Tension headaches are the most common type of headache. Associated with muscle tightness, they cause pain or discomfort in the head, scalp, and neck. Almost everyone will experience a tension headache at some point in their life. Tension headaches are primary headaches, meaning another condition does not cause them.
Tension headaches differ from migraines as these headaches do not cause visual disturbances, nausea, or vomiting. While extreme sensitivity to light and sound are common migraine symptoms, they are not common with tension headaches. Tension headaches are typically not as debilitating as migraines are, as many people experiencing a tension headache can continue their daily activities without interruptions.
Most tension headaches don’t require medical treatment and will dissipate on their own. If your headache is accompanied by a very stiff neck, fever, vomiting, confusion, nausea, weakness, numbness, or slurred speech, seek emergency medical treatment.
You can treat many tension headaches by making simple lifestyle changes to prevent future headaches. Reducing your caffeine, alcohol, and usage of other drugs can help prevent future tension headaches. Getting at least eight hours of sleep per night and reducing your time using electronic devices is also recommended.
Other treatment options include:
Over-the-counter pain medication: aspirin, ibuprofen, naproxen sodium, or acetaminophen
Prescription medications such as muscle relaxers, antidepressants, tricyclic antidepressants, and anticonvulsants
Many of these prescribed medications are preventative medications that may take several weeks to take effect.
Yoga, functional mobility training, or other stretches for your neck and shoulders
Biofeedback and stress-management training
Trigger point injections
Heat therapy on your neck and shoulders
Dull, pressure-like pain in your head: Many describe this feeling like a tight band wrapping around your head squeezing it.
Pain in scalp, temples, back of the neck, and shoulders
Tension headaches can last for a few minutes to a few days and may be worsened with stress, fatigue, noise, bright lights, or glare.
Try to keep a headache diary that lists how often your tension headaches occur, the severity and duration of your headaches, and any triggers you’ve noticed. If you notice any changes in your symptoms, such as sharp increases in the severity and frequency of headaches or new symptoms, contact a medical professional.
Your doctor will ask about your medical history, your family’s medical history, diet, and lifestyle, and if any head trauma recently occurred. Tension headaches tend to run in families, so knowing your family’s history of headaches can help your doctor better diagnose your head pain.
There is no diagnostic test to diagnose tension headaches, but your doctor may order the following diagnostic tests to rule out other causes of head pain:
Episodic tension headaches: can last from thirty minutes to a week and occur less than fifteen days per month for at least three months
Chronic tension headaches: may last hours or be continuous and occur more than fifteen days per month for at least three months
Alcohol or other drug usage
Caffeine – too much or not enough
Eye strain, especially from too much screen time
Fatigue or overexertion
Infections such as cold, flu, sinus infection, or COVID-19
Tension or contraction in the muscles of your neck, scalp, and shoulders
Tension headaches are most common in adults and teenagers but can affect anyone. Women are more likely than men to live with tension headaches.