Tension Headaches Causes, Prevention And Treatment


A tension-type headache (TTH) feels like a tight band wrapping around the head and ranges in intensity from mild to moderate. The most frequent sort of headache is a tension headache, however, it is unclear what causes them.

There are remedies for headaches of this nature. To effectively manage tension-type headaches, one must strike a balance between healthy routines, non-drug treatments, and appropriate pharmaceutical use.


It is unknown what causes tension-type headaches. Previously, experts believed that tension-type headaches were caused by facial, neck, and scalp muscle contractions, possibly as a result of heightened emotions, tension, or stress. According to research, the cause is not muscle contraction.

According to the most widely accepted view, those who get tension-type headaches have heightened pain sensitivity. A sensitised pain system may cause increased muscular discomfort which is a symptom of tension-type headaches.

Stress is the most common factor in tension headaches.

How to check if you have Tension Headaches?

Schedule a visit with a doctor.

Consult a doctor if tension-type headaches interfere with your life or if you require headache medication more than twice per week.

Consult your doctor if your headache pattern changes or if they suddenly start to feel different, even if you have a history of headaches. Sometimes, severe medical conditions like a brain tumour or the rupture of an aneurysm might be detected by headaches.

When to seek emergency assistance

Seek emergency care if you experience any of the following symptoms or signs:

  • Sudden, intense headache
  • Headache and fever
  • Stiff neck
  • Mental disorientation
  • Convulsions
  • Double vision, weakness, numbness, or trouble speaking
  • Headache following a head injury, especially if it intensifies

Risk Factors

If you have any of the following, you could be more susceptible to tension headaches:

  • Eye fatigue, such as that brought on by prolonged computer use.
  • Other head and neck pain brought on by conditions including temporomandibular disorders.
  • Sleep issues, such as sleeplessness.
  • Stress is brought on by obligations to one's family, employment, or other aspects of one's life, such as starting or ending a job or managing too many responsibilities.


Tension-type headache warning signs and symptoms include:

  • Dull, throbbing headache
  • Tenderness in the muscles of the scalp, neck, and shoulder 
  • Tightness or pressure across the forehead, on the sides, or at the back of the head

There are two primary classifications of tension-type headaches: episodic and chronic.

Periodic headaches of the tension kind

Periodic headaches of this nature might last anywhere from 30 minutes to a week. Less than 15 days a month for at least three months, there are frequent episodic tension-type headaches. Chronic headaches of the tension variety may develop after repeated episodes.

Persistent tension headaches

Hours can pass with this kind of tension-type headache, which can also be chronic. Chronic headaches are those that last for at least three months and happen at least 15 days a month.

Anxiety-related headaches can be hard to tell migraines apart. Additionally, migraines can develop if you frequently experience episodic headaches of the tension variety.

Contrary to some migraine subtypes, tension headaches typically do not come with visual disturbances, nausea, or vomiting. Although exercise frequently makes migraine pain worse, tension-type headache pain is unaffected. A tension-type headache may be accompanied by an increase in sensitivity to light or sound, but this symptom is uncommon.


Techniques like biofeedback training and relaxation treatment can assist lower stress in addition to routine exercise.

Training in biofeedback. This method teaches you how to manage specific bodily reactions that lessen discomfort. You are linked to equipment during a biofeedback session that tracks and provides input on bodily processes including muscular tension, heart rate, and blood pressure. Then, you learn how to control your own breathing and heart rate while releasing muscle tension.

The cognitive behavioural approach. Talk therapy like this one might teach you how to control your stress levels and lessen the frequency and intensity of your headaches.

Other methods of relaxing. Deep breathing, yoga, meditation, and progressive muscle relaxation are among the relaxation techniques that may reduce headaches. You can learn to unwind.

Employing books, movies, or apps at home or in classrooms.

If you get tension-type headaches, taking medication along with stress-reduction strategies may be more beneficial than either treatment by itself.

A healthy lifestyle may also aid in preventing headaches:

  • Sleep well, but not too much.
  • Avoid smoking.
  • Regularly moving around.
  • Frequently consume balanced meals.
  • Take in a lot of water.
  • Limit your use of alcohol, coffee, and sugary foods.


Some persons who get tension-type headaches choose not to contact a doctor and instead try to manage the pain on their own. Unfortunately, frequent use of over-the-counter painkillers can actually lead to a different kind of headache called a medication overuse headache.

Acute remedies

There are several drugs, both prescription and over-the-counter, that may be used to lessen the discomfort of a headache, including:

Drugs that reduce pain. The initial line of treatment for headache pain reduction is the use of simple painkillers that are accessible over the counter. Aspirin, ibuprofen (Advil, Motrin IB, and other brands), and naproxen sodium (Aleve) are a few of them.

Medicines in combination. Caffeine or a sedative medicine is frequently included with aspirin, acetaminophen (Tylenol, other brands), or both in a single prescription. Single-ingredient pain medications may not be as effective as combinations.

Relievers. Numerous combination medications are available over-the-counter.

Drugs and triptans. When a person experiences both episodic tension-type headaches and migraines, a triptan can effectively relieve the pain. Narcotics, often known as opioids, are rarely utilised due to their negative effects and risk for addiction.

Preventative drugs

If you experience frequent or persistent headaches that are not helped by painkillers and other treatments, your doctor may recommend drugs to lessen the frequency and intensity of episodes.

Preventive drugs may consist of:

Tricyclic mood stabilisers. Amitriptyline and protriptyline are two of the most used tricyclic antidepressants for treating tension headaches. These drugs may have constipation, drowsiness, and dry mouth as side effects.

Additional antidepressants. The usage of the antidepressant venlafaxine (Effexor) is also supported by evidence.

Drugs that relax muscles and anticonvulsants. Anticonvulsants like gabapentin and topiramate (Topamax, Qsymia, other brands) are other drugs that may prevent tension-type headaches. It requires more research.

It might take a few weeks or longer for preventative drugs to develop in your system and start working. So do not give up if you have not noticed any changes right away after starting a medication.

The effectiveness of preventative medicine will be checked by your doctor as they monitor your therapy. In the interim, excessive usage of painkillers for your headaches may negate the beneficial benefits of preventative medications. When taking preventative medication, discuss with your doctor how frequently you should take painkillers.

You could only require rest, cold packs, or a lengthy hot shower to ease a tension-type headache. You can lessen the intensity and frequency of chronic tension-type headaches without needing medication by using a number of different tactics. Consider a few of the following:

Control your level of tension. By organising your day and preparing ahead, you may assist to lessen your stress. Allowing additional time to unwind is another option. If you find yourself in a difficult circumstance, think about taking a step back.

Choose between hot and cold. A tension-type headache may be relieved by applying heat or ice, depending on your preference, too painful muscles. Use a low-heat heating pad, a hot water bottle, a warm compress, or a heated cloth for warmth. Taking a hot shower or bath may also be useful. To protect your skin from the cold, wrap ice, an ice pack, or frozen veggies in a towel.

Maintain good posture. Maintaining proper posture helps prevent your muscles from tensing. Hold your shoulders back and your head level when you are standing. Draw in your buttocks and abdomen. Make sure your thighs are parallel to the floor and that your head is not sagging forward when you are sitting.

Complications of Tension Headaches

Due to tension headaches being so frequent, they have a significant impact on quality of life and work performance, especially if they are chronic. The persistent discomfort could prevent you from participating in activities. You might not be able to go to work, or if you can, your performance might be compromised.

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Page last reviewed: May 15, 2023

Next review due: May 15, 2025

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