Tension Headache

What is a tension headache?

A tension headache is a headache caused by tense muscles in your face, neck, or scalp. It is also sometimes called a muscle-contraction headache. Tension headaches are very common.

How does it occur?

The muscles of your face, neck, and scalp may become tense because of:

  • anxiety or stress

  • staying in one position for a long time

  • injury, such as in a car accident.

  • depression.

Headaches can also be triggered by:

  • having too little or too much sleep

  • eating too little or too much

  • drinking too much alcohol

  • being somewhere that is noisy

  • working hard indoors or outdoors

  • medical problems.

What are the symptoms?

The symptoms may be:

  • a feeling like a tight band is around your head

  • dull and steady pain that worsens through the day, sometimes with a sore neck

  • trouble concentrating

  • trouble sleeping

  • pain that starts or gets worse with stress, fatigue, noise, or glare.

Your muscles might twitch or spasm. Sometimes your head may feel like it is throbbing.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine you. No single test can confirm that a headache is a tension headache. The diagnosis is based on your symptoms, medical history, and a physical exam.

Your health care provider may ask:

  • When did the headache start?

  • How bad is it?

  • Where is the pain located?

  • What kind of pain is it? Is it sharp, burning, or throbbing?

  • Do you have other symptoms, such as nerve tingling or weakness?

  • Do you have a fever?

  • Do you feel sick or vomit?

  • Do you have eye pain or vision changes?

  • Did you have an accident or injury before the pain started?

  • Did you take any drugs before the pain started?

  • Have you had other headaches like this one?

  • What stresses are you having?

Often it is hard to know if a headache is a tension headache or a mild migraine headache.

How is it treated?

You can reduce muscle tightness and relieve pain with:

  • nonprescription medicine

  • relaxation exercises

  • biofeedback

  • regular physical exercise.

If the pain continues, your health care provider might refer you to a physical therapist or prescribe a stronger pain reliever.

How long will the effects last?

Symptoms usually last a few hours to a day.

How can I take care of myself?

  • Rest in a quiet, dark room until symptoms lessen or go away.

  • Take a pain reliever such as aspirin, acetaminophen, ibuprofen, or other medicine your health care provider recommends or prescribes. Do this as soon as you notice symptoms. Recognizing early warning signs of headache and starting treatment right away is crucial to having less pain.

  • Do not smoke.

  • Do not drink a lot of alcohol.

  • Massage your neck, shoulders, and back. Put heat, an ice pack, or a cold washcloth on these areas.
    See your health care provider right away if:

  • The pain seems unusually severe.

  • You also have numbness or tingling in your face, arms, or legs.

  • Your arms or legs feel weak.

  • You have changes in your vision that do not go away.

What can be done to help prevent tension headaches?

  • Try to identify and avoid situations that cause tension or stress. Consider getting counseling to help you reduce the stress in your life.

  • Learn to use relaxation techniques.

  • Exercise regularly and get enough sleep.

  • Try not to push yourself too hard.

  • Eat meals regularly.

  • Keep your sense of humor. This reduces tension.

For more information, call or write:

American Council for Headache Education (ACHE)
19 Mantua
Mt. Royal, NJ 08061
800-255-ACHE (255-2243)
Web site: http://www.achenet.org
Educational materials, referrals to support groups

National Headache Foundation
428 West St. James Place, 2nd Floor
Chicago, IL 60657
Web site: http://www.headaches.org
Educational materials, list of headache specialists, information specialists