Tension Headache

• A tension headache is a harmless type of headache which can cause a tight feeling on both sides of the head
• Tension headaches are caused by tense muscles of the head
• Tension headache therapies focus on relieving your symptoms

A tension headache is a type of headache which occurs frequently. It is not a sign of an underlying condition, but it can cause symptoms that affect your daily activities and mood. Tension headaches usually go away on their own, but additional measures can be taken to get rid of a tension headache earlier on. In this guide by Ada’s medical team, you’ll find more information about tension headaches, the possible symptoms you may experience, and the treatment options. 

A tension headache, also known as a tension-type headache, is a common type of headache which can cause pain or a tight feeling on both sides of your head. You can feel this discomfort on the head, the scalp, or at the back of the neck. This condition is harmless and is assumed to be caused by stress and subsequent  tightness of the muscles present on the head. 1

Tension headache symptoms are limited to pain that can be felt on your head, your face or your neck. As opposed to migraine headaches, a tension headache can most commonly be felt on both sides of the head. The pain can be dull or can feel like a tight feeling or as if something is pressing on your head. The painful area can feel tender to the touch. 1

Tension headaches usually don’t get worse from physical activity as opposed to some other types of headaches. In some cases, you may be more sensitive to strong lights and sounds. 2
The pain of tension headaches is usually mild to moderate. If you are experiencing severe pain, you should contact your healthcare provider.

The exact causes of a tension headache are not well understood yet. A possible explanation is sustained contraction of the muscles of the head which causes them to become tense. This can happen due to:

• stress,
• an injury to the head,
• or anxiety. 3

Other tension headache causes can include: 1

• Interrupted or too little sleep
• Consuming too much caffeine 
• Not eating on time 
• Taking too many painkillers 

How long tension headaches last can vary. In some cases, the headache can be relieved after as little as 30 minutes, although some cases can last for several days. 1

In order to diagnose you with a tension headache, your healthcare provider will ask you about the symptoms that you are experiencing. You will also be asked questions about your medical history in order to rule out any other possible causes of your symptoms. There are no laboratory tests or imagery which is needed to make the diagnosis. 2

In some cases, your healthcare provider may ask you to keep a headache diary. This can be useful for your healthcare provider to understand your symptoms, their frequency, and their intensity. Headache diaries can also help discover the triggers that cause your headache. 2

Tension headache treatment is aimed at relieving the symptoms of your headache. You can relieve your tension headache by: 1

• Taking painkillers such as paracetamol, aspirin or ibuprofen in limited amounts, as overuse of this medication can also cause headaches 4
• Doing activities that help you relax
• Tackling sleep issues if present 
• Dealing with stress in a healthy way

If your neck is feeling very tense, your healthcare provider may also recommend physical therapy. 

Tension headache self-care can help prevent tension headaches. If you often have issues with recurring tension headaches, then it can help to make some lifestyle changes to help you relax and sleep better.

These measures include: 5

• A headache diary: Keeping a diary of when and where headaches takes place, as well as how severe the headaches are, can be useful in identifying headache triggers. Using this information, it may become easier to avoid these triggers.
• Stress relief and lifestyle changes: In many cases, stress is a contributing factor to tension headaches. Relaxation techniques such as meditation, yoga or other methods like acupuncture may be effective in preventing headaches. Furthermore, a regular exercise regime and a healthy, balanced diet can help prevent tension headaches by reducing the overall-stress level.
• Medication: In some cases, particularly when headaches are frequent and severe, preventive medication may be advised by a doctor. Amitriptyline, an antidepressant, is the most commonly prescribed medication for this purpose.

The lifestyle changes needed will vary from person to person, and it may take a period of trial and error before results can be seen.

• Tension-type headache

Tension headaches are a common, but harmless condition which causes a dull, tight feeling on both sides of your head. Several lifestyle changes can help prevent and relieve tension headache symptoms. Some examples are doing activities that help you relax and get enough sleep. 

Q: Where is a tension headache felt? 
A: A tension headache can hurt on both sides of your face, head, and neck. 

Q: Can a tension headache last for days? 
A: A tension headache can last anywhere between minutes and several days. You can relieve your symptoms with pain medication and lifestyle alterations to reduce your stress levels and improve your sleep. 

Q: How to get rid of a tension headache? 
A: You can treat a tension headache by taking over-the-counter pain medication. The use of this medication should be limited, however, as overuse can cause headaches as well. You can also do exercises to reduce your stress levels and tackle sleep issues if they are present. 

Q: Can anxiety cause tension headaches?  
A: Several factors such as stress, anxiety, and depression can be a cause for tension headaches, as they may increase the tension in the muscles on the head.