over-the-counter drugs used to treat tension headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension headaches (see Migraine Medications).
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD