A tension headache is pain or discomfort in your head, scalp, or neck, usually associated with muscle tightness in these areas. Tension headaches are one of the most common forms of headaches. They may occur at any age, but they are most common in adults and adolescents.
Tension headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, a head injury, or anxiety.
When You Have a Tension Headache
Hot or cold showers or baths may relieve a headache for some people. You may also want to rest in a quiet room with a cool cloth on your head.
Over-the-counter painkillers such as aspirin, ibuprofen, or acetaminophen may relieve pain if relaxation techniques do not work. If you are planning to take part in an activity that you know will trigger a headache, taking one of these painkillers beforehand may be helpful.
Follow your health care provider’s directions about how you are taking medicines. Rebound headaches -- headaches that keep coming back -- may occur from overuse of painkillers. Patients who take pain medication more than 3 days a week on a regular basis can develop rebound headaches. Aspirin and ibuprofen can irritate your stomach. Your daily dose of acetaminophen should not be over 4,000 mg.
Preventing Tension Headaches
Understanding your headache triggers can help you avoid situations that cause your headaches. A headache diary can help. When you get a headache, write down the day and time the pain began. The diary should include notes about what you ate and drank over the past 24 hours, how much you slept, and when and what was going on in your life right before the pain started. Also write down information about how long the headache lasted, and what made it stop.
You may need to make lifestyle changes if you have chronic tension headaches. This may include changing your sleep habits (usually to get more sleep) and getting more exercise. In some situations, you may need to change your job or sports activities.
Other tips to prevent tension headaches:
Use a different pillow or change sleeping positions.
Practice good posture when reading, working, or doing other activities.
Exercise and stretch your back, neck, and shoulders often when typing, working on computers, or doing other close work.
Have your eyes checked. If you have glasses, use them.
Learn and practice stress management. Some people find relaxation exercises or meditation helpful.
If your health care provider asks you to take medicines every day to prevent headaches or help with stress, take them the way they were prescribed. Make sure you report any side effects.
When to Call the Doctor
Call 911 if:
You are experiencing "the worst headache of your life."
You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a headache before.
The headache starts very suddenly.
Also, call your doctor if:
Your headache patterns or pain change.
Treatments that once worked are no longer helpful.
You have side effects from medication.
You are pregnant or could become pregnant -- some medications should not be taken during pregnancy.
Your headaches are more severe when lying down.
Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol. 2008:7(1):70-83.
Halker RB, Hastriter EV, Dodick DW. Chronic daily headache: an evidence-based and systematic approach to a challenging problem. Neurology. 2011 Feb 15;76(7 Suppl 2):S37-43.
Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.