Tension Headaches

What are tension headaches?

Approximately three out of four adults in the U.S. suffer from tension headaches, making them the most common form of headache.

Tension headaches are as different as the people who suffer from them. While many people experience the characteristic tight-band feeling around their head, others may experience other types of pain or symptoms, including:

• Sharp and steady pain
• Pain that throbs and lingers
• Pain in the neck and shoulders

In general, pain from these headaches is most often dull and all over the head. These headaches are most common for middle-aged people, presumably because of the connection to stress (see below for causes). These headaches are said to be chronic if they occur in sufferers more than 15 times per month.

Along with primary symptoms, people with tension headaches often report secondary ailments. These may include irritability, disrupted concentration, and sensitivity to noise or light.

What are major tension headache causes?

While it was believed that tension headaches occurred from neck or scalp muscles becoming tense and contracting, researchers have found this to be true in only some cases of tension headaches. A new theory suggests that interference in nerve pathways to the brain is a more likely cause of these types of headaches. Tension headaches also usually occur in response to some sort of habitual trigger.

Unfortunately, these types of headaches can be frustrating because they often have untraceable triggers. For most people, though, staring at a screen for too long is a common trigger. The most common trigger may be working under chronic stress.

Other tension headache triggers include:

• Certain foods and beverages (e.g., processed meats)
• Traumatic events
• Fatigue
• Problems in the head and neck
• Alcohol
• Caffeine
• Nicotine

It’s important to note that alcohol, caffeine, and nicotine may all cause headaches both in overconsumption or withdrawal from usual levels of consumption.

How to track your headache triggers

Treating tension headaches starts with keeping a pain journal to track the frequency, onset, and duration of your headaches.

Download Arizona Pain’s headache journal to document what you are experiencing. This record can be extremely useful during your next visit with your doctor, and it takes the pressure off of you to remember and describe your exact symptoms.

Your headache journal can also track what treatments you attempted (medication, herbal remedies, or a dark room) and the effects of that treatment. Writing down behavior and feelings that accompany head pain in a headache journal is a helpful exercise.

How to treat tension headaches

While sufferers can usually fight through the day, persistent pain can be frustrating and exhausting. Over-the-counter pain medication such as ibuprofen and aspirin can temporarily relieve pain and sometimes outlast the headache altogether.

In some cases, patients may actually experience headaches from using too many of these quick-fix medications (these are called overuse headaches). For chronic headaches, your doctor may instead prescribe antidepressants and muscle relaxants as preventative medications for chronic headaches. It is not well-understood how antidepressants work on chronic pain, but they do help to relieve tension headaches.

Your doctor will also consider your environment when determining the nature of tension headaches. Paying attention to surrounding factors and noting them in your journal can help identity possible triggers of these types of headaches. Whether you have extreme daily stress from your job, your home, or caring for a loved one, your environment plays a big role in the development of tension headaches.

By identifying these triggers, your doctor can recommend subtle lifestyle changes. These could reduce the amount and severity of your tension headaches. Whether it’s perfecting posture or squeezing a stress ball, small changes can help.

Other popular, non-invasive, and non-pharmaceutical treatments of tension headaches are gaining traction as a way to manage stress and reduce the pain response. Mindfulness meditation in particular received a new round of support in a review of studies published in JAMA Internal Medicine in 2019. The review found that meditation was one of three therapies that were most successful in reducing pain (the other two were cognitive behavioral therapy and clinical hypnosis). For patients used to taking medications with crippling side effects, this is welcome news.

Acupuncture, massage therapy, and biofeedback have also become viable treatment options for chronic headaches.