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Tension Headache

(Muscle Contraction Headache; Tension-Type Headache)

Definition

Tension headache is a spreading, steady head pain that can be mild or severe.
Tension Headache: Areas of Pain
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Causes

Tension headaches develop when muscles in the neck, face, and scalp contract.
The cause is not known. Genes are thought to play a role.

Risk Factors

This problem often starts in people who are 25 years of age and older. It is also more common in women.
Other things that may raise the risk are:
  • Stress
  • Mental tension
  • Being emotionally upset

Symptoms

Some tension headaches happen often. Others happen only once in a while. They do not often get in the way of daily activities.
Tension headaches are:
  • Felt on both sides of the head
  • Have a pressing or tightening feeling

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. A neurological exam may also be done. This is often enough to make the diagnosis.

Treatment

The goal is to manage symptoms and lower the risk of future headaches. Choices are:

Medications

The doctor may advise:
  • Over-the-counter pain medicine, such as ibuprofen
  • Prescription pain relievers
Taking a caffeine supplement with a pain reliever may also help.
Antidepressants may also be given to lower the risk of future headaches.

Other Management

Other ways to manage headaches are:
  • Physical therapy, such as massage, exercise, treatments to improve posture, and hot and cold packs
  • Stress management and relaxation methods
  • Biofeedback to learn how to control muscle tension

Prevention

A person who gets tension headaches may be given antidepressants to lower the risk of getting them in the future.

RESOURCES

American Headache Society
http://www.americanheadachesociety.org
National Headache Foundation
http://www.headaches.org

CANADIAN RESOURCES

Canadian Headache Society
https://headachesociety.ca
Help for Headaches
http://www.headache-help.org

References

Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.
Headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Updated December 31, 2019. Accessed April 9, 2020.
Tension-type headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tension-type-headache . Updated February 8, 2017. Accessed April 9, 2020.
Tension-type headache. National Headache Foundation website. Available at: https://headaches.org/2007/10/25/tension-type-headache. Accessed April 9, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 02/2020
  • Update Date: 04/09/2020
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