Tension Headaches

What is a tension headache?

Tension headaches are the most common type of headache. Stress and muscle tension are often factors in tension type headaches. Tension headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia).

What are the symptoms of a tension headache?

While symptoms may differ, the following are common symptoms of a tension type headache:

  • Slow onset of the headache

  • Head usually hurts on both sides

  • Pain is dull or feels like a band or vice around the head

  • Pain may involve the back (posterior) part of the head or neck

  • Pain is usually mild to moderate, but not severe

The symptoms of tension headaches may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

Tension headaches: What are the facts? 

The following information is from the American Council for Headache Education regarding tension headaches:

  • Tension headaches are the most common type of headache, affecting 30 to 78 percent of the general population.

  • Tension headaches typically cause a steady ache, rather than a throbbing one, and tend to affect both sides of the head.

  • Some people get tension headaches in response to stressful events or hectic days.

  • Tension headaches may be chronic, occurring frequently or every day.

How are tension headaches diagnosed?

Tension headaches are diagnosed primarily based upon reported symptoms, but a thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.

Tracking and sharing information about your headache with your doctor helps with the process of making an accurate diagnosis.

Questions commonly asked during the exam may include, but are not limited to, the following:

  • When do headaches occur?

  • What is the location of the headache?

  • What do the headaches feel like?

  • How long do the headaches last?

  • Have there been changes in behavior or personality?

  • Do changes in position or sitting up cause the headache?

  • Do you have trouble sleeping?

  • Do you have a history of stress?

  • Is there a history of head injury?

If the history is consistent with tension-type headaches and the neurological exam is normal, no further diagnostic testing may be necessary. However, if the headache is not found to be the primary problem, then other tests may be needed to determine the cause.

Tests which may be used to determine the cause of a tension headache may include:

  • Blood tests. Various blood chemistry and other laboratory tests may be run to check for underlying conditions.

  • Sinus X-rays. A diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.

What is the treatment for tension headaches?

Specific treatment for headaches will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Type of headaches

  • Severity and frequency of the headaches

  • Your tolerance for specific medications, procedures, or therapies

  • Your opinion or preference

The ultimate goal of treatment is to stop headaches from occurring. Adequate headache management depends on reducing stress and tension. Some suggestions for tension headache management from the American Headache Society include:

  • Going to sleep and waking at the same time each day

  • Exercising regularly each day for at least 30 minutes

  • Eating meals without skipping any, especially breakfast

  • Avoiding headache triggers, such as certain foods and lack of sleep

  • Resting in a quiet, dark environment as needed

  • Stress management (yoga or other relaxation exercises)

  • Medications, as recommended by your doctor