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Health Services

TENSION HEADACHE

EphNotes

WHAT IS IT?

A tension headache is head pain that results from muscle tightening (contraction) in the neck and head. The muscle contraction leads to a slight decrease in blood flow to the surrounding areas and an irritation of pain fibers in the skin, muscles, and blood vessel walls.

WHAT CAUSES IT?

The causes are unknown. Anxiety, depression, and emotional conflicts are often associated with tension headaches. Headaches may also result from muscle strain associated with injury to the neck muscles. An abnormality in the bones at the back of the neck (cervical vertebrae) or in the area where the mouth opens and closes (temporomandibular joint) may also put tension on the surrounding muscles and lead to a tension headache. On occasion, a child who has been incorrectly fitted with glasses may suffer from a tension headache due to eye muscle strain.

WHAT ARE ITS COMMON SYMPTOMS?

More than 90 percent of tension headaches are on both sides of the head. The headache is often described as a pressure or band-like sensation around the head. The dull, steady pain builds gradually and is often intense at the end of the day. In some individuals, the headache continues day and night. Even after sleep, the headache may still be present.

IS IT CONTAGIOUS?

No.

HOW LONG WILL IT LAST?

Tension headaches may last a few hours, several days, weeks, or even months.

HOW IS IT TREATED?

Treatment for this problem consists of two important parts: (1) what you can do, and (2) what your health care provider can do.

  1. Some people get relief by applying heat to the area of the head or neck where the pain is most severe. Apply heat in the form of a dry towel warmed in the oven, or use a heating pad on a low setting for brief time periods. Other people gain relief by applying an ice bag wrapped in a towel to the painful area.
  2. A gentle fingertip massage over the area just in front of and above the ears (temporal area) may reduce the pain.
  3. Lying down and relaxing may also help to decrease the pain. Many people find concentrating on a soothing thought or image while taking slow, deep breaths helps them relax.
  4. Record on a calendar the date of the headache, the time it started and ended, the amount of medication you took. Remember to brink this record with you on follow-up visits to your health care provider. It will help in your treatment.

WHAT CAN YOUR HEALTH CARE PROVIDER DO?

If the cause of the tension headache is a cervical vertebrae or temporomandibular joint problem, medical correction of the condition will be necessary. Incorrectly fitted eyeglasses must be refitted if they are the cause of tension headaches. A neck injury that is contributing to a tension headache can be helped with supportive collar, which allows the muscles in the neck to rest and relax.

Medications are needed for some individuals. Your health care provider may prescribe one or more of the following medications.

  • Analgesics — These medicines reduce the pain of a tension headache.
  • Muscle relaxants — These medications aid in relaxation by causing sedation and decreasing anxiety. They have little or no direct effect on relaxing the muscles of the head and neck that contribute to the headache. Some of these medications can become addictive.

CAN YOU PREVENT IT?

Because tension headaches recur in some individuals for years and because continual use of medication can lead to serious side effects, prevention is a key aspect in the management of tension headaches.

Tension headaches are often a response to stress, anxiety, and emotional conflict in a person’s life. It is important to find ways to reduce these conflicts. Regular exercise (e.g., walking, biking, swimming) and relaxation techniques (e.g., yoga, meditation) may help you. Exercise and relaxation not only reduce stress but also decrease the severity of head pain. A trained counselor can help provide assistance to identify the stresses in your life and make suggestions to resolve the problems.

COMMON MYTHS

It is a myth that tension headaches are inherited. However, people tend to imitate the stress reduction and responses of those around them. They may develop a tension headache as a result of ineffective stress management.

FOLLOW-UP

It is important to return for your follow-up care as advised.

RESOURCES

Call your local community center, YMCA, YWCA, or adult education program for information about classes in yoga, meditation, aerobic dance, or other exercise classes. A community mental health center can assist in an evaluation for stress and make a referral to a counselor for you.

REMEMBER

Notify your health care provider if you have any of the following:

  • Changes in vision
  • Difficulty speaking
  • Numbness or tingling in your arms or legs
  • Marked change in severity of your headache
  • Sudden onset of a fever with a headache
  • Difficulty walking
  • Questions concerning the symptoms you are experiencing

Information provided by University of Illinois Health Resource Center

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