Tension-Type Headaches

What is a tension headache?

Tension-type headaches are the most common kind of head pain. They usually feel like a band around your head or tightness in your neck and shoulders. These headaches are often linked to stress, poor posture or tired muscles. But with the right care, you can manage or even prevent them.

Here's what you should know about tension headaches and how Banner Brain & Spine can help you find relief.

Is your headache caused by muscle tension or stress?

If you have a tension-type headache, it may feel like dull, tightening pressure around your head, caused by tense muscles in your neck, scalp or shoulders.

Your muscles may get tight because of:

• Stress or anxiety: Muscle tension from emotional stress 
• Poor posture: Sitting too long in the same position
• Screen time: Looking at screens without taking breaks
• Clenching your jaw: Grinding your teeth or tensing the muscles in your jaw
• Lack of sleep: not getting the rest you need affects how your muscles work

There are two main types of tension headaches:

• Episodic tension-type headaches: You have headaches less than 15 days a month for at least three months.
• Chronic tension-type headaches: You have headaches for 15 or more days a month for at least three months. These headaches may last for hours or even days.

These headaches are different from migraines. They're usually milder and not linked with nausea or changes in your vision. Migraines may get worse when you’re physically active, but tension headaches usually don’t.

What does a tension headache feel like?

Tension-type headaches often come on slowly and affect both sides of the head. The pain is typically mild to moderate and not throbbing.

You may feel:

• Dull, steady ache: Pain on both sides of your head
• Tightness or pressure: Like a band around your forehead
• Soreness: In your neck, shoulders or scalp
• Scalp tenderness: Sensitive areas when you touch your head
• Fatigue: Feeling tired or having trouble focusing
• Irritability: Mood changes from the discomfort

The pain may last 30 minutes or longer. If you have chronic tension headaches, you may feel as if you’re always dealing with headache pain and pressure.

Why do tension-type headaches happen?

Experts in headache care have found that tension-type headaches are linked to how your brain and muscles react to emotional or physical stress and fatigue.

Common triggers include:

• Stress: Work deadlines, personal pressures or major life changes
• Muscle tension: Tight muscles from stress, posture problems or long hours at a desk with poor ergonomics or screen positioning
• Lack of sleep: Poor sleep or not sleeping enough
• Anxiety or depression: Mental health conditions may affect muscle tension

Other possible triggers include:

• Dehydration: Not drinking enough water throughout the day
• Skipping meals: Low blood sugar from not eating regularly
• Eye strain: Looking at screens without breaks
• Weather changes: Cold weather or changes in barometric pressure
• Medication overuse: Taking over-the-counter pain medications more than 10 days per month can cause more headaches

How can you treat tension headaches and find relief?

There are several ways you can treat tension-type headaches:

• Apply heat or cold to your head, such as a heating pad, hot towel, ice pack or frozen vegetables wrapped in cloth.
• Over-the-counter (OTC) medications like ibuprofen (Advil), acetaminophen (Tylenol), aspirin or naproxen sodium (Aleve) may also help you find relief. Combining aspirin or acetaminophen with caffeine may be more effective. Talk with your health care provider before using these medications for an extended period as taking them too often can cause medication overuse headaches. 

You may also want to try:

• Stress management: Techniques can help you reduce daily stress 
• Talk therapy: Cognitive behavioral therapy (CBT) with a licensed behavioral health provider may help you manage the stress that’s causing your headaches
• Muscle relaxation techniques: Massage or stretching may loosen tight, tense muscles
• Breathing exercises: Deep breathing may reduce tension
• Yoga or meditation: These mind-body approaches can help over time
• Biofeedback training: You can learn to control your muscle tension, heart rate and blood pressure
• Acupuncture: This alternative treatment option may give you temporary relief from chronic headache pain
• Good lifestyle habits: Eating regular meals, drinking plenty of water and getting the sleep you need may make headaches less frequent

When should you seek help for a tension headache?

Tension headaches are common, but that doesn't mean you have to live with them. You should see a health care provider if your headaches:

• Happen more than a few times per week
• Affect your work, school or activities
• Don't go away with home care and over-the-counter treatments
• Need pain relievers more than twice a week

You should get immediate medical attention if:

• Pain is sudden, severe or changes quickly
• You have neurological symptoms like vision changes, trouble speaking or weakness
• Headaches include fever, stiff neck, mental confusion, seizures, double vision or numbness
• Headache occurs after a head injury, especially if it gets worse

What should you expect during your medical evaluation?

If you get headaches often or they're affecting your daily life, it's time to talk with a health care provider. During your visit, they may:

• Ask about your headache patterns and how often you have headaches
• Ask you where the pain is located and how intense it is
• Help you spot what might be triggering your headaches
• Ask you to track your symptoms and lifestyle factors in a headache diary 
• Review your medical history and current medications

Questions your provider may ask:

• Is the pain sharp, dull, throbbing or constant?
• How much are you able to do during the headache?
• Do your headaches wake you or prevent you from sleeping?
• Do you feel pain all over your head or just in certain areas?

Most tension headaches don't require imaging like CT scans or MRIs. But your provider might order these tests if you have unusual symptoms or if there are warning signs that could point to a more serious condition.

Your health care provider will work with you to find the best treatment approach. Preventive medications for chronic headaches may include antidepressants, anti-seizure medicines or muscle relaxants. It can take several weeks for these medicines to build up in your system and start to work.

If you have chronic tension-type headaches, you may also need to see a headache specialist for more targeted treatment options. It’s important to get the care you need, since chronic pain can also cause anxiety and depression and affect your relationships and quality of life.

Can you prevent tension headaches from returning?

Yes. You can make small changes in your daily routine to help prevent tension headaches:

• Get enough sleep: Aim for seven to nine hours each night
• Stay hydrated: Drink plenty of water throughout the day
• Check your posture: When you’re sitting, keep your shoulders back and head level and make sure your thighs are parallel to the ground. 
• Take regular breaks: Step away from screens or desk work to move and stretch your neck and shoulders
• Manage stress: Use guided tools, relaxation techniques or therapy
• Stay physically active: Regular exercise helps prevent tension headaches
• Limit triggers: It may help to reduce alcohol and caffeine and stop smoking

Expert care for headache pain at Banner Brain & Spine

You don't have to live with headache pain. At Banner Brain & Spine, our team provides:

• Board-certified neurologists trained in headache disorders and evidence-based care
• Access to therapy such as behavioral support for stress management and muscle relaxation
• Imaging tools like CT scans and MRI when needed to make sure you get the right diagnosis
• Support services to help you cope with chronic pain through counseling and support groups

If you’re tired of trying to push through the pain, we can help you find answers. Reach out to the Banner Brain & Spine team and take the first step toward a comprehensive evaluation so you can get the relief you need.