Tension headache is the most common type of headache, which presents as a constant ache on both sides of the head. Some individuals also note other symptoms, such as tightening of the neck muscles and increased pressure behind the eyes.
Almost everyone experiences a tension headache from time to time and they can affect individuals of any age. They are very common and it is estimated that up to half of all adults suffer from a tension headache at least once per month.
Although the cause of tension headaches is unknown, there are various triggers that are associated with their onset. These include:
- Stress and anxiety
- Straining of the eyes
- Poor posture
- Alcohol consumption
- Excessive smoking or withdrawal
- Excessive caffeine or withdrawal
- Skipping meals
- Sedentary activities
- Exposure to bright light
- Certain noises or smells
Tension headaches are considered to be primary headaches, as they are not caused by an underlying condition and occur in their own right.
Tension headache usually causes a bilateral mild to moderate aching pain in the head. It is often described as a feeling of a tight band around the head and may also lead to tightening of the neck muscles and higher pressure behind the eyes.
These symptoms of tension headache usually resolve within a few hours, but may last for several days in some cases. Although tension headaches may cause considerable inconvenience to the individual, they do not typically prevent people from carrying out daily activities.
Most people get a tension headache from time to time and simple treatment for the condition can usually be sought without a diagnosis from a general practitioner. However, individuals who suffer from frequent tension headaches that have a significant impact on their daily activities may require medical intervention to prevent or reduce the frequency of the headaches.
Diagnosis usually includes a consultation to discuss medical and family history, in addition to diet and lifestyle factors that may play a role in causing headache.
Diagnosis also helps to differentiate tension headache from other types of headache with an underlying cause that may require a specific treatment approach. Headaches with a sudden onset that are unlike previous headaches should be investigated further, particularly those following physical trauma to the head or those accompanied by symptoms such as weakness, numbness slurred speech or confusion.
Tension headaches can usually be managed with simple lifestyle changes or analgesic medications.
Lifestyle changes often include methods to relieve stress, such as yoga, massage or exercise. Avoidance of lifestyle triggers is also important to prevent the recurrence of tension headaches. Some individuals also find that alternative treatment methods can help to relieve pain, including massage or acupuncture.
Keeping a headache diary is often useful for individuals that get headaches often, as it helps to identify patterns and triggers that lead to the presentation of symptoms.
Analgesic medications such as paracetamol, ibuprofen or aspirin are often used to relieve pain caused be tension headache. However, it is important that these medications are not used in excess – more than three days a week – as persistent use can lead to the development of medication-overuse headache. Occasionally antidepressant medications such as amitriptyline may be recommended to prevent tension headaches.