Tension Headaches

Tension headaches, also known as stress headaches, are the most common of headaches. A tension headache is usually mild to moderate pain accompanied by a feeling of pressure around the head. Since they are quite common, tension headaches tend to be highly treatable, with a wide range of care options available to suit each person’s needs.

Wellness & Prevention

The vast majority of headaches (about 90 percent) are tension headaches. A tension headache is painful, but does not typically cause nausea, vomiting or light sensitivity and is not hereditary. Although uncomfortable, tension headaches don’t usually interfere with a person’s ability to function.

Symptoms of a tension headache may include:

  • Dull, aching pain in the head
  • Headache pain that’s accompanied by tightness or pressure across the forehead, in the back or the neck or through the upper shoulders
  • Feeling like muscles are tender in the scalp, neck or shoulders

There are two types of tension headaches:

  • Episodic tension headaches can last anywhere from a half hour to a week. If the headaches happen on more than 15 days per month over the course of three months, then they may be considered chronic tension headaches instead of episodic.
  • Chronic tension headaches can last for hours and may be continuous. Tension headaches that happen on 15 days or more a month for at least three months are considered chronic.

The cause of tension headaches is unknown, but a number of factors may trigger them. These include fatigue, stress, alcohol use, caffeine use and eye strain. People of all ages can get tension headaches, but they most frequently occur in middle age. Women are more likely to have tension headaches than men.

For some people, tight muscles are believed to play a role in this type of headache. In cases where muscle tension is not an identifiable reason for tension headaches, the cause is unknown.

Muscle tension in the back of the neck or scalp can be caused by:

  • Poor posture
  • Inadequate rest
  • Emotional or mental stress
  • Anxiety or depression
  • Fatigue
  • Overexertion
  • Hunger

Identifying any triggers that may result in tension headaches is important, as avoiding triggers and reducing stress can both help to prevent headaches from developing. There are several steps people can take proactively:

  • Stress management: Identifying stressors is the first step to managing stress. If someone does not have the option of removing the source of stress, than learning healthy coping skills is critical. A healthy diet, regular exercise, good sleep habits and supportive emotional relationships can all help to reduce stress.
  • Massage or physical therapy: Chronic muscle tension can result in chronic tension headaches. Both massage and physical therapy can help soothe tight muscles and reduce headaches.
  • Biofeedback: This technique teaches people how to control their body function. Small electrical sensors are attached to the skin that measure muscle tightness and other vital signs. Information from biofeedback can help people make subtle changes to reduce muscle tension.


A clear description of your pain can help your doctor diagnose your headache. Individuals should be able to describe the characteristics of their headache, including:

  • Location: Which parts of the head are affected?
  • Intensity: How severe is pain? Are you able to function during a headache?
  • Sensation: Is pain pulsing and stabbing or constant and dull?

People may undergo a number of tests for accurate diagnosis, including diagnostic imaging tests. Neurological exams may also be run. Once these tests have ruled out any other issues that could be causing recurrent headaches, your doctor can make an accurate tension headache diagnosis.


Many people with chronic tension headaches treat themselves with over-the-counter medication. This can be effective in the immediate short-term, but overuse of pain relievers can have unintended side effects, including making headaches worse in some cases. Professional treatment for tension headaches is focused on pain relief and prevention.

If noticeable muscle tension is present, other remedies may be helpful, such as using an ice pack or getting a massage. Taking a warm bath or shower can also help. Sometimes a nap or light exercise, such as a walk, can also soothe the pain.


Because there is no cure for tension headaches, ongoing management of symptoms is needed. These include managing stress levels, avoiding triggers and alleviating muscle tension if necessary. It’s also important to continue working regularly with healthcare providers so that any treatments in use can be evaluated. Often, a combination of treatments is needed for effective care of tension headaches.