What Are Tension Headaches? Causes, Symptoms, and Treatments

Tension headaches, also known as tension-type headaches, are very common. Around every 2 in 3 American adults have the occasional tension headache, with a small number of people experiencing much more frequent symptoms. Though tension headaches are uncomfortable, they’re not usually signs of more serious health problems. Headaches are a fact of life, and just about everyone gets one from time to time. But, if you’re getting tension headaches regularly, they can easily affect your daily life and ability to function.

Symptoms

The main symptom of a tension headache is a dull ache in the head (and sometimes, the face or neck). People with tension headaches usually feel like a band of pressure is wrapped around their heads. Some people feel tightness or aching in areas like the scalp, neck, and shoulders muscles during a tension headache.

The pain from a tension headache is dull, not throbbing, and you do not have nausea, eye pain, or sinus pain, which can indicate different types of headaches. Tension headache symptoms usually cause only mild to moderate pain and discomfort. However, they can make it difficult to enjoy normal activities or focus on daily tasks. Many people opt out of social activities or struggle to stay productive at work due to tension headaches.

Most headaches are nothing serious. However, if you get a sudden headache that is very painful, and you experience slurred speech, a stiff neck, or a fever along with your headache, seek medical attention right away. You should also get help immediately if you have a headache after getting a concussion.

Episodic vs. Chronic Tension Headaches

There are two main types of tension headaches: episodic and chronic. Both types of tension headaches have the same symptoms but differ based on how many you have and how often.

Episodic tension headaches may last 30 minutes, but they typically do not last longer than 1 week. Your headaches are episodic if you don’t have them more than 15 days a month in a 3-month period.

Chronic tension headaches can last for months and occur 15 or more days each month for at least 3 months. When tension headaches are chronic, they are extremely disruptive to normal life. It’s also worth noting that episodic tension headaches can become chronic, especially if the episodes start occurring more frequently.

Causes

The exact cause of tension headaches isn’t known. They don’t seem to be hereditary and can occur at any age. However, they are more common in adults and older teens, particularly females. Most experts believe that stress is a major trigger. People with tight muscles in the areas of the neck and shoulders also often get tension headaches.

Because stress is a potential trigger, risk factors for tension headaches include being under chronic stress from any source, such as a high-pressure job or caring for an ill family member. Other factors that can make tension headaches more likely include:

Eye strain from prolonged use or screen time
Insomnia and other sleep problems
Pain in the head and neck from other sources or poor posture
Excessive caffeine or alcohol consumption (or withdrawal)
Smoking
Minor illnesses, such as a cold or sinus infection
Jaw clenching/teeth grinding
Fatigue

How to Prevent Tension Headaches

You might not be able to prevent every tension headache, but there are ways to help reduce how often you get them. The best preventative steps are lifestyle changes to minimize your stress and promote overall health.

Consider these self-care steps to help prevent tension headaches:

Get enough sleep
Exercise regularly
Watch your diet and don’t skip meals
Drink lots of water
Limit caffeine to under 400 mg per day (about 4 cups of coffee)
Reduce alcohol intake
Meditate regularly
Use breathing exercises to manage stress
Take breaks and make time to relax
Quit smoking

Many people who are under a lot of stress don’t feel like they have the time or energy to focus on important health-boosting activities like getting enough sleep and eating healthy food. This can make the problem even worse. Taking care of yourself and making time to relax can make a huge difference in how often you get tension headaches.

How To Know if You Have Tension Headaches

There are several different types of headaches. How can you know if you’re experiencing a tension headache or a different kind of head pain?

Usually, the symptoms of a tension headache are uncomfortable but not unbearable. You might be able to work or go to school, but your head pain may make it difficult to focus. Your symptoms are likely limited to a dull aching and soreness in the head, face, neck, or shoulders.

If your tension headache symptoms are affecting your daily life, then it’s a good idea to talk with your doctor. There are no diagnostic tests for the condition, so your doctor will typically make a tension headache diagnosis based on your medical history and a conversation with you. They will ask you questions about your symptoms and lifestyle to learn more about your possible triggers.

Depending on what they learn about your headaches, your doctor might recommend an MRI (magnetic resonance imaging) scan to rule out other issues that might be causing your symptoms. This is to ensure that there is nothing more serious going on before they provide headache management recommendations.

Treatment Options

The occasional headache is pretty easy to deal with. Most people take over-the-counter pain medications to manage mild head pain. If you have headaches more often than not, then your tension headaches are probably causing problems and frustration in your daily life.

If you notice that your headaches are increasing, you might want to start keeping a headache diary. This will help you track your symptoms, and you’ll be able to see if any patterns could point to specific triggers, like eating certain foods or experiencing specific types of stress.

Typically, treatments for frequent tension headaches include preventative lifestyle changes in addition to medications and other treatments. If you think your headaches are being caused by stress in your life, then lifestyle modifications can help you control both your stress and your headaches.

In addition to preventative steps, other medical and lifestyle changes can help ease tension headaches. Treatment options may include:

Over-the-counter pain medications, including ibuprofen, aspirin, acetaminophen, and naproxen sodium
Muscle relaxers
Antidepressants
Acupuncture or massage
Relaxation training
Counseling
Meditation
Home remedies, such as aromatherapy or hot/cold therapy
Biofeedback—a type of therapy that involves relaxation exercises to reduce headache triggers

Make sure to communicate with your doctor about any over-the-counter pain medications you are taking, especially if you are taking them frequently to treat tension headaches. Not only will they become less effective over time, but some pain medications can cause liver or kidney damage or other issues when used too often.

Next Steps

Tension headaches aren’t dangerous but can be extremely disruptive to your daily life and overall well-being. If you’re experiencing tension headache symptoms regularly, then it might be time to talk with your doctor about management and treatment options. They can offer you potential solutions and recommend some lifestyle changes to help you live a more comfortable life with fewer headaches.

Resource Links:

“Tension-type Headaches” via Cleveland Clinic
“Tension Headache” via Mount Sinai
“Tension-type Headaches: Self-care Measure for Relief” via the Mayo Clinic