A tension headache is the most common type of headache. It can cause mild, moderate, or intense pain in your head, neck, and behind your eyes. Some people say that a tension headache feels like a tight band around their forehead.
Most people who experience tension headaches have episodic headaches. These occur one or two times per month on average. However, tension headaches can also be chronic. According to the Cleveland Clinic, chronic headaches affect about 3 per cent of the U.S. population and include headache episodes that last for more than 15 days per month. Women are twice as likely as men to have tension headaches.
Causes of tension headaches
Tension headaches are caused by muscle contractions in the head and neck regions. A variety of foods, activities, and stressors can cause these types of contractions. Some people develop tension headaches after staring at a computer screen for a long time, or after driving for long periods. Cold temperatures may also trigger a tension headache.
Other triggers for tension headaches include:
Alcohol
Eyestrain
Dry eyes
Fatigue
Smoking
A cold or flu
A sinus infection
Caffeine
Poor posture
Emotional stress
Symptoms of a tension headache
Symptoms of a tension headache include:
Dull head pain
Pressure around the forehead
Tenderness around the forehead and scalp
The pain is usually mild or moderate, but it can also be intense. In this case, you might confuse your tension headache with a migraine. This is a type of headache that causes throbbing pain on one or both sides of your head.
However, tension headaches don’t have all the symptoms of migraines, such as nausea and vomiting. In rare cases, a tension headache can lead to sensitivity to light and loud noise, similar to migraines.
Considerations
In severe cases, your doctor may run tests to rule out other problems, such as a brain tumour. Tests used to check for other conditions may include a CT scan, which uses X-rays to take pictures of your internal organs. Your doctor may also use an MRI, which allows them to examine your soft tissues.
How to treat a tension headache?
Medications and home care
You can take over-the-counter (OTC) pain medications, such as ibuprofen or aspirin, to get rid of a tension headache. However, these should only be used occasionally.
According to the Mayo Clinic, using OTC medications too much may lead to “overuse” or “rebound” headaches. These types of headaches occur when you become so accustomed to a medication that you experience pain when the drugs wear off.
OTC drugs are sometimes not enough to treat recurring tension headaches. In such cases, your doctor may give you a prescription for medication, such as:
Indomethacin
Ketorolac
Naproxen
Opiates
Prescription-strength acetaminophen
If painkillers aren’t working, your doctor may prescribe a muscle relaxant. This is a medication that helps stop muscle contractions. Your doctor may also prescribe an antidepressant, such as a selective serotonin reuptake inhibitor (SSRI). SSRIs can stabilize your brain’s levels of serotonin and can help you cope with stress.
Your doctor may also recommend other treatments, such as:
Stress management classes. These can teach you ways to cope with stress and how to relieve tension.
Biofeedback. This is a relaxation technique that teaches you to manage pain and stress.
Cognitive-behavioural therapy (CBT). CBT is talk therapy that helps you recognize situations that cause you stress, anxiety, and tension.
Acupuncture. This is an alternative therapy that may reduce stress and tension by applying fine needles to specific areas of your body.
Supplements
Some supplements may also help relieve tension headaches. However, since alternative remedies can interact with conventional medications, you should always discuss these with a doctor first.
According to the National Center for Complementary and Integrative Health, the following supplements may help prevent tension headaches:
Butterbur
Coenzyme Q10
Feverfew
Magnesium
Riboflavin (vitamin B-2)
The following may also ease a tension headache:
Apply a heating pad or ice pack to your head for 5 to 10 minutes several times a day.
Take a hot bath or shower to relax tense muscles.
Improve your posture.
Take frequent computer breaks to prevent eye strain.
However, these techniques may not keep all tension headaches from returning.
Preventing future tension headaches
Since tension headaches are often caused by specific triggers, identifying the factors that cause your headaches is one way to prevent future episodes.
A headache diary can help you determine the cause of your tension headaches. Record your daily meals, beverages, activities, and any situations that trigger stress. For each day that you have a tension headache, make a note of it. After several weeks or months, you may be able to make a connection. For example, if your journal shows that headaches occurred on days when you ate a particular food, this food may be your trigger.
Outlook for people with tension headaches
Tension headaches often respond to treatment and rarely cause any permanent neurological damage. Still, chronic tension headaches can affect your quality of life. These headaches can also make it difficult for you to participate in physical activities. You may also miss days of work or school. If it becomes a serious problem, talk to your doctor.
It’s important not to ignore severe symptoms. Seek medical attention immediately if you have a headache that starts suddenly or a headache accompanied by:
Slurred speech
Loss of balance
High fever
This can indicate a much more serious problem, such as a stroke, tumour, or an aneurysm.
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