Tension Headaches

Tension Headache

What Are Tension Headaches?

A tension headache is named not only for the role stress may play in triggering the pain, but also for the contraction of neck, face, and scalp muscles brought on by stressful events.

Tension headaches are 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 to 3 percent of people on a chronic basis, with twice as many women affected as men.

These are the most common type of headache. In fact, 90 percent of all headaches are classified as tension headaches. Other names for them 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 headaches 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. They have not been linked to hormones or foods (as migraines have), 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 risk factors for tension headaches 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 tension headaches 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, this headache will be accompanied by:

Nausea
Blurred vision or other vision changes
Hearing changes.

(Click Tension Headache Symptoms for more information, including how long symptoms typically last.)

Diagnosing Tension Headaches

In order to diagnose tension headaches, your healthcare provider will ask a number of questions about the headache, such as how often you have them or where the pain is. He or she will also ask about other symptoms that you may experience. Your healthcare provider will 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.

(Click Tension Headache Diagnosis for more information.)

Treating Tension Headaches

There are many different treatment options for tension headaches, based on their frequency, severity, and disability. Most people with infrequent tension headaches do fine with over-the-counter medications. Other people may need more powerful medicines. Finally, others may have tension headaches so frequently (chronically) that preventive treatment is recommended.

In general, your healthcare provider may recommend one or more treatment options, including:

Treating specific causes
Medications
Other therapies.

(Click Treatment for Tension Headaches to learn more, including medications that may be recommended.)

Migraines Versus Tension Headaches

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).